Department of Preventive and Restorative Dental Sciences, Advanced Specialty Program in Endodontics, University of California, San Francisco School of Dentistry, San Francisco, California.
Department of Preventive and Restorative Dental Sciences, Advanced Specialty Program in Endodontics, University of California, San Francisco School of Dentistry, San Francisco, California.
J Endod. 2024 Mar;50(3):336-343. doi: 10.1016/j.joen.2023.11.016. Epub 2023 Dec 24.
Accurately diagnosing the state of dental pulp is crucial when addressing tooth pain to determine the best treatment approach. This study aimed to investigate the concentration of inflammatory mediators in the dental pulp of mature teeth that have been exposed via caries but show no signs of apical periodontitis.
Samples of pulpal blood from adults with mature teeth responsive to pulp testing and have carious pulp exposures were obtained. These samples were analyzed for 12 inflammatory cytokines and other inflammatory proteins using the Luminex assay platform. Clinical factors were correlated with cytokine levels, and statistical analysis was performed to evaluate the impact of these factors on cytokine expression.
Of the 36 patients that were included, 44.44% took pain medications, 33.33% had prolonged pulpal bleeding, 41.67% felt spontaneous pain, and 72.22% were diagnosed with symptomatic irreversible pulpitis. Significant correlations existed between presenting pain scores and levels of interleukin (IL)-1α, IL-6, and IL-8 (P < .05). Factors like analgesic medication intake, pain to percussion, pain to thermal testing, spontaneous pain, and nocturnal pain were significantly associated with higher levels of specific inflammatory proteins. No significant associations were observed with pain to palpation, bleeding time, or pulpal diagnosis.
Inflammatory proteins, including cytokine levels may play a critical role in characterizing pulpal inflammation. Future studies should investigate the role of these potential biomarkers in determining the diagnosis of pulpitis and the prognosis of vital pulp therapy.
准确诊断牙髓状态对于处理牙痛至关重要，这有助于确定最佳的治疗方法。本研究旨在探讨龋暴露但无根尖周炎迹象的成熟恒牙牙髓中炎症介质的浓度。
从对牙髓测试有反应且有龋暴露的成人成熟牙齿中获取牙髓血样。使用 Luminex 分析平台分析这些样本中的 12 种炎症细胞因子和其他炎症蛋白。将临床因素与细胞因子水平相关联，并进行统计分析，以评估这些因素对细胞因子表达的影响。
在纳入的 36 名患者中，44.44%服用了止痛药，33.33%出现了延长的牙髓出血，41.67%感到自发性疼痛，72.22%被诊断为有症状的不可复性牙髓炎。目前的疼痛评分与白细胞介素 (IL)-1α、IL-6 和 IL-8 的水平之间存在显著相关性（P<.05）。服用镇痛药、叩诊痛、热测试痛、自发性疼痛和夜间疼痛等因素与特定炎症蛋白水平的升高显著相关。而压痛、出血时间或牙髓诊断与这些因素均无显著相关性。
炎症蛋白，包括细胞因子水平，可能在表征牙髓炎症中起关键作用。未来的研究应探讨这些潜在生物标志物在确定牙髓炎诊断和有活力的牙髓治疗预后中的作用。
