Chronic Oral Inflammation and the Progression of Periodontal Pathology in the Third Molar Region

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.