{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:24:17Z","timestamp":1787772257194,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n The dental pulp, derived from mesenchymal tissue, undergoes complex inflammatory changes during the progression of dental caries. Accurate assessment of pulpal status is essential for successful pulp therapy in primary teeth, which are inherently more susceptible to pulpal involvement due to their anatomical characteristics. Conventional diagnostic methods are often unreliable in pediatric patients, particularly when treatment is performed under general anesthesia. Biomarker-based evaluation of pulpal blood may provide an objective alternative for assessing pulpal inflammation.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n This study aimed to investigate matrix metalloproteinase-9 (MMP-9) levels in pulpal blood as a potential biomarker of inflammation in primary teeth.<\/jats:p>\n <\/jats:sec>\n \n Settings and Design:<\/jats:title>\n This prospective, observational pilot study was conducted in the Department of Pediatric Dentistry, D. Y. Patil Dental School, Pune.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Ten mandibular primary second molars from healthy children aged 4\u20138 years with deep carious lesions approaching the pulp were included. Pulpal blood samples (100 \u03bcL) were collected under aseptic conditions during pulpotomy or pulpectomy procedures. Gelatin zymography was performed to assess the gelatinolytic activity of MMP-9, followed by densitometric quantification. Pulpal bleeding control time was recorded to evaluate its association with MMP-9 levels.<\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis:<\/jats:title>\n \n Data were analyzed using SPSS version 13. Associations were assessed using the Chi-square test, and differences in MMP-9 levels were analyzed using the unpaired\n t<\/jats:italic>\n -test, with statistical significance set at\n P<\/jats:italic>\n < 0.001.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Zymographic analysis revealed gelatinolytic bands corresponding to MMP-9 (71\u2013124 kDa). Intense enzymatic activity was observed in two samples from teeth diagnosed with irreversible pulpitis requiring pulpectomy, while samples from reversible pulpitis showed minimal or undetectable activity. No significant correlation was found between MMP-9 levels and pulpal hemostasis duration.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Elevated MMP-9 levels reflect severe pulpal inflammation in primary molars, highlighting its potential as a biochemical biomarker. Further large-scale studies are required to validate its diagnostic and prognostic utility in pediatric endodontics.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jisppd.jisppd_497_25","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:00:57Z","timestamp":1772175657000},"page":"57-63","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of matrix metalloproteinase-9 in pulpal blood as a biomarker of inflammation in primary teeth: An in vivo pilot study"],"prefix":"10.4103","volume":"44","author":[{"given":"Pritesh","family":"Gawali","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, D. Y. Patil Dental School, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul J.","family":"Hegde","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, D. Y. Patil Dental School, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand L.","family":"Shigli","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, D. Y. Patil Dental School, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayalaxmi","family":"Mohite","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, D. Y. Patil Dental School, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"R1-20260227","doi-asserted-by":"crossref","first-page":"788","DOI":"10.2741\/e286","article-title":"Dental pulp and dentin tissue engineering and regeneration: Advancement and challenge","volume":"3","author":"Huang","year":"2011","journal-title":"Front Biosci (Elite Ed)"},{"key":"R2-20260227","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/bja\/aet128","article-title":"Neuroinflammation and the generation of neuropathic pain","volume":"111","author":"Ellis","year":"2013","journal-title":"Br J Anaesth"},{"key":"R3-20260227","doi-asserted-by":"crossref","first-page":"665","DOI":"10.3390\/medicina58050665","article-title":"A diagnostic insight of dental pulp testing methods in pediatric dentistry","volume":"58","author":"Igna","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"R4-20260227","doi-asserted-by":"crossref","first-page":"431","DOI":"10.5005\/jp-journals-10005-3062","article-title":"Assessment of pulp chamber morphology of primary maxillary and mandibular molars using spiral computed tomography: An analytical study","volume":"18","author":"Maheshwari","year":"2025","journal-title":"Int J Clin Pediatr Dent"},{"key":"R5-20260227","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1111\/j.1365-2591.2010.01754.x","article-title":"Review of pulp sensibility tests. Part I: General information and thermal tests","volume":"43","author":"Jafarzadeh","year":"2010","journal-title":"Int Endod J"},{"key":"R6-20260227","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s00784-019-02992-z","article-title":"Pulpal anesthesia in pediatric patients following supplemental mandibular buccal infiltration in vital permanent mandibular molars with deep caries","volume":"24","author":"Chompu-Inwai","year":"2020","journal-title":"Clin Oral Investig"},{"key":"R7-20260227","doi-asserted-by":"crossref","first-page":"368504221109217","DOI":"10.1177\/00368504221109217","article-title":"Tooth root resorption: A review","volume":"105","author":"Heboyan","year":"2022","journal-title":"Sci Prog"},{"key":"R8-20260227","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/1535370217750088","article-title":"Biomarker definitions and their applications","volume":"243","author":"Califf","year":"2018","journal-title":"Exp Biol Med (Maywood)"},{"key":"R9-20260227","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":"R10-20260227","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1186\/s12903-024-04795-5","article-title":"Assessment of MMP levels in reversible and irreversible pulpitis and a randomized controlled trial comparing clinical success of two different calcium-silicate cements in pulpotomy treatment of primary molars with an 18-month follow-up","volume":"24","author":"Gerihan","year":"2024","journal-title":"BMC Oral Health"},{"key":"R11-20260227","doi-asserted-by":"crossref","first-page":"286","DOI":"10.14744\/eej.2023.41736","article-title":"Evaluating the concentration of MMP-9 and TNF- ? in pulpal blood at various stages of pulpal inflammation in diabetics: A cross sectional study","volume":"8","author":"Agrawal","year":"2023","journal-title":"Eur Endod J"},{"key":"R12-20260227","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.joen.2015.10.020","article-title":"A prospective clinical pilot study on the level of matrix metalloproteinase-9 in dental pulpal blood as a marker for the state of inflammation in the pulp tissue","volume":"42","author":"Mente","year":"2016","journal-title":"J Endod"},{"key":"R13-20260227","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4103\/jofs.jofs_65_22","article-title":"Estimation of matrix metalloproteinases-9 (MMP-9) levels in children with early childhood caries","volume":"14","author":"Reenayai","year":"2022","journal-title":"J Orofac Sci"},{"key":"R14-20260227","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/j.joen.2017.03.033","article-title":"Partial pulpotomy in mature permanent teeth with clinical signs indicative of irreversible pulpitis: A randomized clinical trial","volume":"43","author":"Taha","year":"2017","journal-title":"J Endod"},{"key":"R15-20260227","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.joen.2016.10.027","article-title":"Treatment outcomes of mineral trioxide aggregate pulpotomy in vital permanent teeth with carious pulp exposure: The retrospective study","volume":"43","author":"Linsuwanont","year":"2017","journal-title":"J Endod"},{"key":"R16-20260227","doi-asserted-by":"crossref","first-page":"7724","DOI":"10.1523\/JNEUROSCI.21-19-07724.2001","article-title":"Effects of matrix metalloproteinase-9 gene knock-out on the proteolysis of blood-brain barrier and white matter components after cerebral ischemia","volume":"21","author":"Asahi","year":"2001","journal-title":"J Neurosci"}],"container-title":["Journal of Indian Society of Pedodontics and Preventive Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_497_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:34:27Z","timestamp":1787769267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_497_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jisppd.jisppd_497_25","relation":{},"ISSN":["0970-4388","1998-3905"],"issn-type":[{"value":"0970-4388","type":"print"},{"value":"1998-3905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}