Biomarkers for Differentiating Reversible and Irreversible Pulpitis (PULPBIOM)
July 30, 2026 updated by: Safa
Role of Inflammatory, Oxidative Stress, Neurogenic, and Immunological Biomarkers in Pulp Blood for the Differential Diagnosis of Reversible and Irreversible Pulpitis
This observational study aims to evaluate the role of inflammatory, oxidative stress, neurogenic, and immunological biomarkers obtained from pulpal blood in the differential diagnosis of normal pulp, reversible pulpitis, and irreversible pulpitis.
A total of 75 teeth from systemically healthy individuals aged 12-35 years will be included and classified into three groups: normal pulp, reversible pulpitis, and irreversible pulpitis, based on clinical examination, radiographic findings, and pulp sensibility tests. No additional treatment procedures will be performed for research purposes. All dental procedures will be carried out according to routine clinical protocols.
During routine treatment, after pulp exposure, approximately 50 μL of pulpal blood that would otherwise be discarded as medical waste will be collected using a micropipette. Samples will be stored and analyzed using Enzyme-Linked ImmunoSorbent Assay (ELISA) to determine the levels of inflammatory, neurogenic, immunological, and oxidative stress biomarkers. The results will be compared among the three groups to identify biomarkers that may improve the accuracy of pulpitis diagnosis and support clinical decision-making.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Current diagnosis of pulpal status relies primarily on clinical symptoms, sensibility tests, and radiographic findings, which may not always accurately reflect the underlying histopathological condition of the pulp.
This study aims to investigate inflammatory, neurogenic, immunological, and oxidative stress biomarkers obtained from pulpal blood samples collected during routine dental treatment.
Biomarker levels will be compared among teeth with normal pulp, reversible pulpitis, and irreversible pulpitis.
The findings may contribute to the development of objective diagnostic tools for more accurate differentiation of pulpal conditions and improved treatment decision-making.
Study Type
Observational
Enrollment (Actual)
90
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Kütahya
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Kütahya, Kütahya, Turkey (Türkiye), 43100
- Kütahya Health Sciences University Faculty of Dentistry
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Yes
Sampling Method
Non-Probability Sample
Study Population
Adults aged 12-35 years who presented to the Department of Endodontics or Pediatric Dentistry for routine restorative or root canal treatment and met the study eligibility criteria.
Participants were classified into three groups according to pulpal diagnosis: normal pulp, reversible pulpitis, and irreversible pulpitis.
Only systemically healthy individuals with vital teeth and sufficient pulpal blood sample collection during routine treatment procedures were included.
Description
Inclusion Criteria:
- Individuals aged 12 to 35 years
- Systemically healthy individuals
- Patients presenting for routine restorative treatment or root canal treatment
- Teeth classified into one of the following pulpal status groups: healthy pulp, reversible pulpitis, or irreversible pulpitis
- Confirmation of pulp vitality by pulp sensibility tests
- Ability to obtain pulp exposure and collect an adequate pulpal blood sample during treatment
Exclusion Criteria:
- No response to pulp sensibility tests
- Teeth that are not restorable
- Presence of a sinus tract
- Radiographic evidence of periapical pathology
- Presence of internal or external root resorption
- Teeth with open apices
- Presence of systemic disease
- Pregnancy
- History of non-steroidal anti-inflammatory drug (NSAID) or antibiotic use within the last week
- Requirement for prophylactic antibiotic use
- Teeth in which pulp exposure cannot be achieved after complete caries removal
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Normal Pulp
Teeth diagnosed with healthy pulp and scheduled for elective root canal treatment due to prosthetic indications.
|
Collection of pulpal blood samples during routine dental treatment followed by biomarker analysis using ELISA.
|
|
Reversible Pulpitis
Teeth diagnosed with reversible pulpitis based on clinical examination, radiographic findings, and pulp sensibility tests.
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Collection of pulpal blood samples during routine dental treatment followed by biomarker analysis using ELISA.
|
|
Irreversible Pulpitis
Teeth diagnosed with irreversible pulpitis based on clinical examination, radiographic findings, and pulp sensibility tests.
|
Collection of pulpal blood samples during routine dental treatment followed by biomarker analysis using ELISA.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Levels of inflammatory, neurogenic, immunological, and oxidative stress biomarkers in pulpal blood samples
Time Frame: At the time of treatment (baseline)
|
Comparison of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), matrix metalloproteinase-9 (MMP-9), transforming growth factor-beta 1 (TGF-β1), presepsin, substance p, semaphoric 3A (SEMA3A), semaphoric 4D (SEMA4D), semaphoric 7A (SEMA7A), total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD) levels among healthy pulp, reversible pulpitis, and irreversible pulpitis groups.
|
At the time of treatment (baseline)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic performance of pulpal blood biomarkers
Time Frame: At the time of treatment (baseline)
|
Evaluation of the ability of measured biomarkers to differentiate healthy pulp, reversible pulpitis, and irreversible pulpitis.
|
At the time of treatment (baseline)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 1, 2025
Primary Completion (Actual)
June 1, 2026
Study Completion (Actual)
June 10, 2026
Study Registration Dates
First Submitted
June 14, 2026
First Submitted That Met QC Criteria
June 14, 2026
First Posted (Actual)
June 22, 2026
Study Record Updates
Last Update Posted (Actual)
July 31, 2026
Last Update Submitted That Met QC Criteria
July 30, 2026
Last Verified
July 1, 2026
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- KURNAZ-PULPBIOMARKERS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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