Morbidity & Mortality Conference on Anesthesia

Abstract

volving the health of this many individuals attracts scrutiny. Data supporting treatment recommendations must be current. Following a critical review of the literature directed to 3rd molar treatment, the AAOMS Board implemented a series of clinical trials designed to update knowledge on recovery after 3rd molar surgery and the potential clinical problems with retaining 3rd molars. A key component was enrolling asymptomatic patients willing to retain 3rd molars over time in a longitudinal trial. Blakey et al reported on baseline periodontal data from patients enrolled in the trial at the University of Kentucky and the University of North Carolina. Surprisingly, 25% had at least one periodontal probing depth 5 mm (PD) in the 3rd molar region, 33% if patients were at least 25 years old. White et al confirmed that these same patients had elevated levels of periodontal pathogens and elevated GCF inflammatory mediators, IL-1 , in the 3rd molar region. Overall not considering 3rd molars, patients were periodontally healthy. Third molars were usually not studied in periodontal studies. In analyses of available 3rd molar data from large data bases, NHANES III for younger subjects and ARIC for those 50 to 75 years old, the visible presence of 3rd molars increased the odds of finding increased periodontal PD more anterior in the studied quadrant. The recent focus on oral inflammation and a systemic inflammatory response has led clinical investigators to document an acute phase inflammatory response from the liver, increased serum CRP levels, in patients with periodontal disease. Our data suggest that 3rd molar periodontal pathology plays an important role in oral inflammation and in the systemic inflammatory response.