Effect of endodontic treatment on local inflammatory biomarkers in teeth with apical periodontitis

Abstract

Abstract

Effect of endodontic treatment on local inflammatory biomarkers in teeth with apical periodontitis

Sam Yun DDS, Joshua Hong DMD MMSc, Pallavi Suhag DDS MMSc, Summer Tan, Ozge Erdogan DDS DMSc, Jennifer Gibbs DDS PhD

Introduction: The purpose of this study was to measure biomarkers from teeth with apical periodontitis through gingival crevicular fluid (GCF) and periapical fluid( PF) to capture the host response after root canal therapy.

Methodology: Participants with pulpal necrosis with radiographic signs of periapical pathology, requiring primary root canal treatment (RCT) were recruited for the study. Clinical/radiographic data were collected at each visit. GCF was collected from a healthy control tooth and a diseased tooth pre-operatively (1st visit), at the 2nd treatment visit, and at 1-month and 6-month follow up visits. PF samples were collected at the 1st visit after cleaning and shaping and at the 2nd visit before obturation. Samples were analyzed using multiplex immuno-assays (Meso Scale Discovery), for multiple targets.

Results: For this analysis, samples from 11 participants were analyzed. When comparing GCF biomarkers between study visit 1 and 2: In the success group, there was a decrease or no change in expression for IL-1B, IL-4, IL-13, MMP-2, and MMP-9 and an increase in expression for IL-2. In the failure group, there was an increase in expression for all biomarkers. When comparing PF biomarkers between study visit 1 and 2: In the success group, there was a decrease in expression in IL-1b, IL-4, MMP-2, and MMP-9 and an increase in expression in IL-13. In the failure group, there was an increase in expression for all biomarkers except IL-4. In both groups, IL-2 was not detected. When analyzing the correlation between GCF/PF in study visit 1 and 2: The first study visit had a moderate positive correlation with the coefficient of determination being 0.3169 and the second study visit had a stronger positive correlation with the coefficient of determination being 0.7884. Lastly, when comparing GCF biomarkers between study visit 1 and 4: In the success group, there was a decrease in expression in all cytokines except IL-1b. In the failure group, there was an increase in expression in IL-1b, IL-2, MMP-2, no change in expression, in MMP-2, and decrease in expression in IL-4 and IL-13.

Conclusion: IL-1b and MMP-9 showed decrease in expression in the GCF and PF samples in the success group and increase in expression in the failure group at the early time points. MMP-2 showed increase in expression in the GCF and PF samples in the failure group at the early time points, and decrease in expression in the success group at the late time point. IL-4 showed decrease in expression in the GCF and PF samples in the success group at late time point. IL-2 showed increase in expression in the GCF and PF samples in the failure group at both the early and late time points. For study visits 1 and 2, GCF and PF showed similar biomarker patterns, and therefore GCF can be a good reflection of what is going on in the periapical region. Potential biomarkers that may merit further investigation can include IL-2, MMP-2, and MMP-9.