{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:49:59Z","timestamp":1791377399301,"version":"4.3.2"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Int Soc Prev Community Dent"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>bstract<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Biomarker-based evaluation of endodontic outcomes offers an objective alternative to traditional clinical assessments. The human nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing-3 (NLRP3) inflammasome is emerging as a potential indicator in inflammatory dental conditions. The aim was to correlate changes in pain levels with gingival crevicular fluid (GCF) levels of the NLRP3 inflammasome in patients with symptomatic irreversible pulpitis (SIP), before and after nonsurgical endodontic treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This nonrandomized matched comparative study included 15 SIP patients (45 teeth: involved, adjacent, and contralateral) and 15 healthy controls (15 teeth). GCF samples were analyzed via enzyme-linked immunosorbent assay. Pain was assessed using the Heft Parker visual analog scale (HP-VAS). Data were analyzed using linear mixed models, the Wilcoxon signed-rank test, and the Spearman correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Baseline GCF-NLRP3 levels were significantly higher in SIP-affected teeth (4.33 \u00b1 0.98 ng\/mL) than in controls (1.34 \u00b1 0.45 ng\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). A significant difference was observed between involved and contralateral teeth (mean difference = 2.96; 95% CI = 2.28\u20133.65). Post-treatment levels in both involved and adjacent teeth decreased (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). HP-VAS scores also showed a significant reduction (median difference: 69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The reduction in the NLRP3 inflammasome activity was significantly correlated with pain reduction, with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value (&lt;0.001) after the treatment (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.686; 95% CI = 0.22\u20130.91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>GCF-NLRP3 levels can serve as a reliable biomarker for evaluating endodontic treatment outcomes in SIP, reflecting both local inflammation and patient-reported pain. Integrating GCF-NLRP3 monitoring may enhance the diagnostic accuracy and inform treatment planning. Future studies should assess longitudinal trends and therapeutic thresholds. GCF-NLRP3 could be a promising biomarker for assessing the outcome of endodontic treatment. This finding opens up new possibilities for improving the efficacy of endodontic procedures and, ultimately, patient care<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>The clinical study was registered under the clinical trial registry-India www.ctri.nic.in (CTRI\/2023\/07\/055526) on July 24, 2023. The supporting document can be produced through requisition mail to the corresponding author.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jispcd.jispcd_31_25","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T16:06:56Z","timestamp":1759853216000},"page":"415-425","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["GCF NLRP3 as a Biomarker for Assessing Endodontic Treatment Outcomes in Symptomatic Irreversible Pulpitis: A Comparative Nonrandomized, Observational Cross-Sectional Study"],"prefix":"10.4103","volume":"15","author":[{"given":"Neha","family":"Neha","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dax","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjana","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpa","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev Kumar","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Delhi Cancer Registry, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"CIT0001-20251030","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.cden.2016.08.009","article-title":"Endodontic treatment outcomes","volume":"61","author":"Chugal","year":"2017","journal-title":"Dent Clin North Am"},{"key":"CIT0002-20251030","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/febs.13133","article-title":"Structural mechanisms of inflammasome assembly","volume":"282","author":"Lu","year":"2015","journal-title":"FEBS J"},{"key":"CIT0003-20251030","doi-asserted-by":"crossref","first-page":"4223","DOI":"10.3390\/ijms21124223","article-title":"Focus on the role of NLRP3 inflammasome in diseases","volume":"21","author":"Fusco","year":"2020","journal-title":"Int J Mol Sci"},{"key":"CIT0004-20251030","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/s41392-023-01687-y","article-title":"The role of inflammasomes in human diseases and their potential as therapeutic targets","volume":"9","author":"Yao","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"CIT0005-20251030","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/iej.13855","article-title":"Regulation of caries-induced pulp inflammation by NLRP3 inflammasome: A laboratory-based investigation","volume":"56","author":"Al Natour","year":"2023","journal-title":"Int Endod J"},{"key":"CIT0006-20251030","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.joen.2012.09.023","article-title":"NLRP3 is expressed in human dental pulp cells and tissues","volume":"38","author":"Song","year":"2012","journal-title":"J Endod"},{"key":"CIT0007-20251030","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s00441-015-2118-7","article-title":"Activation of the NLRP3\/caspase-1 inflammasome in human dental pulp tissue and human dental pulp fibroblasts","volume":"361","author":"Jiang","year":"2015","journal-title":"Cell Tissue Res"},{"key":"CIT0008-20251030","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/iej.13762","article-title":"Effectiveness of diagnosing pulpitis: A systematic review","volume":"56","author":"Donnermeyer","year":"2023","journal-title":"Int Endod J"},{"key":"CIT0009-20251030","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1902\/jop.2017.170244","article-title":"Salivary levels of NLRP3 inflammasome-related proteins as potential biomarkers of periodontal clinical