Chronic Oral Inflammation and the Progression of Periodontal Pathology in the Third Molar Region
published online 21 April 2006.
Purpose
To assess the association between risk markers of chronic oral inflammation and changes over time in periodontal probing depth (PD) in the third molar region, the distal of a second molar, or around a third molar.
Subjects and Methods
The data from these analyses are part of a study of subjects enrolled with 4 asymptomatic third molars with adjacent second molars in an institutional review board-approved longitudinal trial. Full-mouth periodontal probing was conducted at enrollment and follow-up. Enrollment levels of periodontal pathogens and gingival crevicular fluid inflammatory mediators were assayed as indicators of the degree of oral inflammation. Subjects were categorized as those who had at least a 2 mm change in periodontal PD between baseline and follow-up in the third molar region and those who did not. The relationship between aggregated subject baseline PD, levels of periodontal pathogens, and gingival crevicular fluid IL-1β, and the proportion of subjects with changes in PD ≥2 mm versus those with PD <2 mm were compared with Cochran-Mantel-Haenzsel statistics. Level of significance was set at 0.05. Risk assessment models for a change in PD ≥2 mm were developed using logistic regression analysis.
Results
Twenty-four percent of 254 subjects exhibited a change in PD from baseline to follow-up of ≥2 mm in the third molar region. Of these, 95% had a baseline PD of ≥4 mm. Both high (≥105) “orange” and “red” complex bacteria and PD of ≥4 mm detected at enrollment were significantly associated with a change in PD ≥2 mm. Odds of a change in PD ≥2 mm were increased if baseline pathogen levels were ≥105 or a PD of ≥4 mm was detected at enrollment.
Conclusion
Our findings are consistent with chronic oral inflammation leading to a progression of periodontal disease in the third molar region.
⁎Dalton L. McMichael Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
†OraPharma Distinguished Professor, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC
‡Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
§Professor, Department of Oral and Maxillofacial Surgery, Assistant Dean, College of Dentistry, University of Kentucky, Lexington, KY
¶Former Senior Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
∥Clinical Research Fellow, Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
#Professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
Address correspondence and reprint requests to Dr White: Department of Oral and Maxillofacial Surgery, CB 7450, School of Dentistry, University of North Carolina, Chapel Hill, NC 37599-7450
Supported in part by the Oral and Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, and Dental Foundation of North Carolina.
ABSTRACT