Evaluation of pulpal inflammation level in young permanent teeth using biomarker levels

Background: In today’s clinic, there are no definitive diagnostic criteria for determining the level of pulp inflammation. Increased biomarker levels in pulp inflammation enable the quantitative measurement of pulp inflammation and provide objective data. Based on this, in our study, the level of pulp inflammation was measured using biomarkers, and the increased biomarker level was compared with the clinical parameters used to determine the level of pulp inflammation. In addition, biomarker levels were compared in teeth classified as reversible pulpitis (RP) and irreversible pulpitis (IRP) according to clinical diagnostic parameters. Furthermore, the effect of Presepsin, a novel biomarker used in the assessment of pulp inflammation, was demonstrated. Methods: The study was conducted on teeth that underwent pulpotomy and were classified as RP (n = 30) and IRP (n = 30) based on clinical parameters. During the treatment period, pain, bleeding time, severity and color findings were recorded. Bleeding samples were taken to measure the level of inflammation in pulp, and the biomarkers TNF-α (Tumor Necrosis Factor α), IL-6 (Interleukin 6), IL-1β (Interleukin 1β), IL-8 (Interleukin 8), and Presepsin were evaluated. Results: When clinical parameters were examined, a significant difference was found between the presence of spontaneous pain, pulp bleeding more than 3 minutes, severe bleeding, and an increase in biomarker levels. When comparing the pulp of RP and IRP teeth, biomarker levels in the coronal pulp were similar, while in the radicular pulp, biomarker levels in IRP teeth were significantly higher. Presepsin demonstrated the highest sensitivity and specificity in distinguishing IRP teeth from RP teeth. Conclusions: Clinically assessed pain, pulp bleeding time and severity data can be considered in the evaluation of pulp inflammation. Among the biomarkers, Presepsin, which has the highest sensitivity and specificity in distinguishing between RP and IRP teeth, can be considered an important biomarker in the evaluation of pulp inflammation.

Dental pulp diseases; Pulpotomy; Biomarkers; Presepsin

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