status","volume":"88","author":"Isaza-Guzm\u00e1n","year":"2017","journal-title":"J Periodontol"},{"key":"CIT0010-20251030","doi-asserted-by":"crossref","first-page":"552","DOI":"10.4103\/jisp.jisp_185_23","article-title":"Salivary levels of NLRP3 protein are significantly raised in chronic periodontitis: A systematic review and meta-analysis of clinical studies","volume":"27","author":"Abraham","year":"2023","journal-title":"J Indian Soc Periodontol"},{"key":"CIT0011-20251030","doi-asserted-by":"crossref","first-page":"307","DOI":"10.4103\/jispcd.JISPCD_55_23","article-title":"Gingival crevicular fluid levels of neurokinin A and substance P in patients with symptomatic irreversible pulpitis: A systematic review and meta-analysis","volume":"13","author":"Abraham","year":"2023","journal-title":"J Int Soc Prev Community Dent"},{"key":"CIT0012-20251030","doi-asserted-by":"crossref","first-page":"227\u2013233","DOI":"10.11607\/ofph.2007","article-title":"Acute dental pain and salivary biomarkers for stress and inflammation in patients with pulpal or periapical inflammation","volume":"33","author":"Haug","year":"2019","journal-title":"J Oral Facial Pain Headache"},{"key":"CIT0013-20251030","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.5395\/rde.2020.45.e40","article-title":"Effects of endodontic treatment on salivary levels of CGRP and substance P: A pilot study","volume":"45","author":"Arslan","year":"2020","journal-title":"Restor Dent Endod"},{"key":"CIT0014-20251030","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1016\/j.joen.2020.07.013","article-title":"Comparison of neurokinin A, substance P, interleukin 8, and matrix metalloproteinase-8 changes in pulp tissue and gingival crevicular fluid samples of healthy and symptomatic irreversible pulpitis teeth","volume":"46","author":"Akbal Dincer","year":"2020","journal-title":"J Endod"},{"key":"CIT0015-20251030","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.joen.2023.08.013","article-title":"Symptomatic irreversible pulpitis induces increased levels of human NLRP3 in gingival crevicular fluid compared to saliva: A case control observational study","volume":"49","author":"Abraham","year":"2023","journal-title":"J Endod"},{"key":"CIT0016-20251030","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.3390\/molecules26051208","article-title":"Gingival crevicular fluid (GCF): A diagnostic tool for the detection of periodontal health and diseases","volume":"26","author":"Bibi","year":"2021","journal-title":"Molecules"},{"key":"CIT0017-20251030","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/0304-3959(84)90835-2","article-title":"An experimental basis for revising the graphic rating scale for pain","volume":"19","author":"Heft","year":"1984","journal-title":"Pain"},{"key":"CIT0018-20251030","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/2041-210X.13434","article-title":"Robustness of linear mixed-effects models to violations of distributional assumptions","volume":"11","author":"Schielzeth","year":"2020","journal-title":"Methods Ecol Evol"},{"key":"CIT0019-20251030","doi-asserted-by":"crossref","first-page":"2576","DOI":"10.3758\/s13428-021-01587-5","article-title":"Violating the normality assumption may be the lesser of two evils","volume":"53","author":"Knief","year":"2021","journal-title":"Behav Res Methods"},{"key":"CIT0020-20251030","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1111\/j.1365-2591.2006.01180.x","article-title":"Quality guidelines for endodontic treatment: Consensus report of the European Society of Endodontology","volume":"39","year":"2006","journal-title":"Int Endod J"},{"key":"CIT0021-20251030","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.joen.2023.01.005","article-title":"Impact of case difficulty, endodontic mishaps, and instrumentation method on endodontic treatment outcome and quality of life: A four-year follow-up study","volume":"49","author":"Johnsen","year":"2023","journal-title":"J Endod"},{"key":"CIT0022-20251030","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.joen.2007.10.022","article-title":"Interleukin-8 is increased in gingival crevicular fluid from patients with acute pulpitis","volume":"34","author":"Karapanou","year":"2008","journal-title":"J Endod"},{"key":"CIT0023-20251030","doi-asserted-by":"crossref","first-page":"e0167289","DOI":"10.1371\/journal.pone.0167289","article-title":"Biological markers for pulpal inflammation: A systematic review","volume":"11","author":"Rechenberg","year":"2016","journal-title":"PLoS One"},{"key":"CIT0024-20251030","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/j.joen.2017.02.009","article-title":"Pulp inflammation diagnosis from clinical to inflammatory mediators: A systematic review","volume":"43","author":"Zanini","year":"2017","journal-title":"J Endod"},{"key":"CIT0025-20251030","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/iej.13950","article-title":"Molecular biomarkers for objective assessment of symptomatic pulpitis: A systematic review and meta-analysis","volume":"56","author":"Karrar","year":"2023","journal-title":"Int Endod J"},{"key":"CIT0026-20251030","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/00004770-200201000-00005","article-title":"Vascular endothelial growth factor (VEGF) expression in healthy and inflamed human dental pulps","volume":"28","author":"Artese","year":"2002","journal-title":"J Endod"},{"key":"CIT0027-20251030","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/S0099-2399(96)80242-1","article-title":"Neurogenic inflammation and tooth pulp innervation pattern in sympathectomized rats","volume":"22","author":"Komorowski","year":"1996","journal-title":"J Endod"}],"container-title":["Journal of International Society of Preventive and Community Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_31_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:28:37Z","timestamp":1787837317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_31_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jispcd.jispcd_31_25","relation":{},"ISSN":["2231-0762","2250-1002"],"issn-type":[{"value":"2231-0762","type":"print"},{"value":"2250-1002","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-02-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}