Molar Periodontal Pathology Research Articles

Changes Over Time in the Prevalence of Caries Experience or Periodontal Pathology on Third Molars in Young Adults

To assess the prevalence of caries experience and periodontal pathology on third molar teeth compared with first and second molars and teeth more anterior from subjects who had data collected over time in a longitudinal clinical study. Healthy subjects with 4 asymptomatic third molars and data for at least 4 years after enrollment were included in these analyses. The presence or absence of caries experience on the occlusal surface of the third molars and any surface of the first or second molars was assessed using a visual-tactile caries examination. Full mouth periodontal probing, 6 sites per tooth, was conducted as a measure of clinical periodontal status. The primary outcome measures were at least 1 periodontal probing depth of at least 4 mm versus none, and caries experience versus no caries experience. The prevalence of caries experience and periodontal pathologic findings at follow-up and the relationship of the occurrence between the third molars and teeth more anterior in the mouth were examined using McNemar's statistics. The follow-up was a median of 6.9 years (interquartile range 4.6 to 7.7 years) for 179 subjects, with a mean age of 29 years. More subjects were female (54%) and white (80%). At follow-up, 85% of the subjects had caries experience detected on the first or second molars, and only 50% had a third molar affected. In contrast, at follow-up, the presence of at least 1 periodontal probing depth of at least 4 mm was marginally more prevalent on the third molars than on the first or second molars (56% and 50%, respectively). Fewer subjects had third molars free of caries experience and periodontal pathology at follow-up compared with at enrollment (28% versus 38%, respectively). The prevalence of both third molar caries experience and third molar periodontal pathology increased from baseline to the follow-up examination. At follow-up, the prevalence of caries experience was greater on the first or second molars than on the third molars, and periodontal pathology were greater on the third molars than on the more anterior teeth.

Prevalence of Third Molars With Caries Experience or Periodontal Pathology in Young Adults

We assessed the prevalence of caries experience and periodontal pathology on asymptomatic third molars in young adults. Healthy subjects with 4 asymptomatic third molars were enrolled in an institutional review board-approved study during a 5-year period. Full mouth periodontal probing, 6 sites per tooth, was the measure of clinical periodontal status. The presence or absence of occlusal caries experience (carious lesions or restorations, including sealants) on third molars and on any surface of the first and second molars were assessed using a visual-tactile examination and panoramic radiographs. The primary outcome measures were at least 1 periodontal probing depth of at least 4 mm versus none and caries experience versus no caries experience. The data were analyzed from 409 subjects, who averaged 25 years old. More subjects were female (53%) and white (76%). More subjects had at least 1 periodontal probing depth of 4 mm or deeper on a third molar (55%) than on the distal of a second molar (46%). These findings were more likely to be detected around a third molar in subjects with all third molars at the occlusal plane (72%) than in subjects with at least one third molar below (33%). Overall, fewer subjects were affected by third molar caries experience than first or second molars (24% vs 73%, respectively). Of the subset of subjects with all four third molars at the occlusal plane, 26% were affected by both third molar periodontal pathology and caries experience and 16% were caries and periodontal pathology free. In these cross-sectional analyses, periodontal pathology was detected more frequently on third molars than on first and second molars and caries experience was detected more frequently on first and second molars than on third molars.

Changes Over Time in the Periodontal Status of Young Adults With No Third Molar Periodontal Pathology at Enrollment

To assess changes in periodontal status over time in subjects with all third molar region periodontal probing depths (PDs) of less than 4 mm at enrollment. Subjects were a subsample of young adults enrolled with 4 asymptomatic third molars in an institutional review board-approved longitudinal study. Full-mouth periodontal PD data, 6 sites per tooth, were measures of periodontal status. Data were aggregated to subject and jaw levels. A PD of 4 mm or greater was considered an indicator variable for periodontal pathology. Subjects were classified according to PD at follow-up: all PDs of less than 4 mm or at least 1 PD of 4 mm or greater. The demographic differences and the third molar anatomic position at baseline were compared to assess whether enrollment factors were related to the changes in periodontal pathology. The level of significance was set at .05. One hundred six subjects had all third molar region PDs of less than 4 mm at enrollment and were aged 25 years on average. Of these, 38% had a change in third molar region periodontal status, with at least 1 third molar region PD of 4 mm or greater detected at a median follow-up of 4.1 years (interquartile range, 2.4-5.9 years). A PD of at least 4 mm was detected significantly more often in the mandibular third molar region than in the maxillary third molar region (P < .01). No significant differences in age, gender, education, or length of follow-up were detected between the 40 subjects with a change in periodontal status in the third molar region and the 66 subjects who remained periodontally healthy (P > .05). At follow-up, 50% of subjects with at least 1 PD of 4 mm or greater in the third molar region had at least 1 PD of 4 mm or greater in non-third molar regions as compared with 15% of subjects with all third molar region PDs of less than 4 mm (P < .01). Periodontal pathology developing over time in healthy young adults was significantly more likely in the mandibular third molar region and mandibular non-third molars.

