{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:26:32Z","timestamp":1790803592449,"version":"4.1.0"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Obstructive sleep apnea (OSA) and periodontitis have demonstrated epidemiological and clinical associations. This study aimed to characterize salivary microbiome alterations in patients with OSA, periodontitis, and their comorbidity (OSA+PD), and to explore potential microbial markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This cross-sectional study included 125 adults divided into four groups: healthy controls (H, n=26), patients with OSA (OSA\/O, n=42), patients with periodontitis (PD\/P, n=15), and patients with OSA and periodontitis (OSA+PD\/OP, n=42). Participants underwent nocturnal polysomnography and comprehensive periodontal examinations. Saliva samples were collected and analyzed using 16S ribosomal DNA gene sequencing to evaluate microbial distribution and community structure across groups. Receiver operating characteristic (ROC) curves were generated for key taxa combining with clinical indicators, and the area under the curve (AUC) values were calculated to assess diagnostic relevance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Oral microbial diversity was significantly altered in OSA, PD, and OSA+PD groups. Alpha diversity was reduced in all patient groups compared to healthy controls, with the periodontitis group showing the highest diversity and evenness. Beta diversity revealed that periodontitis having the strongest impact and the comorbid group exhibiting intermediate characteristics between OSA and periodontitis. Key taxa, including <jats:italic>Tannerella<\/jats:italic>, <jats:italic>Treponema<\/jats:italic>, <jats:italic>Prevotella<\/jats:italic>, <jats:italic>Slackia<\/jats:italic>, and <jats:italic>Streptococcus constellatus<\/jats:italic>, exhibited significant intergroup differences. BugBase phenotype analysis revealed an increased abundance of aerobic and a reduced presence of anaerobic microbial profiles in the OSA and OSA+PD groups. Additionally, <jats:italic>Rothia<\/jats:italic> and <jats:italic>Micrococcaceae<\/jats:italic> were more abundant in the OSA group, regardless of periodontal status. Receiver operating characteristic (ROC) analysis indicated that <jats:italic>Rothia<\/jats:italic> and <jats:italic>Parvimonas<\/jats:italic> reliably differentiated between OSA and OSA+PD (AUC=0.715, 0.702) and also between periodontitis and OSA+PD (<jats:italic>Rothia<\/jats:italic>: AUC=0.879).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>OSA is associated with distinct changes in salivary microbiota, including reduced microbial richness and altered functional profiles, which may contribute to early periodontal dysbiosis. <jats:italic>Rothia<\/jats:italic> has been identified as a potential microbial biomarker for OSA-related periodontitis, while <jats:italic>Rothia<\/jats:italic> and <jats:italic>Parvimonas<\/jats:italic> may play a key role in periodontitis-related OSA. However, as this is a cross-sectional study, causal relationships and the predictive value of microbial biomarkers remain to be confirmed in longitudinal studies. These results highlight the need for integrated management of OSA and periodontitis and suggest microbial profiling as a useful diagnostic tool.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1642766","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T06:02:14Z","timestamp":1757397734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Alterations of the salivary microbiome in obstructive sleep apnea and their association with periodontitis"],"prefix":"10.3389","volume":"15","author":[{"given":"Jiong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jike","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxia","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuli","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangru","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1038\/s41586-020-2288-7","article-title":"C9orf72 suppresses systemic and neural inflammation induced by gut bacteria","volume":"582","author":"Aaron","year":"2020","journal-title":"Nature"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2020.115009","article-title":"A case series of patients with Gemella endocarditis","volume":"97","author":"Abarna","year":"2020","journal-title":"Diagn. Microbiol. Infect. Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/s2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Adam","year":"2019","journal-title":"Lancet Respir. Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/jcpe.13767","article-title":"The association between respiratory diseases and periodontitis: A systematic review and meta-analysis","volume":"50","author":"Ana","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4081\/mm.2019.8014","article-title":"Atopobium vaginae: a literature review, on findings and potential clinical implications","author":"Andrea","year":"2019","journal-title":"Microbiol. Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2019.00216","article-title":"Identification of salivary microbiota and its association with host inflammatory mediators in periodontitis","volume":"9","author":"Anna","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1164\/rccm.201801-0119oc","article-title":"Severe obstructive sleep apnea is associated with alterations in the nasal microbiome and an increase in inflammation","volume":"199","author":"Benjamin","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/s41368-023-00266-9","article-title":"Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability","author":"Bob","year":"2024","journal-title":"Int. J. Oral. Sci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-021-02412-1","article-title":"Obstructive sleep apnea syndrome in non-obese patients","author":"Caterina","year":"2021","journal-title":"Sleep Breathing"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-019-0260-4","article-title":"Analysis of oral microbiota in patients with obstructive sleep apnea-associated hypertension","author":"Chih-Yuan","year":"2019","journal-title":"Hypertens. Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1042\/cs20180891","article-title":"Gut microbiota in obstructive sleep apnea\u2013hypopnea syndrome: disease-related dysbiosis and metabolic comorbidities","author":"Chih-Yuan","year":"2019","journal-title":"Clin. Sci"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12536","article-title":"Periodontitis and metabolic diseases (diabetes and obesity): Tackling multimorbidity","author":"Crystal","year":"2023","journal-title":"Periodontol. 2000"},{"key":"B13","doi-asserted-by":"publisher","first-page":"763","DOI":"10.2147\/nss.S307012","article-title":"Exhaled nitric oxide as a surrogate marker for obstructive sleep apnea severity grading: an in-hospital population study","volume":"13","author":"Dang-Thi-Mai","year":"2021","journal-title":"Nat. Sci. Sleep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13807","article-title":"Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe)","volume":"50","author":"David","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13769","article-title":"Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies","author":"Diogo","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-016-1811-6","article-title":"Streptococcus mitis and Gemella haemolysans were simultaneously found in atherosclerotic and oral plaques of elderly without periodontitis-a pilot study","volume":"21","author":"Eberhard","year":"2016","journal-title":"Clin. Oral. Invest"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1080\/03602530802186603","article-title":"Arylamine N-acetyltransferases: from structure to function","author":"Edith","year":"2008","journal-title":"Drug Metab. Rev"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-020-0548-6","article-title":"PICRUSt2 for prediction of metagenome functions","author":"Gavin","year":"2020","journal-title":"Nat. Biotechnol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/jre.13337","article-title":"Burden of severe periodontitis and edentulism in 2021, with projections up to 2050: The Global Burden of Disease 2021 study","author":"Gustavo","year":"2024","journal-title":"J. Periodontal Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2016.160365","article-title":"Does obstructive sleep apnea increase the risk for periodontal disease? A case-control study","author":"Hikmet","year":"2017","journal-title":"J. Periodontol."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12185935","article-title":"Putative bidirectionality of chronic obstructive pulmonary disease and periodontal disease: A review of the literature","author":"Hiroyuki","year":"2023","journal-title":"J. Clin. Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2016.05.004","article-title":"A new perspective on microbes formerly known as nitrite-oxidizing bacteria","author":"Holger","year":"2016","journal-title":"Trends Microbiol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2023.15.3.316","article-title":"Surface active salivary metabolites indicate oxidative stress and inflammation in obstructive sleep apnea","volume":"15","author":"Jiyoung","year":"2023","journal-title":"Allergy Asthma Immunol. Res."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2023.2225261","article-title":"Site-specialization of human oral Gemella species","author":"Juli\u00e1n","year":"2023","journal-title":"J. Oral. Microbiol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.am2022-5619","article-title":"Abstract 5619: Co-occurrence ofLactobacillusandCandida sp.in periodontal disease severity suggests cancer-related dysbiosis","author":"Kimil","year":"2022","journal-title":"Cancer Res"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1159\/000531866","article-title":"Inhaler steroid use changes oral and airway bacterial and fungal microbiome profile in asthma patients","author":"K\u0131v\u0131lc\u0131m","year":"2023","journal-title":"Int. Arch. Allergy Immunol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3390\/dj11080194","article-title":"Exploring the role of IL-17A in oral dysbiosis-associated periodontitis and its correlation with systemic inflammatory disease","author":"Koichiro","year":"2023","journal-title":"Dent. J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.165.7.2104126","article-title":"Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients","author":"Larissa","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fpls.2014.00597","article-title":"Diversity and regulation of ATP sulfurylase in photosynthetic organisms","author":"Laura","year":"2014","journal-title":"Front. Plant Sci"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00086608","article-title":"Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link","author":"Lena","year":"2009","journal-title":"Eur. Respir. J"},{"key":"B31","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/j.apjtm.2016.06.002","article-title":"Expression of RUNX2 and MDM21 in rats with periodontitis under chronic intermittent hypoxia","volume":"9","author":"Li","year":"2016","journal-title":"Asian Pacif. J. Trop. Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00784-024-05913-x","article-title":"Current clinical framework on nitric oxide role in periodontal disease and blood pressure","volume":"28","author":"Lima","year":"2024","journal-title":"Clin. Oral. Invest."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00124","article-title":"Saliva microbiome changes in patients with periodontitis with and without chronic obstructive pulmonary disease","author":"Lin","year":"2020","journal-title":"Front. Cell. Infect. Microbiol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12338","article-title":"Prevention and management of periodontal diseases and dental caries in the older adults","author":"Lubna","year":"2020","journal-title":"Periodontol. 2000"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1993.tb18343.x","article-title":"Methods for collecting saliva","author":"Mahvash","year":"1993","journal-title":"Ann. New York Acad. Sci"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12528","article-title":"Periodontitis and atherosclerotic cardiovascular disease: A critical appraisal","author":"Maria Clotilde","year":"2023","journal-title":"Periodontol. 2000"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2005.1725","article-title":"Defining operational taxonomic units using DNA barcode data","author":"Mark","year":"2005","journal-title":"Philos. Trans. R. Soc. B"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1002\/jper.18-0006","article-title":"Staging and grading of periodontitis: Framework and proposal of a new classification and case definition","author":"Maurizio S","year":"2018","journal-title":"J. Periodontol."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.934298","article-title":"Patients with obstructive sleep apnea can favor the predisposing factors of periodontitis by the presence of P. melaninogenica and C. albicans, increasing the severity of the periodontal disease","volume":"12","author":"Mayra A","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e14340","article-title":"Biomarkers for the severity of periodontal disease in patients with obstructive sleep apnea:IL-1 \u03b2, IL-6, IL-17A, and IL-33","volume":"9","author":"Mayra A","year":"2023","journal-title":"Heliyon"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders-third edition","author":"Michael","year":"2014","journal-title":"Chest"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12296","article-title":"The role of the microbiota in periodontal disease","author":"Michael","year":"2020","journal-title":"Periodontol. 2000"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00002-2022","article-title":"Gut microbiota mediate vascular dysfunction in a murine model of sleep apnoea: effect of probiotics","author":"Mohammad","year":"2022","journal-title":"Eur. Respir. J"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1902\/jop.2007.060519","article-title":"Hypoxia and reoxygenation augment bone-resorbing factor production from human periodontal ligament cells","volume":"78","author":"Motohira","year":"2007","journal-title":"J. Periodontol."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-023-04869-8","article-title":"Relationship of obstructive sleep apnea with periodontal condition and its local and systemic risk factors","author":"Natalia Arango","year":"2023","journal-title":"Clin. Oral. Invest."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-015-1544-y","article-title":"Is there an association between obstructive sleep apnea syndrome and periodontal inflammation","author":"Nejat","year":"2015","journal-title":"Clin. Oral. Invest."},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192013219","article-title":"Saliva analysis of pH and antioxidant capacity in adult obstructive sleep apnea patients","volume":"19","author":"Nicol\u00f2","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2017.01.005","article-title":"Isolation and identification methods of Rothia species in oral cavities","author":"Osamu","year":"2017","journal-title":"J. Microbiol. Methods"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1038\/s41580-020-0227-y","article-title":"Cellular adaptation to hypoxia through hypoxia inducible factors and beyond","author":"Pearl","year":"2020","journal-title":"Nat. Rev. Mol. Cell Biol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/6682020","article-title":"Analysis of the salivary microbiome in obstructive sleep apnea syndrome patients","volume":"2020","author":"Peizeng","year":"2021","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-021-04012-5","article-title":"Periodontitis severity in obstructive sleep apnea patients","volume":"26","author":"Petra","year":"2021","journal-title":"Clin. Oral. Invest"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18061128","article-title":"Inducible nitric oxide synthase polymorphisms and nitric oxide levels in individuals with chronic periodontitis","author":"Raquel Mantuaneli","year":"2017","journal-title":"Int. J. Mol. Sci"},{"key":"B53","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/prd.12342","article-title":"Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way","volume":"84","author":"Sczepanik","year":"2020","journal-title":"Periodontol. 