Dentinal And Crevicular Fluids As Diagnostic Tool For Pulp Inflammation

To evaluate the concentration of alpha-1-antichymotrypsin in dentinal fluid and lactate dehydrogenase (LDH) and alkaline phosphatase (ALKP) in gingival crevicular fluid (GCF) in teeth with reversible and irreversible pulpitis. Dentinal fluid samples (n=117) and gingival crevicular fluid (n=117) were collected from 117 maxillary and mandibular molars, originating 1 control and 3 experimental groups: G1 (control) – clinically healthy pulp; G2 – initial pulpitis; G3 - acute pulpitis; G4 – chronic pulpitis. Dentinal fluid was collected using cellulose membrane; GCF samples were collected using absorbent paper points size 20. As soon as the samples were obtained, the teeth were extracted and serial histological sections were prepared for histomorphological study in order to confirm clinical diagnosis. Alpha-1-antichymotrypsin (AACT) in dentinal fluid samples were analyzed by enzyme-linked immunosorbent assay, LDH and ALKP in GCF samples were evaluated by spectrophotometric analysis. The results defined that there was a significant difference in AACT concentration between groups (р<0.01). Data of Tukey post hoc test showed that the concentration of AACT in the control group doesn't statistically differ from the group 4. In the group 2 was identified the highest AACT-concentration more than 5.35 ng/ml (р<0.001), with decreasing inflammation extension (2.06 – 5.34 ng/ml).There was a significant difference in LDH and ALKP concentration between groups (р<0.05). Using of biomarkers of dentinal fluid and GCF as indicators of pulp inflammation appears to be a promising approach in decision making during treatment of carious deep lesions.