Risk Markers for Second Molar Periodontal Pathology After Third Molar Removal

Risk Markers for Second Molar Periodontal Pathology After Third Molar Removal

Changes Over Time in the Periodontal Status of Young Adults With No Third Molar Periodontal Pathology at Enrollment

Statement of the Problem: Patients with periodontally healthy third molars want to know the likelihood of their teeth remaining free of periodontal pathology if the third molars are retained. The purpose of this study is to assess the changes in periodontal status over time in subjects with all third molar region periodontal probing depths (PD) <4mm at enrollment and the association of new periodontal pathology at the third molar site with new pathology in the non-third molar dentition.

Morbidity & Mortality Conference on Anesthesia

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.

Risk Markers for Periodontal Pathology Over Time in the Third Molar and Non–Third Molar Regions in Young Adults

This study was conducted to analyze the clinical impact of risk markers for third molar and non-third molar periodontal pathology over time. Data were obtained from healthy adults with 4 asymptomatic third molars in an institutional review board-approved trial. Full-mouth periodontal probing depth (PD) data were collected as clinical measures of possible periodontal pathology. The third molar region included the 6 third molar probing sites and the 2 second molar distal probing sites (maximum of 16 sites per jaw). The non-third molar region included all remaining probing sites (maximum of 80 sites per jaw). Periodontal PDs were considered indicator variables for clinically detected periodontal pathology or its absence at baseline and follow-up. Subjects were grouped based on all PD less than 4 mm (no disease), 1 to 3 PD >or=4 mm (incipient disease), or at least 4 PD >or=4 mm (early disease). Levels of periodontal pathogens and gingival crevicular fluid inflammatory mediators at baseline also were assayed as risk markers for periodontal pathology. Baseline risk markers and possible confounding variables were included in risk assessment models to derive odds ratios and 95% confidence intervals for periodontal pathology in the third molar and non-third molar regions at follow-up. A total of 195 subjects had a median follow-up of 5.9 years (interquartile range [IQR] = 4.6 to 6.9 years). Median age at enrollment was 26.2 years (IQR = 22 to 34 years); 52% were female, 84% were Caucasian, and 10% were African-American. A significant association was found between baseline and follow-up third molar region and non-third molar region periodontal pathology indicators (P < .01). Subjects who had incipient or early disease in the third molar region at baseline were significantly more likely to have an indication of periodontal pathology at follow-up in the third molar region and in the non-third molar region compared with those in whom no disease was detected at baseline. In young adults, the presence of periodontal pathology as indicated by periodontal PDs in the third molar region at baseline was predictive of detection of periodontal pathology in the third molar and non-third molar regions at follow-up.

Risk Markers for Changes in Periodontal Pathology in the Third Molar and Non-Third Molar Regions

