Biological markers and pulp pH values for the clinical prediction of suppurative pulpitis

This study aims to explore the association between abnormal biomarkers in gingival crevicular fluid and pulp blood pH values and the occurrence of suppurative pulpitis.

A retrospective analysis was conducted on the clinical data of 203 patients who visited Wuxi Stomatological Hospital from March 2024 to March 2025. According to clinical manifestations, the patients were divided into the chronic suppurative pulpitis group (61 cases), the acute suppurative pulpitis group (65 cases), and the orthodontic control group (77 cases). Logistic regression analysis was used to screen the risk factors for suppurative pulpitis, and a forest plot was drawn based on the analysis results. Additionally, a receiver operating characteristic (ROC) curve was plotted to evaluate the discriminatory power of the model. Moreover, scatter plots of the correlation between pulp blood pH values and various gingival crevicular fluid markers were drawn, and the predictive ability of each marker for abnormal pH values was evaluated using the ROC curve.

Pearson correlation analysis showed that IL-1β and CX3CR1 were negatively correlated with the pH value of dental pulp blood. CX3CR1 was positively correlated with the VAS pain score. Clustering heatmap showed that CX3CR1, IL-1β, TNF-α, PTX-3, and TREM-1 were highly clustered in the acute group. Multivariate Logistic regression analysis identified VAS pain score, IL-1β, and TNF-α as independent risk factors. ROC curve showed that VAS pain score, IL-1β, and TNF-α had good predictive abilities for suppurative pulpitis; IL-1β, TNF-α, CX3CR1 and ICAM-1 also showed good predictive abilities for abnormal pH values.

VAS pain score, IL-1β, and TNF-α were identified as independent predictors of suppurative pulpitis.