Abstract
Introduction
Pulpal diagnostics might be improved by using molecular markers found in dentinal
fluid. In the current pilot study, we tested whether matrix metallopeptidase 9 (MMP-9)
levels in dentinal fluid were detectable and differed between pulps from symptomatic
teeth diagnosed with irreversible pulpitis and healthy counterparts.
Methods
Thirty-one patients participated; 19 were diagnosed with irreversible pulpitis, and
12 were in need of replacement of a filling close to the pulp space in a clinically
healthy tooth. Dentinal fluid was collected during a period of 2 minutes from dentin
cavities by using folded polyvinylidene difluoride (PVDF) membranes, which were then
transferred to microcentrifugation tubes containing physiologic saline solution. Total
MMP-9 levels in these solutions were assessed by using a human MMP-9 fluorescent assay,
detection limit 0.25 ng/mL. MMP-9 levels between groups were compared by using Mann-Whitney
U test (alpha <0.05).
Results
Three specimens from the symptomatic teeth were not included because coronal pulps
proved to be necrotic on access. Dentinal fluid samples from symptomatic teeth had
significantly higher MMP-9 levels than those from clinically healthy counterparts
(P < .05). However, merely 7 of the 16 pulpitis samples contained detectable levels
of MMP-9. None of the clinically healthy control specimens contained any detectable
amounts of MMP-9.
Conclusions
With a sensitive assay, it was possible to detect an enzyme linked with pulp tissue
destruction (MMP-9) in dentinal fluid. However, the collection method needs to be
improved to provide predictable fluid yields. Longitudinal studies should be performed
to assess the predictive value of molecular markers in dentinal fluid on pulpal pathosis.
Key Words
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© 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