Identify risk markers at baseline associated with changes in periodontal probing depth (PD) over time for the 3rd molar region and non-3rd molars in young adults. The data were from healthy subjects with four asymptomatic 3rd molars, enrolled in an IRB-approved longitudinal trial. Demographic and oral health data were collected at baseline. Gingival crevicular fluid (GCF) samples were taken from the mesial of all 1st molars and distal of all 2nd molars. GCF samples were independently analyzed by ELISA for levels of IL-1β and PGE2 as a measure of oral inflammation. A pooled patient mediator level was then calculated as the mean of the eight site values. Subgingival biofilm samples were taken from the distal of all 2nd molars prior to periodontal probing. The presence and levels of periodontal pathogens were determined using whole chromosomal DNA probes and checkerboard DNA-DNA hybridization. Baseline subject levels of periodontal pathogens were chosen to determine the level of periodontal pathogens in subjects’ biofilm. Gingival crevicular fluid (GCF) inflammatory mediators were chosen to assess subjects’ immune response to the pathogens. Full mouth PD, six sites per tooth, was conducted to determine periodontal status at baseline and at longest follow-up. The 3rd molar region was defined as the PD for 6 sites around the 3rd molars and the 2 sites on the distal of the 2nd molars. The non-3rd molar region was defined as the remainder of the PD sites in the mouth. A PD >4mm was considered indicative of periodontal pathology. The primary outcome measures for this study were the occurrence at longest follow-up of a PD in the 3rd molar region and in non-3rd molars in study subjects, dichotomized by PD<, >4mm. Predictor variables at baseline were subjects: 3rd molar region PD, levels of “orange cluster” and “red cluster” periodontal pathogens, and levels of GCF IL-1β and PGE2. Changes from enrollment to longest follow-up were compared by the McNemar’s Test. Level of significance was 0.05. Data from 195 subjects were available with a median follow-up of 5.9 years (IQ 4.6-6.9y). Median age at enrollment was 26.2 years (IQ 22-34y); 52% were female, 84% Caucasian and 10% African American. If at least one PD >4mm was detected in the 3rd molar region at baseline, 64% subjects had at least one PD >4mm in the 3rd molar region at follow-up and 18% at least four PD >4mm compared to baseline PD <4mm, 15% and 5%, respectively. Non-3rd molar region PD >4mm was also significantly more likely. The extent of 3rd molar periodontal pathology at baseline predicted the extent of 3rd molar and non-3rd molar periodontal pathology at longest follow-up. If at least four PD >4mm were detected in the 3rd molar region at follow-up, median number PD >4mm was 7 (IQ 5-12). If subjects had at least four PD >4mm in non-3rd molars at follow-up, median number PD >4mm was 11 (IQ 7-18.5). Baseline subject levels of GCF IL-1β were significant predictors of periodontal pathology at follow-up in the 3rd molar region and non-3rd molar region. If baseline levels of GCF IL-1β were above the median 432.0 ng/m/L (IQ 196.5-869.7), 73% of subjects had at least one PD >4mm in the 3rd molar region at follow-up vs. 54% below the median, and 58% of subjects had at least one PD >4mm in the non-3rd molar region at follow-up vs. 39%. Baseline levels of “orange” or “red” cluster pathogens significantly predicted follow-up 3rd molar region PD >4mm, but not non-3rd molar PD >4mm. The presence of risk markers for oral inflammation were associated with worsening 3rd molar and non-3rd molar periodontal pathology.

The Oral and Systemic Impact of Third Molar Periodontal Pathology

Analyze in pregnant subjects the relationship between third molar periodontal pathology, and subjects' overall periodontal status. Assess also, the associations between postpartum periodontal status by jaw and a systemic impact, preterm birth, or elevated serum C-reactive protein (CRP). Data were from an IRB-approved study, Oral Conditions and Pregnancy. In this clinical study, full-mouth periodontal examinations including third molars were conducted at greater than 24 weeks of pregnancy and again within 72 hours of delivery. For our analyses, mean periodontal probing depth (PD) by visible tooth and by jaw were calculated at enrollment and postpartum. Subjects were categorized by 3 broad levels of periodontal health, considered the primary outcome variable. The primary predictor variable for levels of periodontal health was the presence or absence of visible third molars. Mean periodontal probing depth in the mandible or maxilla at term was considered an indicator of a possible risk of systemic exposure, increasing the odds of preterm birth, less than 37 weeks gestation, or elevated serum CRP levels. Chi-square and t tests were used to determine statistical significance, .05. Significant predictor variables were included in multivariable models. Unconditional logistic multivariate models were used to derive odds ratios (OR) and 95% confidence intervals (CI). Data from examinations at enrollment and postpartum were available for 1,020 and 891 subjects, respectively. Visible third molars were detected in 405 subjects at enrollment and in 360 subjects at term. No subjects had third molars removed during the study. At enrollment and postpartum, subjects with visible third molars were significantly more likely to have moderate/severe periodontal disease, 23.5% versus 8.5%, and 18.3 versus 9.4%, respectively. Mean PD was significantly greater for maxillary and mandibular molars than for more anterior teeth, P < .01. In both jaws, mean PD tended to be progressively greater from first to third molars. No differences were found in mean PD by jaw. In subjects with visible third molars, adjusting for the severity of mandibular periodontal disease, the level of maxillary periodontal disease was significantly associated with preterm birth, P < .01, OR 2.6 (95% CI 1.1-6.8), or the upper quartile of serum CRP at term, at least 23.0 mg/L postpartum, P = .05, OR 2.5 (95% CI 1.2-5.1). Subjects' detected levels of periodontal disease were greater at enrollment and postpartum if visible third molars were detected.

