ArticleJournal of oral biology and craniofacial research
Spatiotemporal quantification of gingival crevicular fluid NLRP3 expression during non-surgical endodontic management of pulp necrosis with symptomatic apical periodontitis: A prospective case-control analysis.
Article in Journal of oral biology and craniofacial research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate gingival crevicular fluid (GCF) NOD-like receptor protein 3 (NLRP3) levels in pulp necrosis (PN) with symptomatic apical periodontitis (SAP) before and after non-surgical endodontic therapy (NSET) and compare them with periodontally healthy controls. Methods: GCF samples were collected from healthy controls (n = 30) and patients with PN and SAP (n = 30) at baseline and one-week following standardized two-visit NSET. Sampling was performed at three sites per patient: the involved tooth, contralateral and adjacent teeth. NLRP3 concentrations were quantified using enzyme-linked immunosorbent assay. Data distribution and variance assumptions were verified using Anderson-Darling and Levene's tests. Between-group and between-site differences were evaluated using unpaired t-tests and analysis of covariance, with longitudinal and clustered observations modelled using linear mixed-effects analysis. Diagnostic performance was examined using receiver operating characteristic (ROC) analysis. Results: Baseline NLRP3 concentrations were significantly higher at involved sites than in controls (adjusted mean difference 3.97 ng/mL; 95% CI 3.82-4.12; p < 0.05), and were also elevated at adjacent sites (1.11 ng/mL; 95% CI 0.98-1.24; p < 0.05). One week after NSET, a significant reduction was observed at involved sites (0.32 ng/mL; 95% CI 0.17-0.47; p < 0.05). Significant differences were detected across the three sampled locations (adjusted mean differences 2.93, 4.01, and 1.08 ng/mL). ROC analysis indicated excellent discriminatory ability (AUC = 1.0), with an optimal baseline threshold >2 ng/mL. Conclusions: Within the limitations of this exploratory clinical study, GCF NLRP3 levels were elevated in PN with SAP and decreased following NSET, supporting its potential role as a candidate inflammatory biomarker.
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