Risk factors associated with the severity of pericoronitis of mandibular third molar.

PURPOSE: The factors related to pericoronitis severity are unclear, and this study aimed to address this knowledge gap. MATERIALS AND METHODS: In total, 113 patients with pericoronitis were included, and their demographic, clinical, and radiographic characteristics were recorded. The Patient-Clinician Pericoronitis Classification was used to score and categorize the severity of pericoronitis. Statistical analysis was conducted to examine the participants' characteristics, validity of the Patient-Clinician Pericoronitis Classification, and risk factors associated with the severity of pericoronitis. RESULTS: The demographic, clinical, and radiographic characteristics of males and females were similar, except for Winter's classification, pain, and intraoral swelling. The constructive validity of the Patient-Clinician Pericoronitis Classification was confirmed with three latent factors, including infection level, patient discomfort, and social interference. Ordinal logistic multivariate regression analysis revealed that upper respiratory tract infection was the sole risk factor associated with pericoronitis severity in males (odds ratio = 4.838). In females, pericoronitis on the right side (odds ratio = 2.486), distal radiolucency (odds ratio = 5.203), and menstruation (odds ratio = 3.416) were significant risk factors. CONCLUSION: This study demonstrated the constructive validity of the Patient-Clinician Pericoronitis Classification. Among females, pericoronitis in mandibular third molars on the right side with radiolucency in menstruating individuals was more severe. In males, upper respiratory tract infection was the sole risk factor associated with pericoronitis severity. CLINICAL RELEVANCE: Individuals with risk factors should be aware of severe pericoronitis in the coming future.

Influence of inflammation on bleeding and wound healing following surgical extraction of impacted lower third molars.

OBJECTIVE: This study aimed to investigate the effect of inflammatory states following impacted lower third molar (ILTM) surgery regarding postoperative bleeding and wound healing. METHODS: The study included patients who underwent extraction of ILTMs associated with or without inflammatory conditions. Post-extraction bleeding and wound healing were assessed. In addition, mean grey values (MGVs) of alveolar bone and bone height using an orthopantomography radiograph were analyzed. RESULTS: A total of 376 patients were enrolled; 171 pericoronitis, 51 pulpitis, 44 chronic periapical periodontitis, 36 chronic periodontitis, and 74 control. The bleeding score in the control group was significantly lower than in the periapical periodontitis and periodontitis groups. Excellent wound healing for control, pericoronitis, pulpitis, periapical periodontitis, and periodontitis groups was (78.38%, 35.67%, 70.59%, 70.45%, and 33.33%, respectively). Patients with pericoronitis and periodontitis had significantly poorer wound healing (P < 0.01). The MGV in periapical periodontitis and periodontitis was considerably lower than in the control group. CONCLUSIONS: The inflammatory conditions associated with ILTMs increase the risk of bleeding. So suturing with the placement of local hemostatic agents over a pressure pack alone is recommended. The poorest wound healing was in localized gingival inflammation. Furthermore, MGV was affected by age and was lower with periapical periodontitis.

Erbium, chromium:Yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser versus diode laser in the treatment of pericoronitis.

Background: There are limited number of studies about the lasers used for the treatment of pericoronitis infection. Aim: To compare the Er, Cr:YSGG laser and diode laser applications clinically in the treatment of pericoronitis infection. Patients and Methods: Sixty patients with pericoronitis infection were divided into three groups using block randomization: Er, Cr:YSGG + antibiotic group, n = 20 (mean age: 24.20 ± 6.13; 14 females, 6 males); diode group + antibiotic, n = 20 (mean age: 23.45 ± 2.96; 14 females, 6 males); and antibiotic, n = 20 (mean age: 22.45 ± 3.02; 11 females, 9 males). In addition, laser application was performed for patients in the Er, Cr:YSGG and diode laser groups on the 1st and 2nd days until the extraction day. Tooth extractions were performed on the 3rd day for all patients. Patients' pain (with visual analog scale [VAS]), lymphadenopathy, and local edema were clinically evaluated in the first 3 days and on the 7th day of treatment. Results: Pain score on the 2nd day of treatment was determined to be significantly lower in the Er, Cr:YSGG + antibiotic laser group as compared with the other two groups (P = 0.019). Although regression of lymphadenopathy on the 3rd day was highest (P = 0.025) in the Er, Cr:YSGG group, there was no significant difference between the groups regarding local edema. Conclusion: Er, Cr:YSGG laser improved the healing process in the treatment of pericoronitis and made an important contribution to the treatment.