Changes in Third Molar and Nonthird Molar Periodontal Pathology Over Time

The purpose of this study was to assess changes in periodontal probing depth (PD) over time for third molar and nonthird molar regions in young adults. The data were obtained from healthy subjects with 4 asymptomatic third molars, enrolled in an IRB-approved longitudinal trial. Demographic and oral health data were collected at baseline. Full-mouth PD, 6 sites per tooth, was conducted to determine periodontal status at baseline and at longest follow-up. The third molar region was defined as the PD for 6 sites around the third molars and the 2 sites on the distal of the second molars. The nonthird molar region was defined as the remainder of the PD sites in the mouth. The primary outcome measures for this study were the occurrence of a PD greater than or equal to 4 mm and the increase in PD of at least 2 mm in the third molar and nonthird molar regions. Changes from enrollment to longest follow-up were compared by the binomial or McNemar's test. Level of significance was .05. Data from 195 subjects were available, and the median follow-up was 5.9 years (interquartile range [IQ], 4.6 to 6.9 years). Median age at enrollment was 26.2 years (IQ, 22.0 to 34.0 years); 52% were female, 84% were Caucasian, and 10% were African American. The proportion of subjects with at least 1 involved site in nonthird molars increased significantly from baseline to follow-up, 36% to 49% (P < .01), reflecting mostly changes in mandibular nonthird molars, 33% to 48% (P < .01). Of the 122 subjects who presented at baseline with at least 1 PD greater than or equal to 4 mm in the third molar region, the proportion of subjects with at least 1 involved site in nonthird molars increased significantly from baseline to follow-up, 48% to 59% (P = .05), also reflecting mostly changes in mandibular nonthird molars, 44% to 59% (P = .05). In this unique longitudinal clinical study of early periodontal disease in young adults, periodontal pathology worsened over time for nonthird molars. This was more likely if PD greater than or equal to 4 mm was detected in the third molar region.

Third Molars and Progression of Periodontal Pathology During Pregnancy

This study was conducted to evaluate the association between third molar periodontal pathology at enrollment and periodontal disease progression during pregnancy. The data were derived from patients in an institutional review board-approved prospective study known as the Oral Conditions and Pregnancy (OCAP) study. Demographic, health behavior, and medical history data were obtained from medical records. Full-mouth periodontal examinations of 6 periodontal probing sites for each visible tooth, including third molars, were conducted at less than 26 weeks of pregnancy and within 72 hours postpartum. The primary outcome variable was periodontal progression (4 or more probing sites with at least a 2 mm increase in probing depth (PD), all at least 4 mm deep), between the enrollment and postpartum examinations. The primary predictor variables at enrollment were at least 1 PD >or=4 mm around the third molars, and the upper tertile of the number of third molar probing sites recorded as bleeding on probing (BOP). Bivariate analyses were performed for baseline characteristics. The chi2 test was used to determine statistical significance (P = .05). Significant variables were included in unconditional logistic multivariable models to derive relative risk ratios (RRs) and 95% confidence intervals (CIs). Data from enrollment and term were available for 360 subjects with visible third molars (mean age, 27.3 years; standard deviation, 5.5 years). At the postpartum examination, 122 subjects (34%) demonstrated periodontal progression. These subjects included 74 of the 176 subjects (42%) in whom a third molar PD >or=4 mm was detected at baseline and 48 of the 184 (26%) without third molar PD >or=4 mm (P = .001). Periodontal progression was found in 40 of the 77 subjects (52%) who were in the upper tertile of the number of third molar probing sites exhibiting BOP at enrollment versus 82 of the 203 (29%) in the lower tertiles (P = .0002). In multivariable models, either third molar PD >or=4 mm at enrollment (RR = 1.4; 95% CI = 1.1 to 2.0) or third molar bleeding on probing (RR = 1.7; 95% CI = 1.3 to 2.3) was associated with periodontal disease progression. Third molar periodontal pathology appears to be a significant risk indicator for periodontal disease progression during pregnancy.

