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Using Spatial Transcriptomics to Identify a Diagnostic Molecular Signature Associated with Reversible Dental

Samer Helal Zaky1, Dhivyaa Rajasundaram2, Alyssa Lu Lee2

  • 1University of Pittsburgh School of Dental Medicine.

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|February 6, 2026
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Summary
This summary is machine-generated.

This study reveals distinct molecular signatures in dental pulpitis, suggesting healing potential even in severe cases. Findings support improved diagnostics for vital pulp therapy, moving beyond simple reversible/irreversible classifications.

Keywords:
Spatial transcriptomicsfibroblastsmacrophagespulpitisreversibility profile

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Area of Science:

  • Endodontics
  • Molecular Biology
  • Dental Research

Background:

  • Current endodontic diagnostics rely on subjective measures, often misclassifying pulp inflammation.
  • This leads to unnecessary tooth devitalization and missed opportunities for conservative treatment.
  • Understanding pulp biology is crucial for accurate diagnosis and maintaining tooth vitality.

Purpose of the Study:

  • To investigate transcriptomic profiles of dental pulpitis.
  • To identify distinct inflammation subtypes beyond reversible/irreversible classifications.
  • To refine diagnostic approaches for pulpitis and improve case selection for vital pulp therapy.

Main Methods:

  • Spatial transcriptomics (Visium-CytAssist-V2) analyzed four dental pulp tissues.
  • Cell deconvolution and differential gene expression identified transcriptomic signatures.
  • Analysis focused on healthy pulp, reversible pulpitis, and irreversible pulpitis, particularly coronal regions near caries.

Main Results:

  • Irreversible pulpitis shared molecular features with reversible pulpitis, including immune-fibroblast ratios and neuroinflammation pathways.
  • Upregulated genes in irreversible pulpitis suggest immune signaling, cell migration, and tissue repair.
  • Specific gene expression patterns (e.g., increased PTN, CXCL14; decreased ENG, SELE) may indicate residual healing potential.

Conclusions:

  • A distinct transcriptomic profile associated with pulp healing was identified.
  • Findings support a nuanced diagnostic approach focusing on immune-fibroblast dynamics.
  • This research has implications for enhancing pulp preservation via vital pulp therapy.