During endodontic treatment of vital cases, are we able to quantify the level of biomarkers present in small samples of pulp tissue excised from the pulp chamber?
What is the appropriate/best methodology to quantify that biomarker?
One possibility is the concentration of MMP-9 .Is as a marker to differentiate between reversible and irreversible pulpitis.
n the included studies, irreversible pulpitis was associated with different expression of various biomarkers compared to non-inflamed controls. These biomarkers were significantly expressed not only in pulp tissue, but also in gingival crevicular fluid that can be collected non-invasively and in dentin fluid that can be analyzed without extirpating the pulpal tissue. This may be used to accurately differentiate diseased from healthy pulp tissue. The main current challenges in the clinical application of biomarkers lie in the identification of biomarkers or biomarker subsets that reliably correlate with pulpal inflammation, the improvement of sample collection (substrate and protein yields), and their analysis (interference of the biomarkers with inflammation of other than pulpal origin). If these hurdles can be overcome, a more accurate pulpal diagnosis and more predictable vital pulp treatment regime may create better clinical outcomes.