Should systemic antibiotics be prescribed in periodontal abscesses and pericoronitis? A systematic review of the literature.

This study assessed whether systemic antibiotics are beneficial or harmful in patients who present with an acute periodontal abscess or pericoronitis, with or without systemic involvement, and, if antibiotics are beneficial, which type, dosage, and duration are the most effective. Medline, Embase, and the Cochrane Library were screened from 1948 up to 1 April 2022 for systematic reviews, randomised clinical trials (RCTs), and other studies. Dedicated websites were consulted for systematic reviews, clinical practice guidelines, and health technology assessments on the topic. Outcomes of interest comprised tooth survival, swelling, pain, tooth mobility, periodontal probing depth, suppuration, adverse effects, quality of life measurements, and medication required for pain relief. Overall, five guidelines, seven systematic reviews, 15 RCTs, and 34 other studies were identified and selected for full-text assessment, but none of them fulfilled the inclusion criteria. At present there is no single randomised or non-randomised controlled trial assessing the harms and clinical effectiveness of systemic antibiotics in adults with a periodontal abscess or pericoronitis.

[A surprising cause of a neck fistula]. / Een verrassende oorzaak van een halsfistel.

A 24-year-old woman presented with trismus, which had left her unable to open her mouth beyond 1 centimetre. It proved to be a pericoronitis with lingual swelling in the region of tooth 38. The trismus disappeared after removal of the 38. After a week, however, a submandibular swelling occurred. From this, an orocutaneous neck fistula developed from which a hay stalk was removed. In retrospect, the hay stalk ended up under the operculum of tooth 38 after eating meat cooked in hay, the stalk next made its way to the neck.

Oral Health-Related Quality of Life and the Use of Oral and Topical Nonsteroidal Anti-Inflammatory Drugs for Pericoronitis.

BACKGROUND Pericoronitis is inflammation of the tissue surrounding a third molar, or wisdom tooth. This study aimed to evaluate the effects of oral and topical analgesic nonsteroidal anti-inflammatory drugs (NSAIDs) on oral health-related quality of life (OHQoL), in terms of oral health and lifestyle, in patients with symptomatic pericoronitis. MATERIAL AND METHODS The study included 60 patients who presented with pericoronitis and who did not undergo surgery within the following seven days. The patients were randomly assigned to three groups and were treated with oral diclofenac (N=20), oral flurbiprofen (N=20), and topical benzydamine (N=20). OHQoL was assessed for all study participants with a self-reported eight-item scale that was developed to evaluate pericoronitis. The total OHQoL scores were calculated for each day during the seven-day study period. RESULTS The study group treated with topical benzydamine had a significantly greater improvement in the OHQoL scores compared with the oral diclofenac and oral flurbiprofen groups on the first four days. Comparison of patients treated with diclofenac and flurbiprofen showed no significant differences for all seven days. A significant initial improvement in OHQoL was found on day 1 for the benzydamine group, on day 2 for the flurbiprofen group, and day 3 for the diclofenac group. CONCLUSIONS In this study, topical benzydamine was found to be a more effective alternative to oral NSAID analgesics, diclofenac and flurbiprofen, in improving OHQoL in patients with pericoronitis.

Streptococcus gwangjuense sp. nov., Isolated from Human Pericoronitis.