Third Molar Periodontal Pathology and Caries in Senior Adults

This study was designed to assess the prevalence at enrollment and incidence over 36 months of periodontal pathology and caries affecting third molars in a community-based study of people over the age of 65 years in North Carolina. A sub-sample of 818 subjects with dental examinations taken from the Piedmont 65+ Study was available for analysis. All visible teeth were examined. Periodontal probing (PD) measures were taken at 2 sites, mesiobuccal and buccal/facial. Clinical data on caries experience were collected by visual-tactile examination. At enrollment, 342 subjects had at least 1 visible third molar that could be examined. PD measures were available for 276 of these same subjects. The significance of comparisons between third molars and nonthird molars were determined by chi(2) tests and the statistical significance was set at .05. Most of the 342 subjects with at least 1 visible third molar were female (57%) or African American (63%). Mean age was 73 years (SD 5.5 years). Of the 197 subjects with caries experience, third molars were affected in 49% of subjects, less than the 87% in nonthird molars. Third molar caries experience was associated with caries experience on nonthird molar teeth (P < .01). Clinical attachment level (CAL) greater than 3 mm was detected at enrollment in third molars in 68% of subjects, and in nonthird molars in 96%. With one exception, CAL greater than 3 mm in third molars was associated with CAL greater than 3 mm elsewhere in the mouth. Few subjects (17%) had clinical evidence of both caries and periodontal pathology affecting third molars. In this older population of individuals with third molars, 21% were free of periodontal pathology or caries experience. Data on the prevalence of third molar periodontal pathology and third molar caries experience in an elderly population should be useful to both clinicians and their younger patients when considering the merits of retaining or removing third molars with no evidence of pathology.

Changes in Third Molar and Non-Third Molar Periodontal Pathology Over Time

Changes in Third Molar and Non-Third Molar Periodontal Pathology Over Time

Reliability of Third Molar Probing Measures and the Systemic Impact of Third Molar Periodontal Pathology

This study examined the reliability of assessing clinical periodontal measures on third molars, and the association between oral inflammation with periodontal pathology including third molars, and systemic inflammation including negative obstetric outcomes. Reliability of third molar probing depth (PD) was assessed for 41 patients by trained examiners. The data for the association between oral inflammation with periodontal pathology and systemic outcomes were derived from an IRB-approved study, "Oral Conditions and Pregnancy." Full mouth periodontal exams including third molars were conducted at less than 24 weeks of pregnancy. Periodontal status, moderate/severe periodontal disease (15 or more sites PD > or =4 mm) was considered as a possible predictor of systemic inflammation and pre-term birth. The upper quartile of the extent of PD for third molars alone (PD > or =4 mm) also was considered as a possible exposure variable for the same outcomes. Chi-square and t tests were used to determine statistical significance (0.05). Significant predictor variables were included in multivariate models. Unconditional logistic multivariate models were used to derive odds ratios (OR) and 95% confidence intervals (CI). Reliability of PD within 1 mm was excellent, and similar for third molars and non-third molars. Data from 1,020 obstetric patients were available for analysis. Eighteen percent of the patients delivered preterm, at less than 37 weeks. Having moderate/severe periodontal disease excluding third molars, was significantly associated with preterm birth (P = .008). Results were more significant if third molars were included (P = .0005). With multivariate models moderate/severe periodontal disease at enrollment including third molar PD, was associated with preterm birth (OR, 1.7; 95% CI, 1.1, 2.6). If only the extent of third molar PD was considered, odds also were increased for preterm birth (OR, 2.4; 95% CI, 1.1, 5.2). If only the extent of third molar PD was considered at enrollment, odds were increased for serum markers of systemic inflammation, elevated serum CRP, and oxidative stress, 8-isoPGF(2alpha). Dental examiners could reliably assess clinical periodontal measures on third molars. Third molars should be included in studies of systemic outcomes associated with oral inflammation. Women of child-bearing age should be made aware of the systemic risks of oral inflammation with third molar periodontal pathology.

