{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:15:39Z","timestamp":1788279339401,"version":"build-2803163510"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the association between obstructive sleep apnea (OSA) and periodontitis using an umbrella meta\u2010analysis (MA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, MEDLINE, Web of Science, Scopus, Embase, and Google Scholar databases were systematically searched before December 2025. MAs reporting odds ratios (OR) for the association between OSA and periodontitis were included. Methodological quality was assessed using AMSTAR\u20102, and certainty of evidence was evaluated using GRADE. Random\u2010effects MA was performed. Egger's test and trim\u2010and\u2010fill analysis were used to assess the publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven MAs encompassing over 225,000 participants were included. A significant association was found between OSA and periodontitis (OR 1.96, 95% CI 1.68\u20132.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200969.5%). After using trim\u2010and\u2010fill method to adjust for publication bias, the association strengthened (OR 2.24, 95% CI 1.92\u20132.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). A dose\u2013response pattern emerged, with severe OSA showing higher odds (OR 2.25) compared to mild\u2013moderate OSA (OR 1.82), though not statistically different (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.44). The association remained consistent among different study qualities and sample sizes. The GRADE assessment rated the certainty of evidence of the main outcome as low due to heterogeneity and publication bias. Further, a high overlap ratio of 26.8% was observed among the included MAs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this review suggest a significant association between OSA and periodontitis, with a greater association of severe OSA with periodontitis. Future studies should examine the impact of periodontal therapy on OSA severity and vice versa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration<\/jats:title>\n                    <jats:p>CRD420251241137<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70300","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:48:10Z","timestamp":1777225690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Obstructive Sleep Apnea and Periodontitis: A Systematic Umbrella Review"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-9514","authenticated-orcid":false,"given":"Mohammed Khalid","family":"Mahmood","sequence":"first","affiliation":[{"name":"Faculty of Medical and Paramedical Sciences, French National Center of Scientific Research (CNRS), French Blood Establishment (EFS), Bio\u2010Cultural Anthropology, Law, Ethics and Health Laboratory (ADES) Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahen Hiwa","family":"Omer","sequence":"additional","affiliation":[{"name":"Department of Dentistry Komar University of Science and Technology Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1413-4934","authenticated-orcid":false,"given":"Sarhang Sarwat","family":"Gul","sequence":"additional","affiliation":[{"name":"Medical Laboratory Department, College of Health and Medical Technology Sulaimani Polytechnic University Sulaimani Iraq"},{"name":"Department of Periodontics, College of Dentistry University of Sulaimani Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yad Mariwan Mohammed","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Dentistry Tishk International University Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve","family":"Tassery","sequence":"additional","affiliation":[{"name":"Dental School of Medicine, Conservative and Endodontic Department Aix\u2010Marseille University Marseille France"},{"name":"Marseille Hospital APHM IHU\u2010MEPHI Institute Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Tardivo","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Paramedical Sciences, French National Center of Scientific Research (CNRS), French Blood Establishment (EFS), Bio\u2010Cultural Anthropology, Law, Ethics and Health Laboratory (ADES) Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Lan","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Paramedical Sciences, French National Center of Scientific Research (CNRS), French Blood Establishment (EFS), Bio\u2010Cultural Anthropology, Law, Ethics and Health Laboratory (ADES) Aix\u2010Marseille University Marseille France"},{"name":"Oral Surgery Department, Timone University Hospital, Marseille Provence\u2010Alpes\u2010C\u00f4te d'Azur  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