A novel facultative anaerobic, Gram-stain-negative coccus, designated strain ChDC B345T, was isolated from human pericoronitis lesion and was characterized by polyphasic taxonomic analysis. The 16S ribosomal RNA gene (16S rDNA) sequence revealed that the strain belonged to the genus Streptococcus. The 16S rDNA sequence of strain ChDC B345T was most closely related to those of  Streptococcus mitis NCTC 12261T (99.5%) and Streptococcus pseudopneumoniae ATCC BAA-960T (99.5%). Complete genome of strain ChDC B345T was 1,972,471 bp in length and the G + C content was 40.2 mol%. Average nucleotide identity values between strain ChDC B345T and S. pseudopneumoniae ATCC BAA-960T or S. mitis NCTC 12261T were 92.17% and 93.63%, respectively. Genome-to-genome distance values between strain ChDC B345T and S. pseudopneumoniae ATCC BAA-960T or S. mitis NCTC 12261T were 47.8% (45.2-50.4%) and 53.0% (51.0-56.4%), respectively. Based on these results, strain ChDC B345T (= KCOM 1679T = JCM 33299T) should be classified as a novel species of genus Streptococcus, for which we propose the name Streptococcus gwangjuense sp. nov.

Application of Denaturing Gradient Gel Electrophoresis to the Analysis of Bacterial Communities Associated With Asymptomatic and Symptomatic Pericoronitis.

PURPOSE: Denaturing gradient gel electrophoresis (DGGE) was used to investigate the bacterial communities associated with asymptomatic and symptomatic pericoronitis. The aim of the study was to compare the fingerprinting patterns of these 2 clinical conditions. MATERIALS AND METHODS: The microbiota of mandibular third molar pockets associated with asymptomatic or symptomatic pericoronitis cases were collected and profiled by the polymerase chain reaction DGGE method. Banding patterns were compared by cluster analysis techniques. RESULTS: Thirteen symptomatic pericoronitis and 7 asymptomatic pericoronitis samples were collected. Comparative analysis of the 2 clinical conditions showed bands that were common to the symptomatic and asymptomatic cases, but most DGGE bands appeared to be unique to the clinical condition. No single band occurred in all profiles. The mean number of bands detected in the 16S rDNA community profiles was 23.8 ± 4.2 (range, 19 to 34) for samples from symptomatic cases and 24.1 ± 2.4 (range, 21 to 29) for those from asymptomatic cases. Cluster analysis and multidimensional scaling analysis of the DGGE banding pattern showed a distinction in the similarity of banding patterns according to the presence or absence of symptoms. CONCLUSIONS: These results suggest that the diversity of pericoronal pocket microbiota in asymptomatic pericoronitis cases differs markedly from that of symptomatic cases.

Is the Level of Nitric Oxide in the Dental Follicular Tissues of Impacted Third Molars With a History of Recurrent Pericoronitis a True Marker of Oxidative Stress?

PURPOSE: Nitric oxide (NO) is an indicator of oxidative stress in several tissues. Its role in dental follicular (DF) tissues of impacted third molars with a history of recurrent pericoronitis is not well elucidated. The present study compared NO levels between inflamed and noninflamed DF tissues of impacted third molars with a history of recurrent pericoronitis. MATERIALS AND METHODS: A cross-sectional study was designed. The study sample included inflamed DF tissues (test group) with certain local inflammatory symptoms, such as pain, tenderness, swelling, and erythema and noninflamed DF tissues (control group) without local inflammatory symptoms of impacted mandibular third molars. Each patient contributed only 1 specimen to the samples. All tissues samples were biochemically investigated for NO levels as an indicator of oxidative stress. The primary predictor variable was inflammatory status; secondary predictor variables were age and gender. The primary outcome variable was NO level. Descriptive and comparative analyses were conducted. RESULTS: The test group consisted of 57 patients (28 men, 29 women; mean age, 23.28 ± 5.16 yr) and the control group consisted of 57 patients (30 men, 27 women; mean age, 23.02 ± 5.42 yr). No relevant intergroup differences were noted for demographic findings such as age and gender. NO levels were significantly higher in inflamed DF tissues of impacted third molars than in noninflamed DF tissues (P < .05). CONCLUSION: Results of this study showed that NO might be used as an indicator of oxidative stress and the necessity to remove impacted mandibular third molars with a history of recurrent pericoronitis.

