Elfezary Mohamed Taha, Waly Ahmed Safaa, Mohamed Eman Hamdy
Department of Pediatric Dentistry, Faculty of Dentistry, Al-Azhar University, Assiut, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
BDJ Open. 2025 May 23;11(1):51. doi: 10.1038/s41405-025-00340-w.
OBJECTIVE/AIM: Dental pulp inflammation is a critical condition in endodontics. Traditional diagnostic methods, such as patient pain history and percussion tests, often lack accuracy in reflecting the true status of pulp inflammation. This study explores the feasibility of using a rapid C-reactive protein (CRP) chairside point-of-care (POC) test as a potential adjunctive tool for detecting dental pulp inflammation. The findings provide preliminary insights to inform future larger-scale validation studies.
This pilot cross-sectional observational study included 20 patients with deep carious lesions. Blood samples were collected from exposed pulp tissue under sterile conditions and analyzed using the CRP rapid POC test (index test). Patient pain history (clinical reference test) and percussion test outcomes were documented. The study assessed feasibility and preliminary diagnostic trends based on test performance and associations with clinical indicators.
The CRP rapid POC test yielded positive results in 55% of cases. Preliminary findings suggest a potential association between CRP levels and percussion test results (p < 0.001), while no significant correlation was observed between CRP levels and patient pain history. The test demonstrated an observed sensitivity of 94.3%, specificity of 87.1%, positive predictive value (PPV) of 90.7%, and negative predictive value (NPV) of 91.9%. However, given the small sample size, these estimates should be interpreted with caution, and further research with larger cohorts is necessary for validation.
This pilot study suggests that the CRP rapid POC test may have potential as a diagnostic aid for detecting dental pulp inflammation. However, these findings are preliminary, and further validation through larger studies and gold-standard comparisons is necessary before clinical implementation can be considered.
牙髓炎症是牙髓病学中的一种关键病症。传统的诊断方法，如患者疼痛史和叩诊测试，在反映牙髓炎症的真实状况时往往缺乏准确性。本研究探讨了使用快速C反应蛋白（CRP）床边即时检测（POC）作为检测牙髓炎症潜在辅助工具的可行性。研究结果为未来大规模验证研究提供了初步见解。
这项前瞻性横断面观察性研究纳入了20例患有深龋病变的患者。在无菌条件下从暴露的牙髓组织采集血样，并使用CRP快速POC检测（指标检测）进行分析。记录患者疼痛史（临床参考检测）和叩诊测试结果。该研究基于检测性能以及与临床指标的关联评估了可行性和初步诊断趋势。
CRP快速POC检测在55%的病例中得出阳性结果。初步研究结果表明CRP水平与叩诊测试结果之间可能存在关联（p < 0.001），而CRP水平与患者疼痛史之间未观察到显著相关性。该检测的观察灵敏度为94.3%，特异度为87.1%，阳性预测值（PPV）为90.7%，阴性预测值（NPV）为91.9%。然而，鉴于样本量较小，这些估计结果应谨慎解读，需要进一步开展更大样本量的研究进行验证。
这项初步研究表明，CRP快速POC检测可能具有作为检测牙髓炎症诊断辅助手段的潜力。然而，这些结果是初步的，在考虑临床应用之前，有必要通过更大规模的研究和与金标准进行比较来进一步验证。
