Third Molar Periodontal Pathology and a Systemic Inflammatory Response

Objectives:

Assess serum risk markers C-Reactive Protein(CRP) and Interleukin-6(IL-6) as measures of systemic inflammation from 3rd molar periodontal pathology.

Methods:

Data were from healthy adults with four asymptomatic 3rd molars (IRB-approved trial). Subjects with body mass index>29, on systemic antibiotics, or using tobacco were excluded. Full mouth periodontal probing(PD) data were collected at longest follow-up as clinical measures of periodontal pathology. PD>=4mm was considered clinically evident periodontal pathology. The 3rd molar region included the six 3rd molar probing sites and two distal probing sites of the 2nd molars(maximum of 16 sites/jaw). The non-3rd molar region included all remaining probing sites(maximum of 80 sites/jaw). Serum samples collected at the same data collecting visit were analyzed for CRP(hs-CRP BN analyzer-Dade Behring) and IL-6(ELISA-R&D Systems).

Outcome variables were serum hs-CRP and IL-6 levels from subjects with at least one PD>=4mm and control subjects with all PD<4mm in the 3rd molar region. Because of sample size, analyses are limited to descriptive statistics.

Results:

Median age for 10 subjects with at least one 3rd molar region PD>=4mm was 36.5 years (IQ 33.0-46.0y).For these subjects median number of 3rd molar region PD>=4mm was 3 (IQ 1-4) and median number of non-3rd molar PD>=4mm was 3 (IQ 0-11). Median serum hs-CRP was 1.80 mg/L (IQ 1.23-5.39) and median serum IL-6 was 1.13 pg/mL(IQ 0.67-1.49).

Median age for 25 control subjects was 35 years (IQ 28-40y). For these subjects the median number of 3rd molar region and non-3rd molar PD>4mm was 0 (IQ 0-0). Median serum hs-CRP was 1.01 mg/L (IQ 0.73-3.07) and median serum IL-6 was 0.67 pg/mL(IQ 0.51-0.93).

Conclusion:

Subjects with early periodontal pathology appear to have a systemic response to the chronic oral inflammation.

Funding Sources: GCRC RR00046, Oral and Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, Dental Foundation of North Carolina