Herpesviral-bacterial co-infection in mandibular third molar pericoronitis.

OBJECTIVE: The aim of this study was to assess the presence of herpesviruses and periodontopathic bacteria and to establish their potential association with pericoronitis. MATERIALS AND METHODS: Fifty samples obtained with paper points (30 from pericoronitis and 20 controls) were subjected to polymerase chain reaction (PCR) analysis. A single-stage and nested PCR assays were used to detect herpesviruses: human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) and six periodontopathic anaerobic bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Parvimonas micra, Treponema denticola, and Tannarella forsythia. RESULTS: Pericoronitis samples harbored HCMV and EBV at significantly higher rates than the control group (70 vs. 40 % and 46.7 vs. 15 %, P = 0.035, P = 0.021, respectively). P. micra and T. forsythia (66.7 vs. 0 %, and 40 vs. 10 %, P = 0.001, P = 0.021, respectively) were significantly more common in pericoronitis compared to the control group. Multivariate logistic regression analysis showed that the presence of T. forsythia was associated with pericoronitis development (OR 7.3, 95 % CI, 1.2-43.2, P = 0.028). CONCLUSION: The occurrence of HCVM and EBV extends our previous knowledge on microbiota in pericoronitis. These PCR-based findings demonstrated that bacterial and viral DNA occurred concomitantly in pericoronitis samples. T. forsythia appeared to be significantly associated with pericoronitis development in the examined sample. CLINICAL RELEVANCE: Herpesviral-bacterial co-infections might exacerbate the progression of pericoronitis.

Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar.

PURPOSE: To analyze the effect of the eruption status of the mandibular third molar (MTM) on distal caries in the mandibular second molar (MSM) by cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Five hundred CBCT images of MTMs from 469 patients were evaluated. Presence of distal caries in MSMs, impaction depths and angulations of MTMs, cementoenamel junction (CEJ) distances between distal MSMs and mesial MTMs, presence of pericoronitis in MTMs, and patient characteristics (age and gender) were assessed. Data were analyzed by χ(2) test, univariate and multivariate logistic regression analyses, and Spearman correlation analysis. Descriptive and bivariate statistics were computed and the P value was set at .05. RESULTS: The overall prevalence of distal caries in the MSM was 52.0%. According to the classification of Pell and Gregory, position A was the impaction depth at which most distal caries in MSMs were present (P = .036). For angulation of the MTM, when mesial angulations were 43° to 73°, MSMs developed more distal caries (P < .0001). For the CEJ distance between the distal MSM and the mesial MTM, when distances ranged from 6 to 15 mm, distal caries in MSMs occurred more frequently (6 to 8 mm, P < .0001; 8 to 15 mm, P = .037). Furthermore, there was a linear correlation between angulation of the MTM and the CEJ distance between the distal MSM and the mesial MTM (P < .0001). CONCLUSIONS: Impaction depth and angulation of the MTM are associated with distal caries in the MSM. Angulation of the MTM is more stable and reliable than the CEJ distance between the distal MSM and the mesial MTM for the estimation of risk factors related to the MTM.

Mandibular third molar surgery in 396 patients at a Norwegian university clinic: Morbidity recorded after 1 week utilizing an e-infrastructure for clinical research.

