Biomarkers of inflammatory external root resorption as a result of traumatic dental injury to permanent teeth in children

Arch Oral Biol. 2019 Mar:99:82-91. doi: 10.1016/j.archoralbio.2019.01.003. Epub 2019 Jan 7.

Abstract

Objective: External inflammatory root resorption (EIRR) is a common complication of traumatic dental injury (TDI) that can be detected radiologically. During EIRR, various proteins are released into gingival sulcus fluid (GCF). The aim of the study was to monitor the levels of selected proteins in GCF in children (8-16 years of age) in order to assess their utility in the early diagnosis of EIRR.

Design: Twenty five children who experienced TDI to permanent incisors with ended root development were enrolled. GCF was collected from injured and control teeth with paper strips within seven days after TDI and on three visits during six-month follow-up. Concentrations of IL-1α, IL-1β, IL-6, IL-8, TNFα, RANKL and MMP-9 in GCF were measured using enzyme-linked immunosorbent assays. EIRR was confirmed by radiological imaging techniques.

Results: Of all analyzed proteins, only the levels of IL-1α, Il-1β and TNFα in GCF from the injured teeth with resorption were higher than in GCF from control teeth on the visit during which the EIRR was diagnosed. In univariate logistic regression model, the concentration of IL-1α in GCF was found as the strongest risk factor for the occurrence of EIRR.

Conclusions: The composition of GCF may be indicative of EIRR after TDI. The monitoring of selected biomarkers in GCF may help to detect EIRR at its early stage and might be useful in reducing radiological exposure in children after TDI. IL-1α can be considered as a potential marker of the EIRR in children after TDI to the permanent teeth.

Keywords: Biomarkers; Cytokines; External root resorption; Inflammation; Traumatic dental injury.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Biomarkers / metabolism*
  • Child
  • Cytokines / metabolism
  • Dentition, Permanent*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gingival Crevicular Fluid / chemistry*
  • Humans
  • Incisor / injuries
  • Incisor / metabolism
  • Inflammation
  • Interleukin-1alpha / metabolism
  • Interleukin-1beta / metabolism
  • Interleukin-6 / metabolism
  • Interleukin-8 / metabolism
  • Logistic Models
  • Male
  • Matrix Metalloproteinase 9 / metabolism
  • Multivariate Analysis
  • Prospective Studies
  • RANK Ligand / metabolism
  • Risk Factors
  • Root Resorption / diagnosis
  • Root Resorption / etiology*
  • Root Resorption / metabolism*
  • Tooth Injuries / complications*
  • Tooth Loss / etiology
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Biomarkers
  • Cytokines
  • IL1A protein, human
  • Interleukin-1alpha
  • Interleukin-1beta
  • Interleukin-6
  • Interleukin-8
  • RANK Ligand
  • TNFSF11 protein, human
  • Tumor Necrosis Factor-alpha
  • Matrix Metalloproteinase 9