{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:09:46Z","timestamp":1792613386332,"version":"4.5.0"},"reference-count":56,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the association of inflammatory mediators with clinical signs and symptoms and their spatial distribution in teeth with pulpitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      Fifty permanent teeth from adults with clinical diagnoses of normal pulp (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917), reversible pulpitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) and symptomatic\/asymptomatic irreversible pulpitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920), were recruited. Two pulp blood samples from each tooth, one at the pulp exposure site (coronal blood) and one at the orifice level (radicular blood), were collected and analysed using multiplex immunoassay. The expression of 52 inflammatory mediators was analysed to compare regional variations within teeth, between groups and amongst teeth with pulpitis regrouped by symptom severity. Statistical comparisons were made using paired comparison tests at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TGF\u03b1 and FGF\u20102 were significantly downregulated in teeth with reversible and irreversible pulpitis compared with healthy controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). IL\u20101\u03b2 was significantly upregulated in the radicular blood of teeth with irreversible pulpitis compared with reversible pulpitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Higher concentrations of inflammatory markers were found in the coronal blood of reversibly inflamed teeth, whilst irreversibly inflamed teeth exhibited elevated fractalkine and IL\u20102 in radicular regions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The spatial distribution of biomarkers in teeth with pulpitis after regrouping by symptom severity demonstrated increased IL\u201022 in coronal blood and IL\u201013 in radicular blood in symptomatic teeth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Radicular blood of teeth with mild symptomatic pulpitis showed significantly increased levels of IL\u201017A but decreased concentrations of TGF\u03b1 and MMP\u20102 compared to asymptomatic teeth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Teeth with severe symptomatic pulpitis exhibited significantly higher levels of IL\u20101\u03b1 and TGF\u03b1 in coronal blood compared with asymptomatic irreversible pulpitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Symptomatic teeth generally exhibited more pronounced coronal inflammatory mediator expression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IL\u20101\u03b2 is a promising biomarker for distinguishing between reversible and irreversible pulpitis. TGF\u03b1 and FGF\u20102 demonstrate significant potential as diagnostic biomarkers in discriminating between states of pulpitis and health. IL\u20101\u03b1, IL\u201013, IL\u201017A, IL\u201022, TGF\u03b1 and MMP2 also showed potential to differentiate between teeth with symptomatic and asymptomatic irreversible pulpitis. Both classification systems used revealed distinct inflammatory mediator patterns, which were found to be correlated with symptom severity, particularly in the coronal region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iej.14275","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T06:14:05Z","timestamp":1750918445000},"page":"1565-1581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Symptom correlation and spatial distribution of inflammatory mediators in pulpitis\u2014A preliminary study"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2913-6423","authenticated-orcid":false,"given":"Ai Leen Shu Jen","family":"Loo","sequence":"first","affiliation":[{"name":"Endodontics, Restorative Dental Sciences Faculty of Dentistry, the University of Hong Kong  Hong Kong SAR Hong 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