OBJECTIVE: To evaluate morbidity 1 week after mandibular third molar (3M) surgery in the authors' department. MATERIALS AND METHODS: A prospective 1-year clinical study of patients followed up for 1 week after 3M surgery was performed. Consecutive patients of 18 years or older having 3M surgery under local anaesthesia were included. Patients not able to attend a follow-up appointment after 1 week were excluded. Demographic data, indication for surgery and clinical findings were recorded. Outcome variables were days requiring analgesic, days absent from work/school and complications. All data recording was performed utilizing an e-infrastructure for clinical research (InReach, University Health Network, www.uhnsl.com). RESULTS: Three hundred and ninety-six patients were examined 1 week after surgery. Mean number of days requiring analgesics was 3.8 and mean number of days absent from work/school after surgery was 0.6. Minor complications were reported by 7% of patients. Female patients reported more days requiring analgesics compared to male patients. Smokers had a higher odds ratio for being absent ≥ 3 days. Prophylactic removal of 3Ms was associated with fewer days requiring analgesics and days absent from work/school as compared to teeth with local disease. CONCLUSION: Overall morbidity after 3M surgery was low. Compared to patients subjected to therapeutic removal of 3Ms, patients undergoing prophylactic removal seem to have less pain and a faster return to normal activities.

Assessment of Third Molar Impaction Pattern and Associated Clinical Symptoms in a Central Anatolian Turkish Population.

OBJECTIVES: The purpose of this study was to assess the pattern of third molar impaction and associated symptoms in a Central Anatolian Turkish population. MATERIAL AND METHODS: A total of 2,133 impacted third molar teeth of 705 panoramic radiographs were reviewed. The positions of impacted third molar teeth on the panoramic radiographs were documented according to the classifications of Pell and Gregory and of Winter. The presence of related symptoms including pain, pericoronitis, lymphadenopathy and trismus was noted for every patient. Distributions of obtained values were compared using the Pearson χ2 test. Nonparametric values were analyzed using the Mann-Whitney U test and Kruskal-Wallis test. RESULTS: The mean age of the subjects was 30.58 ± 11.98 years (range: 19-73); in a review of the 2,133 impacted third molar teeth, the most common angulation of impaction in both maxillaries was vertical (1,177; 55%). Level B impaction was the most common in the maxilla (425/1,037; 39%), while level C impaction was the most common in the mandible (635/1,096; 61%). Pain (272/705; 39%) and pericoronitis (188/705; 27%) were found to be the most common complications of impaction. Among 705 patients (335 males, 370 females), pericoronitis was more prevalent in males (101; 30%) and usually related to lower third molars (236; 22%). The retromolar space was significantly smaller in females (p < 0.05). Moreover, there was a significant difference in retromolar space for the area of jaw (maxillary: 11.3 mm; mandibular: 14.2 mm) and impaction level (A: 14.7 mm; B: 11.1 mm; C: 10.3 mm; p < 0.05). CONCLUSION: The pattern of third molar impaction in a Central Anatolian Turkish population was characterized by a high prevalence rate of level C impaction with vertical position. Pain and pericoronitis were the most common symptoms usually associated with level A impaction and vertical position.

Pain with pericoronitis affects quality of life.

PURPOSE: To assess the association between patients' pericoronitis pain symptoms and quality-of-life (QOL) outcomes for lifestyle and oral function. PATIENTS AND METHODS: Subjects (American Society of Anesthesiologists health risk assessment level I or II) with mild symptoms of pericoronitis were enrolled in a study approved by the institutional review board and asked to complete a QOL instrument specifically for third molar problems covering lifestyle, oral function, and pain. Subjects assessed lifestyle and oral function using a 5-point Likert-type scale, ranging from "no trouble" (score, 1) to "lots of trouble" (score, 5), and worst and average pain using a 7-point Likert-type scale, ranging from "no pain" (score, 1) to "worst pain imaginable" (score, 7). Pain levels reported at enrollment were compared with QOL outcomes for lifestyle and oral function using Spearman correlation coefficients. Correlations of at least 0.6 were considered clinically quite important, and correlations of at least 0.4 were considered clinically important. Associations between these outcome measurements were considered statistically significant at a P value less than .05. RESULTS: Most of the 113 subjects were Caucasian (51%), women (56%), 23 years old or younger (58%), and well educated (91% with at least some college). Mean pain levels ± standard deviation were low (worst pain, 3.3 ± 1.5; average pain, 2.4 ± 1.2). All pain outcomes were significantly associated with items in the lifestyle and oral function domains (P < .01). Clinically important correlations were seen between pain outcomes and daily routine, social life, eating a regular diet, chewing food, and talking (P < .0001). CONCLUSIONS: Clinically important correlations existed between subjects' pericoronitis pain and lifestyle and oral function, associations not often considered by clinicians or policy makers.

