Inflammatory biomarkers in dentinal fluid as an approach to molecular diagnostics in pulpitis

Published on Jun 4, 2020in International Endodontic Journal3.801
· DOI :10.1111/IEJ.13343
Claudia Brizuela7
Estimated H-index: 7
(University of Los Andes),
G. Meza2
Estimated H-index: 2
(University of Los Andes)
+ 7 AuthorsValeria Ramírez8
Estimated H-index: 8
(University of Los Andes)
Sources
Abstract
AIM To explore a set of inflammatory biomarkers obtained from dentinal fluid (DF) from patients with symptomatic irreversible pulpitis (IP), reversible pulpitis (RP) and normal pulp (NP). METHODOLOGY A cross-sectional exploratory study was performed, recruiting 64 patients on the basis of their respective pulp condition. DF samples were obtained from all patients (23, from IP patients; 20, from RP patients; and 21, from NP patients). Quantification of biomarkers was performed using a Luminex® MAGPIX platform system and multiplex assay kits. The Kruskal Wallis test was used for comparisons with regard to pulp state. A simple logistic regression model and the odds ratio (OR) with a 95% level of confidence (p=0.05) were used to evaluate associations between biomarker levels and pulpal diagnosis. The performance discrimination of the biomarkers was evaluated through the construction of a receiver operating characteristic (ROC) curve by calculating the area under the curve (AUC) for IP versus RP after logistic regression modeling. Youden criteria were used to establish cutoff points for biomarkers alone with AUC>70 and p-value<0.05, or estimated probabilities from the multivariable logistic model. RESULTS The biomarkers that had significantly higher values in participants with IP versus RP were IL-1α, VEGF-α and FGF-acid (p<0.05). FGF-acid (OR: 12.62; p = 0.0085; CI 95% 1.91-83.29) and VEGF-α (OR: 2.61; p = 0.0252; CI 95% 1.13-6.03) were associated with pulp diagnoses of IP versus RP. The AUC-ROC curve for FGF-acid was 0.79. The model containing FGF-acid, IL-1α, IL-6, and TIMP-1 had an AUC-ROC of 0.92 for IP versus RP with a significant difference from the FGF-acid ROC curve (p = 0.0231). CONCLUSIONS Dentinal fluid could be used to assay pulpal mediators in the molecular diagnosis of pulpitis. Despite the limitation of the clinical diagnostics used the present study, it was possible to detect a difference between irreversible symptomatic pulpitis and reversible pulpitis associated with the following combined biomarkers: FGF-acid + IL-6 + IL-1α, + TIMP-1.
📖 Papers frequently viewed together
19 Citations
28 Citations
13 Citations
References24
Newest
#1Lars Bjørndal (UCPH: University of Copenhagen)H-Index: 29
#2Stéphane Simon (Paris Diderot University)H-Index: 21
Last. Henry F. Duncan (Trinity College, Dublin)H-Index: 18
view all 4 authors...
: Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, t...
67 CitationsSource
#1Charlotte Jeanneau (AMU: Aix-Marseille University)H-Index: 20
#2Fionnuala Lundy ('QUB': Queen's University Belfast)H-Index: 20
Last. Imad About (AMU: Aix-Marseille University)H-Index: 32
view all 4 authors...
Abstract Fibroblasts represent the most abundant population within the dental pulp. Although other cell types such as odontoblasts and stem cells have been extensively investigated, very little attention was given to the fibroblasts, which have major roles in regulating the pulp biology and function under normal and pathologic conditions. Indeed, although pulp fibroblasts control the pulp vascularization and innervation under physiological conditions, these cells synthesize growth factors that e...
21 CitationsSource
#1Vasudev Ballal (Manipal University)H-Index: 5
#2Sheetal RaoH-Index: 2
Last. Matthias Zehnder (UZH: University of Zurich)H-Index: 54
view all 6 authors...
The analysis of molecular cues in dentinal fluid from an excavated cavity could improve diagnostics in the context of minimally invasive caries treatment. In the current clinical trial we assessed whether the dentinal fluid levels of MMP-9 (matrix metalloproteinase-9; neutrophil gelatinase) would increase with the progression of carious lesions. MMP-9 is associated with neutrophil-related tissue breakdown in the pulp. Absolute MMP-9 levels were contrasted against the levels of MMP-2, an enzyme r...
