title: Chronic oral inflammation and the progression of periodontal pathology in the third molar region.
abstract: OBJECTIVE
  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.
  
  
  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 >or=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 >or=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 >or=2 mm in the third molar region. Of these, 95% had a baseline PD of >or=4 mm. Both high (>or=10(5)) "orange" and "red" complex bacteria and PD of >or=4 mm detected at enrollment were significantly associated with a change in PD >or=2 mm. Odds of a change in PD >or=2 mm were increased if baseline pathogen levels were >or=10(5) or a PD of >or=4 mm was detected at enrollment.
  
  
  CONCLUSIONS
  Our findings are consistent with chronic oral inflammation leading to a progression of periodontal disease in the third molar region.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 37599-7450, USA. ray_white@dentistry.unc.edu
authors.forename: Raymond P
authors.initials: RP
authors.lastname: White
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: George H
authors.initials: GH
authors.lastname: Blakey
authors.forename: Richard H
authors.initials: RH
authors.lastname: Haug
authors.forename: M Thomas
authors.initials: MT
authors.lastname: Jacks
authors.forename: Paige E
authors.initials: PE
authors.lastname: Nance
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003773:Dental Plaque / Q000382:microbiology; D018450:Disease Progression; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry / Q000382:microbiology; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D007375:Interleukin-1 / Q000032:analysis; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000473:pathology*; D016017:Odds Ratio; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology* / Q000473:pathology; D010518:Periodontitis / Q000473:pathology*; D011336:Probability
chemical_list: D018836:Inflammation Mediators; D007375:Interleukin-1