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Assessing MMP levels in pulpitis and efficacy of calcium-silicate cements in pediatric pulpotomy

Pulpitis, Pediatrics Pulpitis, Pediatrics
Pulpitis, Pediatrics Pulpitis, Pediatrics

This study aimed to compare levels of matrix metalloproteinases (MMPs) in reversible and irreversible pulpitis. It also evaluated the effectiveness of two different calcium-silicate cements (mineral trioxide aggregate [MTA] and biodentine) as pulpotomy treatments in primary molars.

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Key take away

MMP-2 and MMP-9 levels in pulpal blood may help assess pulpal inflammation and differentiate between reversible and irreversible pulpitis in primary teeth.  Both biodentine and mineral trioxide aggregate are effective for pediatric pulpotomy in primary molars.

Background

This study aimed to compare levels of matrix metalloproteinases (MMPs) in reversible and irreversible pulpitis. It also evaluated the effectiveness of two different calcium-silicate cements (mineral trioxide aggregate [MTA] and biodentine) as pulpotomy treatments in primary molars.

Method

In this parallel randomized controlled trial, healthy pediatrics (age range 5 to 10 years) were enrolled. Overall, 63 mandibular primary second molars were studied. Group 1 included 42 teeth with reversible pulpitis, while Group 2 had 21 teeth with irreversible pulpitis. Group 1 was split into two subgroups of 21 teeth each. Researchers measured MMP-2, MMP-8, and MMP-9 levels in all samples. Pulpotomy treatments using MTA and Biodentine were done in Group 1, with clinical and radiographic evaluations over 18 months. Statistical analyses included the Fisher's exact test, Kolmogorov-Smirnov test, and t-test.

Result

MMP-2 and MMP-9 expression was markedly higher in specimens with irreversible pulpitis, suggesting a link between these enzymes and the severity of inflammation. Importantly, no vital difference was witnessed in the clinical success rates of pulpotomies performed with either MTA or biodentine, indicating both materials are equally useful for treating primary molars with reversible pulpitis.

Conclusion

The levels of MMP-2 and MMP-9 in pulpal blood could serve as valuable biomarkers for examining pulpal inflammation in primary teeth, making them valuable for diagnosis. Furthermore, biodentine's positive clinical results in pulpotomy procedures support its role as a reliable substitute for MTA in pediatric dentistry.

Source:

BMC Oral Health

Article:

Assessment of MMP levels in reversible and irreversible pulpitis and a randomized controlled trial comparing clinical success of two different calcium-silicate cements in pulpotomy treatment of primary molars with an 18-month follow-up

Authors:

Hazal Ezgi Gerihan et. al.

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