11 CitationsSource
#1Marjorie Zanini (Paris Diderot University)H-Index: 5
#2Elisabeth Meyer (Paris Diderot University)H-Index: 1
Last. Stéphane Simon (French Institute of Health and Medical Research)H-Index: 21
view all 3 authors...
Abstract Introduction Similar to other tissues, the dental pulp mounts an inflammatory reaction as a way to eliminate pathogens and stimulate repair. Pulp inflammation is prerequisite for dentin pulp complex repair and regeneration; otherwise, chronic disease or pulp necrosis occurs. Evaluation of pulp inflammation severity is necessary to predict the clinical success of maintaining pulp vitality. Clinical limitations to evaluating in situ inflammatory status are well-described. A molecular appr...
38 CitationsSource
#1Domenico RicucciH-Index: 39
#2Simona LoghinH-Index: 12
Last. José F. Siqueira (Estácio S.A.)H-Index: 94
view all 3 authors...
Abstract Introduction Clinicians routinely face conditions in which they have to decide whether the dental pulp can be saved or not. This study evaluated how reliable the clinical diagnosis of normal pulp/reversible pulpitis (savable pulp) or irreversible pulpitis (nonsavable pulp) is when compared with the histologic diagnosis. Methods The study material consisted of 95 teeth collected consecutively in a general practice over a 5-year period and extracted for reasons not related to this study. ...
121 CitationsSource
#1Michael Boyle (UIC: University of Illinois at Chicago)H-Index: 2
#1Michael Boyle (UIC: University of Illinois at Chicago)H-Index: 2
Last. Satish B. Alapati (UIC: University of Illinois at Chicago)H-Index: 15
view all 7 authors...
Dental-pulp tissue is often exposed to inflammatory injury. Sequested growth factors or angiogenic signaling proteins that are released following inflammatory injury play a pivotal role in the formation of reparative dentin. While limited or moderate angiogenesis may be helpful for dental pulp maintenance, the induction of significant level of angiogenesis is probably highly detrimental. Hitherto, several studies have addressed the effects of proinflammatory stimuli on the survival and different...
37 CitationsSource
#1Matthias Zehnder (UZH: University of Zurich)H-Index: 54
#2Dan-Krister Rechenberg (UZH: University of Zurich)H-Index: 9
Last. Thomas Attin (UZH: University of Zurich)H-Index: 78
view all 5 authors...
Abstract Objectives To test the hypothesis that a material with higher water absorption than polyvinylidene fluoride (PVDF) could increase the yield of target molecules from exposed dentine. Methods In a series of standard tests, different cellulose membranes were compared to a PVDF counterpart for their ability to absorb water and release protein. In a subsequent randomized clinical trial, the cellulose material with the most favourable values was compared to PVDF regarding the levels of MMP-2 ...
9 CitationsSource
Recent systematic reviews have substantiated the fact that current testing methods to assess the inflammatory state of the pulp and the periapical tissues are of limited value. Consequently, it may be time to search for alternative routes in endodontic diagnostics. Molecular assessment methods could be the future. However, in the field of endodontics, the research in that direction is only about to evolve. Because pulpal and periradicular diseases are related to opportunistic infections, diagnos...
8 CitationsSource
#1Ashraf Abd-Elmeguid (U of A: University of Alberta)H-Index: 5
#2Marwa Abdeldayem (BU: Boston University)H-Index: 1
Last. Donald C. Yu (U of A: University of Alberta)H-Index: 10
view all 6 authors...
Abstract Introduction Dental pulp inflammation and repair are closely related. Osteocalcin (OCN), a glycoprotein present in dentin matrix, is expressed by odontoblasts. Although OCN is considered a reparative molecule inside the dental pulp, it is not clear if it is involved in pulpal inflammation. The objective of this study was to localize OCN in reversible and irreversible pulpitis and to describe its possible function in inflammation. Methods Pulp tissues in the form of reversible and irreve...