A double-blind randomized study evaluating the effect of intra-alveolar chlorhexidine gel on alveolar osteitis after removal of mandibular third molars.

PURPOSE: The main purpose of the present investigation was to determine whether intra-alveolar chlorhexidine (CHX) gel is an effective preventative treatment for alveolar osteitis (AO), as has been strongly suggested by previous investigators. Another goal was to evaluate whether there is a correlation between the use of analgesics during the postoperative week and the development of AO, a correlation that could be a supplement to the commonly used diagnostic criteria for AO. MATERIALS AND METHODS: A double-blinded randomized study was performed to assess whether intra-alveolar administration of CHX decreases AO. To achieve this objective, the extraction and postoperative course of 100 impacted mandibular third molars were studied. Ninety-seven percent of teeth operated on had a diagnosed pathology. The extraction alveoli were treated with CHX or placebo. The intake of analgesics was recorded for 7 days after the operation. RESULTS: Statistically important differences in AO between the control and experimental groups were not found. The intake of analgesics reflected the occurrence of AO with a high degree of importance. CONCLUSION: The present study did not verify that application of CHX gel improves healing after removal of impacted third molars. The patients' postoperative analgesic intake reflected the development of AO.

Effect of Causative Tooth Extraction on Clinical and Biological Parameters of Odontogenic Infection: A Prospective Clinical Trial.

PURPOSE: To prospectively compare changes of body temperature, white blood cell count, fibrinogen, and C-reactive protein between odontogenic infections in which the responsible tooth was removed and odontogenic infections in which the treatment included no extraction. MATERIALS AND METHODS: The sample was composed of patients admitted to the authors' maxillofacial unit for odontogenic infection from 2010 through 2013. One hundred seventy-nine patients were categorized into an extraction or a non-extraction group based on whether the causative tooth was non-restorable or restorable, respectively. Non-restorable teeth were extracted at admission of the patient. Otherwise, the treatment protocol, including incision of the involved space in conjunction with intravenous antibiotics, was the same for the 2 groups. The parameters were measured and recorded at admission and 2 days later. Data records were statistically analyzed by comparing the change of the parameters studied between the extraction and non-extraction groups. P values less than .05 were regarded as statistically significant. RESULTS: One hundred seventy-nine patients fulfilled the inclusion criteria and were enrolled in the study. The mean age of the patients was 39.1 years (minimum, 14 yr; maximum, 81 yr; standard deviation, 15.4 yr). One hundred nine patients (60.9%) were male, and 70 (39.1%) were female. Differences in the mean decrease of axillary temperature, white blood cell count, fibrinogven, and C-reactive protein between the 2 groups were 0.178, 2,300, 1.01, and 0.64, respectively. All these differences were statistically significant (P =.02, .001, .001, and .001, respectively). Also, the mean hospital stay in the extraction group was 1.05 days shorter than in the non-extraction group, with the difference being statistically significant (P = .006). CONCLUSIONS: In odontogenic maxillofacial infections, extraction of the causative tooth is associated with a faster clinical and biological resolution of the infection.

Odontogenic Infections: A 1-year Retrospective Study.

