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

Abstract

AimTo 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).MethodologyA 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 modelling. Youden criteria were used to establish cut‐off points for biomarkers alone with AUC > 70 and P‐value < 0.05, or estimated probabilities from the multivariable logistic model.ResultsThe 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).ConclusionsDentinal fluid could be used to assay pulpal mediators in the molecular diagnosis of pulpitis. Despite the limitation of the clinical diagnostics used in 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.

Association between concentration of active MMP‐9 in pulpal blood and pulpotomy outcome in permanent mature teeth with irreversible pulpitis – a preliminary study

“…2011, Brizuela et al . 2020). The biochemical analysis of GCF or DF could be a useful non‐invasive diagnostic tool for decision making for management of a deep carious lesion.…”

Diagnostic biomarker candidates for pulpitis revealed by bioinformatics analysis of merged microarray gene expression datasets

“…In addition, dental fluid contained within dentinal tubules has been proposed to be potentially useful as a biomarker of different stages of pulpitis. By detecting the dental fluid in tooth cavities using polyvinylidene difluoride membrane, Brizuela et al [18] found that the biomarkers of fibroblast growth factors acid (FGF-acid), interleukin-1α (IL-1α), IL-6, and tissue inhibitor of metalloproteinases 1 (TIMP-1) may collectively be useful for molecular diagnostics in pulpitis. Due to its advantages of ease-of-use and non-invasiveness, the dental fluid test is a promising method for the molecular diagnosis of pulpitis.…”

“…At the cellular or molecular level, a wide range of molecules are released during pulpal and periapical inflammation, including cytokines, proteases, inflammatory mediators, growth factors, and antimicrobial peptides [15,16]. Measurable levels of molecules can be found not only in pulp tissue but also in pulpal blood [17], dentinal fluid [18,19], periapical fluid [1], and gingival crevicular fluid [20], which can be collected noninvasively and analysed without extirpating the pulpal tissue [19,21,22]. The factors that can be used to assess the level of pulp inflammation are called biomarkers of pulpitis [23].…”

Diagnostic biomarker candidates for pulpitis revealed by bioinformatics analysis of merged microarray gene expression datasets

“…At the cellular or molecular level, a wide range of molecules are released during pulpal and periapical in ammation, including cytokines, proteases, in ammatory mediators, growth factors, and antimicrobial peptides [15,16]. Measurable levels of molecules can be found not only in pulp tissue but also in pulpal blood [17], dentinal uid [18,19], periapical uid [1], and gingival crevicular uid [20], which can be collected non-invasively and analysed without extirpating the pulpal tissue [19,21,22]. The factors that can used to assess the level of pulp in ammation are called biomarkers of pulpitis [23].…”