200"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2023032","article-title":"Risk of chronic periodontitis in patients with obstructive sleep apnea in Korea: a nationwide retrospective cohort study","volume":"45","author":"Seon-Rye","year":"2023","journal-title":"Epidemiol. Health"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9640","article-title":"Association of obstructive sleep apnea severity with the composition of the upper airway microbiome","volume":"18","author":"Seung-No","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2023.11.001","article-title":"Effect of periodontal treatment on reducing chronic inflammation in systemically healthy patients with periodontal disease: a multicenter study","author":"Shinji","year":"2023","journal-title":"Am. J. Med"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2016.150587","article-title":"Periodontal status in morbidly obese patients with and without obstructive sleep apnea syndrome risk: A cross-sectional study","author":"S\u00edlvia Helena de Carvalho","year":"2016","journal-title":"J. Periodontol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.1600-051x.1998.tb02419.x","article-title":"Microbial complexes in subgingival plaque","volume":"25","author":"Socransky","year":"1998","journal-title":"J. Clin. Periodontol."},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.746","article-title":"Salivary trefoil factor family peptide 3 (TFF3) and flow rate in persons with and without obstructive sleep apnea: A preliminary study","volume":"9","author":"Supanigar","year":"2023","journal-title":"Clin. And Exp. Dental Res."},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.556746","article-title":"Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome","author":"Suzanne","year":"2005","journal-title":"Circulation"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12216747","article-title":"The link between periodontal disease and asthma: how do these two diseases affect each other","volume":"12","author":"Tamiya","year":"2023","journal-title":"J. Clin. Med."},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02421-2017","article-title":"Sex differences in the associations of obstructive sleep apnoea with epidemiological factors","author":"Tianyi","year":"2018","journal-title":"Eur. Respir. J"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1038\/srep35405","article-title":"Chronic sleep disruption alters gut microbiota, induces systemic and adipose tissue inflammation and insulin resistance in mice","author":"Valeriy","year":"2016","journal-title":"Sci. Rep"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.4317\/medoral.26561","article-title":"Periodontitis associated with risk of obstructive sleep apnea in Peruvian adult patients: A cross-sectional study","volume":"29","author":"W-L","year":"2024","journal-title":"Medicina Oral. Patol. Oral. y Cirugia Bucal"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0220-2020","article-title":"Metabolomics and microbiome profiling as biomarkers in obstructive sleep apnoea: a comprehensive review","author":"Xiaoman","year":"2021","journal-title":"Eur. Respir. Rev"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2023.2182571","article-title":"Changes in the oral and nasal microbiota in pediatric obstructive sleep apnea","author":"Xiaoman","year":"2023","journal-title":"J. Oral. Microbiol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.763334","article-title":"Polarized macrophages in periodontitis: characteristics, function, and molecular signaling","author":"Xiaoyu","year":"2021","journal-title":"Front. Immunol"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.2147\/nss.S347630","article-title":"Altered salivary microbiota in patients with obstructive sleep apnea comorbid hypertension","volume":"14","author":"Xuehui","year":"2022","journal-title":"Nat. Sci. Sleep"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.752475","article-title":"Analysis of salivary microbiome and its association with periodontitis in patients with obstructive sleep apnea","author":"Yanlong","year":"2021","journal-title":"Front. Cell. Infect. Microbiol"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2024.105138","article-title":"Candida species in periodontitis: A new villain or a new target","author":"Yao","year":"2024","journal-title":"J. Dent."},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2023.105052","article-title":"Causal relationship between Gut Microbiota and Obstructive sleep apnea","author":"Yi","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-022-02732-w","article-title":"Whole-genome metagenomic analysis of the oral microbiota in patients with obstructive sleep apnea","author":"Yu","year":"2022","journal-title":"Sleep Breathing"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.4014\/jmb.2503.03042","article-title":"Association between serum uric acid levels and salivary microbiota in patients with obstructive sleep apnea","volume":"35","author":"Yujia","year":"2025","journal-title":"J. Microbiol. Biotechnol."},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271738","article-title":"Incidence and risk of periodontitis in obstructive sleep apnea: A meta-analysis","author":"Zhiqiang","year":"2022","journal-title":"PloS One"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1642766\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T06:02:15Z","timestamp":1757397735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1642766\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":74,"alternative-id":["10.3389\/fcimb.2025.1642766"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1642766","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"article-number":"1642766"}}