The Systemic Impact of Third Molar Periodontal Pathology

used to document successful exploration and instrumentation of the ductal system. The ducts were then harvested, dissected, and any traumatic injuries photographed. Results: All submandibular (n 20) and parotid ducts (n 20) were dilated without complications. The coronary stent was inserted using a guide wire and the balloon inflated to expand the stent. When the balloon was deflated and withdrawn, the stent remained in place, serving as scaffolding for the widened duct. Insertion and handling of a 1mm endoscope, through the stented salivary duct was facile, fast, and effortless in all 20 parotid and 20 submandibular ducts. Insertion of the endoscope was successful in all 10 control parotid and submandibular ducts but with greater difficulty. Results of the clinical and video capture assessment of damage to the ducts will be presented. Conclusion: Intraductal stent placement is feasible and provides easier access for the surgeon with little trauma to the salivary gland duct. Live animal experiments are ongoing.

Third Molar Periodontal Pathology in the Third Decade and Periodontal Pathogens

Statement of the Problem: Increased periodontal probing depth in the 3rd molar region is common for young patients. High levels of pathogens detected on the distal of second molars at baseline might predict periodontal pathology. This study assessed the association between follow-up periodontal probing depths in the 3rd molar region and the baseline levels of periodontal pathogens for patients in a longitudinal trial. Patients and Methods: Data derived from healthy patients with four asymptomatic 3rd molars. Panoramic radiographs were analyzed for 3rd molar angulation as compared to the long axis of the 2nd molar (mesial/ horizontal 25 degrees) and eruption to the occlusal plane. Full mouth periodontal probing (PD) was conducted at follow-up. The baseline levels of bacteria were determined using whole chromosomal DNA probes and DNA checkerboard hybridization. Detected bacteria were grouped into “orange” and “red” complexes according to Socransky. A level of “orange” and “red” complex microorganisms at 105 was considered clinically important. Method of Data Analysis: The follow-up PD in the 3rd molar region, the distal of 2nd or around 3rd molars, were compared to baseline levels of “orange” and “red” complex microorganisms. Level of significance for Chi2 statistics was set at P 0.05. Results: Data from 240 patients were available. Median follow-up was 2.2 y (IQ 2.0, 3.7 y). Baseline median age was 25.9 y (IQ 22, 32.8 y). More were female, 53%, and Caucasian, 82%. At follow-up 12% maxillary mesial/horizontal impacted 3rd and 28% mandibular 3rd molars had a PD 4 mm. Similarly affected were 11% of the maxillary vertical/distal impacted 3rd and 32% of the mandibular 3rd molars. Only 11% maxillary erupted 3rd molars had a PD 4 mm, but 51% of the mandibular erupted 3rd molars were affected. If a patient had a PD 4 mm at follow-up and baseline periodontal pathogens 105, the pathogens 105 were likely to be detected in the same quadrant, 45 of 51 (88%). With a PD 4 mm in the maxilla at follow-up, 43% of patients had baseline pathogen levels detected in the same quadrant 105, as compared to 30% with follow-up PD 4 mm. For the mandible a PD 4 mm in the 3rd molar region at follow-up was associated more often with baseline quadrant levels of pathogens 105, compared to 3rd molar PD 4 mm, 29% vs. 26%. Differences were not statistically significant. Perhaps the short time interval from baseline to follow-up did not allow for high levels of pathogens at baseline to influence follow-up PD. Of the 3rd molar regions in the maxilla with 105 pathogens at baseline, 22% had PD 4 mm at follow-up. In the mandible with 105 pathogens at baseline, 63% had PD 4 mm at follow-up. Conclusion: If pathogens 105 are detected with increased PD, both are likely in the same quadrant. Patients continue to be followed to determine how often baseline levels of pathogens predict increased PD.