Gen Dent. 2021 May-Jun;69(3):73-77.
Irreversible pulpitis is an acute, brief, and painful condition. Oxytocin, cortisol, and secretory immunoglobulin A (sIgA) are released by the body in response to pain and emotional stress. The aim of this study was to investigate the expression of salivary cortisol, sIgA, and oxytocin among patients with irreversible pulpitis. This was an ethically approved case-control study comparing 90 cases of irreversible pulpitis and 40 healthy individuals. Five study groups were established: nonpregnant female pulpitis, pregnant female pulpitis, male pulpitis, healthy (nonpregnant) female control, and healthy male control. Pregnant women in the first trimester were enrolled in the study. Participants received both clinical and radiographic examinations, completed a simple questionnaire related to food intake, habits, and anxiety, and their pain levels were recorded on a visual analog scale in which 0 represented no pain and 10 represented the worst possible pain. Unstimulated saliva samples were collected to measure oxytocin, sIgA, and cortisol levels. Dental pulp specimens were obtained and stained with hematoxylin and eosin to evaluate the agreement between clinical and histologic pulpal diagnoses. The statistical analysis included analysis of variance and Tukey tests. The majority of patients (37%) recorded a score of 8 (severe pain) on the visual analog scale, while a score of 10 (worst possible pain) was recorded only by pregnant women (3%). There was no statistically significant difference among healthy subjects for all salivary samples. Oxytocin levels increased significantly in nonpregnant (P < 0.5) and pregnant (P < 0.001) women with pulpitis. Cortisol (P < 0.01) and sIgA (P < 0.001) levels were significantly elevated only in pregnant women with pulpitis. The results of the present study indicate that acute dental pain during pregnancy can be considered as a pregnancy risk factor because of the resulting elevated oxytocin and cortisol levels.
不可复性牙髓炎是一种急性、短暂且伴有疼痛的病症。人体在感受到疼痛和情绪压力时会释放催产素、皮质醇和分泌型免疫球蛋白 A（sIgA）。本研究旨在探究不可复性牙髓炎患者唾液中皮质醇、sIgA 和催产素的表达情况。这是一项经伦理批准的病例对照研究，比较了 90 例不可复性牙髓炎患者和 40 名健康个体。建立了 5 个研究组：非妊娠女性牙髓炎组、妊娠女性牙髓炎组、男性牙髓炎组、健康（非妊娠）女性对照组和健康男性对照组。研究纳入了妊娠第一孕期的女性。参与者接受了临床和影像学检查，完成了一份与饮食、习惯和焦虑相关的简单问卷，并在视觉模拟评分上记录了他们的疼痛程度，0 表示无痛，10 表示最剧烈的疼痛。采集未刺激唾液样本以测量催产素、sIgA 和皮质醇水平。获取牙髓标本并进行苏木精和伊红染色，以评估临床和组织学牙髓诊断之间的一致性。统计分析包括方差分析和 Tukey 检验。大多数患者（37%）在视觉模拟评分上记录了 8 分（剧烈疼痛），而只有妊娠女性（3%）记录了 10 分（最剧烈的疼痛）。健康受试者的所有唾液样本之间均无统计学差异。非妊娠（P < 0.5）和妊娠（P < 0.001）牙髓炎女性的催产素水平显著升高。皮质醇（P < 0.01）和 sIgA（P < 0.001）水平仅在妊娠牙髓炎女性中显著升高。本研究结果表明，妊娠期间急性牙痛可被视为妊娠的危险因素，因为这会导致催产素和皮质醇水平升高。