30 CitationsSource
#1M. ElSalhy (Kuniv: Kuwait University)H-Index: 1
#2Fawaz Azizieh (Gulf University for Science and Technology)H-Index: 22
Last. Raj Raghupathy (Kuniv: Kuwait University)H-Index: 31
view all 3 authors...
Aim To measure and compare the levels of the cytokines IL-2, IL-6, IL-8, IL-10, TNF-α and IFN-γ in pulpal blood from irreversible pulpitis, asymptomatic caries exposure and normal pulps. Methodology Blood was obtained from pulp exposure sites using cotton pellets. Twenty-five samples were obtained from normal teeth, 40 from asymptomatic caries-exposed pulps and 43 from irreversible pulpitis teeth. Cytokine levels were determined by high-sensitivity ELISA. Data were statistically analysed using K...
74 CitationsSource
Cited By5
Newest
#1Liu Liu (Sichuan University)H-Index: 1
#2Tianyi Wang (Sichuan University)
Last. Dongzhe Song (Sichuan University)H-Index: 16
view all 4 authors...
ABSTRACT null null INTRODUCTION null Molecular diagnosis may overcome the limitations of clinical and histological diagnosis in pulpitis, thereby benefiting many treatment techniques, such as vital pulp therapies. In this study, integrated microarray data on pulpitis were used to obtain a list of normalized differentially expressed (DE) genes for analyzing the molecular mechanisms underlying pulpitis and identifying potential diagnostic biomarkers. null null null METHODS null A systematic search...
Source
#1David Yong (University of Otago)
#2Peter Cathro (University of Otago)H-Index: 9
Conservative pulp therapy (CPT) is an alternative treatment option to tooth removal and root canal treatment (RCT) in the management of deep caries, traumatic pulp exposures, and developmental anomalies. Pulp tissue preservation can extend the long-term survival of teeth through relatively simple restorative procedures. This article aims to update clinicians on the current state of research in materials, techniques and outcomes of vital pulp therapies and provide practical guidelines for their i...
Source
#1Ravi Sharma (AIIMS: All India Institute of Medical Sciences)H-Index: 4
#1Raju Sharma (AIIMS: All India Institute of Medical Sciences)H-Index: 25
Last. Mani Kalaivani (AIIMS: All India Institute of Medical Sciences)H-Index: 29
view all 7 authors...
AIM To investigate the correlation between the concentration of active-matrix metalloproteinases-9 (aMMP-9) in pulpal blood and the outcome of pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis (SIP). METHODOLOGY Forty permanent molar teeth with a clinical diagnosis of SIP and normal apical tissues with periapical index (PAI) score ≤ 2 and ten permanent teeth (8 molars and two premolars) with a diagnosis of normal pulp that required root canal treatment for prosthetic rea...
3 CitationsSource
#1Ming Li (SYSU: Sun Yat-sen University)H-Index: 131
#2J. Tian (SYSU: Sun Yat-sen University)
Last. Xi Wei (SYSU: Sun Yat-sen University)H-Index: 20
view all 7 authors...
AIM To profile molecular changes in lipopolysaccharide (LPS)-induced experimental pulpitis in a rat model and explore the feasibility of a molecular-based diagnostic strategy for pulpitis. METHODOLOGY Seventy-three maxillary incisors of Sprague-Dawley rats were used to establish pulpitis models with LPS. Inflammatory grading was performed in four equal sections of the pulp divided from the injured site to the root apex. An antibody array was used to compare the expression of 67 molecules between...
Source
#1Ming Chen (Southern Medical University)H-Index: 6
#2Junkai Zeng (Southern Medical University)H-Index: 1
Last. Buling Wu (Southern Medical University)H-Index: 14
view all 4 authors...
Background Pulpitis is an inflammatory disease, the grade of which is classified according to the level of inflammation. Traditional methods of evaluating the status of dental pulp tissue in clinical practice have limitations. The rapid and accurate diagnosis of pulpitis is essential for determining the appropriate treatment. By integrating different datasets from the Gene Expression Omnibus (GEO) database, we analysed a merged expression matrix of pulpitis, aiming to identify biological pathway...
1 CitationsSource