Detection Of Inflammatory And Homeostasis Biomarkers After Selective Removal Of Carious Dentin-An In Vivo Feasibility Study

Deep carious dentin lesions induce an immune reaction within the pulp-dentin complex, leading to the release of cytokines, which might be suitable biomarkers in pulp diagnostics. This in vivo feasibility study determines the concentration of different cytokines after selective removal of carious infected dentin (SCR). In our methodology, paired samples are obtained from 21 patients-each of them with two deep carious lesions at posterior teeth without clinical symptoms. After SCR, lesions are randomly assigned to treatment strategy: Group 1 (11 patients): Carious dentin is covered either with Biodentine(TM) (n = 11) or gutta-percha (n = 11) before using the adhesive Optibond(TM) FL. Group 2 (10 patients): The adhesives Clearfil(TM) SE Protect Bond (n = 10) or Clearfil(TM) SE Bond 2 (n = 10) are directly applied. Prepared cavities are rinsed with phosphate buffered saline containing 0.05% Tween 20 (10X) for five minutes immediately after SCR (visit 1) and eight weeks later (visit 2). Rinsing liquid is regained. Concentrations of IL-1 beta, IL-6, IL-10, C-reactive protein (CRP), TNF-alpha, IFN-gamma, TIMP-1, -2, and MMP-7, -8, -9 are assessed by customized multiplex assays, evaluated with fluorescence analyzer. Non-parametric statistical analysis (Wilcoxon, Mann-Whitney U Test, p < 0.05) is performed (SPSS 25). Our results show that concentrations of CRP, IL-1 beta, IL-6, TIMP-1, -2, and MMPs were detectable. Median concentrations of CRP, IL-1 beta und IL-6 were significantly higher in visit 1 (304.9, 107.4, 3.8 pg/mL), compared to visit 2 (67.8, 2.3, 0.0 pg/mL; p(i) < 0.001). The study revealed that the non-invasive determination of cytokines from prepared dental cavities is possible.