OBJECTIVES: The purpose of this study was to analyze the prevalence, demographic patterns and management of odontogenic infections in patients undergoing treatment in an outpatient dental emergency service of a university hospital. MATERIALS AND METHODS: In a retrospective study of the year 2012, all patients suffering from odontogenic infections were included. Demographic data, diagnosis and the conducted treatment were analyzed. Odontogenic infections were defined as pulpitis, apical and marginal periodontitis, abscesses and pericoronitis. RESULTS: A total of 2,058 out of 4,209 emergency patients suffered from odontogenic infections. The majority (45.0%) had an apical periodontitis, 20.8% abscesses, 17.3% a marginal periodontitis, 16.3% a pulpitis and 5.8% a pericoronitis. Mean age was 37.5 ± 17.0 years standard deviation (SD) (1.2-96.4). Most patients were 20 to 29 years (24.6%), followed by the age group of 30 to 39 year old patients (21.0%). Males were affected more frequently (55.5%) than females (45.5%). Most of the patients (64.5%) of the patients received a dental or surgical treatment. Antibiotics were prescribed in 31.7% of cases. Amoxicillin was the most common prescribed antibiotic (54.5%). CONCLUSION: Odontogenic infections represent one of the main reasons for consulting the emergency service. Due to the high number of cases and the severe complications, dentists have to be familiar with the surgical management of odontogenic infections as well as the appropriate use of antibiotics. CLINICAL SIGNIFICANCE: Nearly half of all patients who sought, treatment in the emergency service had an odontogenic infectious disease. This should be considered for the organization and planning of the service.

Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort.

AIM: To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival. MATERIALS AND METHODS: The Kuopio Oral Health and Heart study initiated a case-control study in 1995-1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender-matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) - consisting of 10 teeth - with cardiovascular and all-cause mortality after 15.8 years of median follow-up. RESULTS: In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p-value = 0.02 but not with all-cause mortality (HR = 0.87, p = 0.13). The findings were not mediated by C-reactive protein (CRP) levels ≥3 mg/L or by median fibrinogen levels, but were mediated by CRP levels >5 mg/L. CONCLUSION: Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.

Effect of quality of life measures on the decision to remove third molars in subjects with mild pericoronitis symptoms.

PURPOSE: To assess how quality of life (QoL) measures affect the decision for third molar (3M) removal in patients with mild symptoms of pericoronitis. PATIENTS AND METHODS: Healthy subjects, aged 18 to 35 years, with mild symptoms of pericoronitis were enrolled in an institutional review board-approved study. The demographic, clinical, and QoL data were collected at enrollment. The subjects voluntarily scheduled surgery for 3M removal. The principal outcome variable was their decision to undergo or not undergo surgery within 6 months of enrollment. The possible predictor variables in a multivariate logistic regression analysis were the demographic characteristics, dental insurance, and QoL measures. RESULTS: The mean age of the 113 subjects was 23.2 ± 3.8 years. Of the 113 subjects, 79 elected to undergo 3M removal within 6 months of enrollment (removed group) and 34 elected to retain their 3M at 6 months after enrollment (retained group). A significantly greater proportion of the removed group were white (58% vs 35%; P = .03) and reported having at least "a little trouble" with opening their mouths (38% vs 18%; P = .04) and taking part in social life (27% vs 6%; P = .01). The multivariate logistic regression model suggested the odds of electing 3M removal within 6 months of enrollment were greater for those who were white (odds ratio [OR] 2.69, 95% confidence interval [CI] 1.14 to 6.32) and those who had at least "a little trouble" with interactions in their social life (OR 3.22, 95% CI 1.08 to 9.58). CONCLUSIONS: In subjects with mild pericoronitis symptoms, experiencing problems with oral function and lifestyle, factors not often considered by clinicians, were significantly associated with subjects' decision for early 3M removal.

Evaluation of periodontal pathogens of the mandibular third molar pericoronitis by using real time PCR.

OBJECTIVES: The aim of this study was to investigate the mandibular third molar pericoronitis flora by using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: The quantitative values of Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf) were evaluated in comparison with the healthy third molar flora by using real time PCR. RESULTS: Aa, Cr, Pg, and Pi were not statistically significant but numerically higher than the pericoronitis group. In contrast to samples from control subjects, statistically significant higher numbers of Tf were detected in samples from pericoronitis patients. The study revealed the strong relation between risk of pericoronitis and the presence of Tf. Individuals who have Tf in their samples present with an almost eight times relative risk of pericoronitis as the individuals with an absence of Tf in their samples. CONCLUSION: Tf plays an important role in the development of clinical symptoms related to pericoronitis.