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Symptom correlation and spatial distribution of inflammatory mediators in pulpitis-A preliminary study
Ai Leen Shu Jen Loo1, Rong Cen1, Junwen Wang2
1Endodontics, Restorative Dental Sciences, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, Hong Kong.
International Endodontic Journal
|June 26, 2025
Summary
This study identifies specific inflammatory mediators, such as Interleukin-1 beta (IL-1β), as potential biomarkers for distinguishing between reversible and irreversible pulpitis. Findings highlight distinct inflammatory patterns correlating with symptom severity in teeth.
Area of Science:
- Biomarkers in Endodontics
- Molecular basis of pulp inflammation
- Dental diagnostics
Background:
- Pulpitis, an inflammation of the dental pulp, presents a spectrum from reversible to irreversible stages.
- Accurate diagnosis and differentiation of pulpitis stages are crucial for effective endodontic treatment planning.
- Understanding the spatial distribution of inflammatory mediators within the tooth may offer diagnostic insights.
Purpose of the Study:
- To investigate the association between specific inflammatory mediators and clinical signs/symptoms of pulpitis.
- To analyze the spatial distribution of these mediators within coronal and radicular pulp blood.
- To evaluate the potential of these mediators as diagnostic biomarkers for pulpitis severity.
Main Methods:
- Analysis of 52 inflammatory mediators in pulp blood samples from 50 adult teeth (normal pulp, reversible pulpitis, irreversible pulpitis).
- Collection of blood samples from both coronal (exposure site) and radicular (orifice level) pulp regions.
- Utilized multiplex immunoassay for mediator quantification and statistical analysis (p < 0.05) for comparisons.
Main Results:
- Transforming Growth Factor alpha (TGFα) and Fibroblast Growth Factor 2 (FGF-2) were downregulated in all pulpitis stages compared to healthy controls.
- Interleukin-1 beta (IL-1β) was significantly elevated in the radicular blood of irreversible pulpitis compared to reversible pulpitis.
- Distinct spatial patterns observed: reversible pulpitis showed higher coronal markers, while irreversible pulpitis had elevated fractalkine and IL-2 in radicular regions. Symptomatic teeth showed increased IL-22 (coronal) and IL-13 (radicular).
Conclusions:
- Interleukin-1 beta (IL-1β) shows promise as a biomarker to differentiate reversible from irreversible pulpitis.
- Transforming Growth Factor alpha (TGFα) and Fibroblast Growth Factor 2 (FGF-2) may serve as diagnostic biomarkers for pulpitis states.
- Several mediators (IL-1α, IL-13, IL-17A, IL-22, TGFα, MMP2) show potential in differentiating symptomatic from asymptomatic irreversible pulpitis, with patterns correlating to symptom severity.
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