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Inflammatory mediators and periodontitis in patients with asymptomatic third molars
Raymond P White1, Steven Offenbacher, Ceib Phillips
1Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA. ray_white@dentistry.unc.edu
Purpose:
Our goal was to report the detection and levels of gingival crevicular fluid (GCF) inflammatory mediators, sampled at the mesial of 4 first molars and distal of 4 second molars, in 316 patients with asymptomatic third molars.
Patients And Methods:
Levels of GCF inflammatory mediators, interleukin (IL)-1 beta and prostaglandin (PG)E(2), were determined and log transformed for each patient. Z scores were calculated using the mean and standard deviation of the log values for the entire sample of 316 patients. The log mediator levels and Z scores of patients who had probing depths (PDs) less than 5 mm (n = 238) were compared with patients with at least 1 PD equal to or greater than 5 mm (n = 78) on the distal of second molars or around third molars. A periodontal Composite GCF Inflammation Score was calculated for each patient by summing the Z scores obtained for IL-1 beta and PGE(2) for that patient.
Results:
The levels of GCF IL-1 beta and PGE(2) were higher if a patient had a PD equal to or greater than 5 mm in the third molar region. The Composite GCF Inflammation Score indicated "elevated inflammation" if a PD equal to or greater than 5 mm was found in the third molar region as well.
Conclusions:
These data suggest that asymptomatic patients with PD equal to or greater than 5 mm in the third molar region with associated periodontal attachment loss have increased levels of biochemical mediators of inflammation compared with patients with PD less than 5 mm. These findings are consistent with the concept that early periodontitis in young adults that initiates in the third molar region is associated with increases in key inflammatory mediators.