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-1 beta, 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 aim 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 (>= 10(5)) "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 >= 10(5) 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. (C) 2006 American Association of Oral and Maxillofacial Surgeons.