J Korean Acad Conserv Dent.  2011 May;36(3):196-202. 10.5395/JKACD.2011.36.3.196.

Matrix metalloproteinase-8 and substance P levels in root canal exudates of nonvital teeth

• Shin SJ
• Lee W
• Lee JI
• Baek SH
• Kum KY
• Shon WJ
• Bae KS

• KMID: 1986683
• DOI: http://doi.org/10.5395/JKACD.2011.36.3.196

Abstract

OBJECTIVES
The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth.
MATERIALS AND METHODS
Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (p < 0.05).
RESULTS
MMP-8 and SP levels in GCF were decreased during RCT (p < 0.0001), and they showed a weak positive correlation to each other (p < 0.05). Patients'subjective pain levels and the response from percussion test were significantly related to SP level.
CONCLUSIONS
This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.

Keyword

Canal exudate; MMP-8; SP; Pain

MeSH Terms

Dental Pulp Cavity
Enzyme-Linked Immunosorbent Assay
Ethics Committees, Research
Exudates and Transudates
Humans
Inflammation
Informed Consent
Matrix Metalloproteinase 8
Percussion
Prospective Studies
Substance P
Tooth
Tooth, Nonvital
Matrix Metalloproteinase 8
Substance P

Figure

• 

  Figure 1 The amount of MMP-8 and SP from individual samples.

• 

  Figure 2 Corrected estimates and standard errors of MMP-8 and SP levels in the experimental group. A mixed model was used for adjusting patients' pain level.

• 

  Figure 3 Scatter plot of MMP-8 and SP at each period. (a) At first visit, (b) At second visit, (c) At third visit.

Reference

1. Heyeraas KJ, Kvinnsland I, Byers MR, Jacobsen EB. Nerve fibers immunoreactive to protein gene product 9.5, calcitonin gene-related peptide, substance P, and neuropeptide Y in the dental pulp, periodontal ligament, and gingiva in cats. Acta Odontol Scand. 1993. 51:207–221.

2. Ağan S, Sönmez S, Serdar M. The effect of topical doxycycline usage on gingival crevicular fluid MMP-8 levels of chronic and aggressive periodontitis patients: a pilot study. Int J Dent Hyg. 2006. 4:114–121.

3. Biyikoğlu B, Buduneli N, Kardeşler L, Aksu K, Pitkala M, Sorsa T. Gingival crevicular fluid MMP-8 and -13 and TIMP-1 levels in patients with rheumatoid arthritis and inflammatory periodontal disease. J Periodontol. 2009. 80:1307–1314.

4. Hanioka T, Takaya K, Matsumori Y, Matsuse R, Shizukuishi S. Relationship of the substance P to indicators of host response in human gingival crevicular fluid. J Clin Periodontol. 2000. 27:262–266.

5. Hanemaaijer R, Sorsa T, Konttinen YT, Ding Y, Sutinen M, Visser H, van Hinsbergh VW, Helaakoski T, Kainulainen T, Rönkä H, Tschesche H, Salo T. Matrix metalloproteinase-8 is expressed in rheumatoid synovial fibroblasts and endothelial cells. Regulation by tumor necrosis factor-alpha and doxycycline. J Biol Chem. 1997. 272:31504–31509.

6. Palosaari H, Wahlgren J, Larmas M, Rönkä H, Sorsa T, Salo T, Tjäderhane L. The expression of MMP-8 in human odontoblasts and dental pulp cells is down-regulated by TGF-beta1. J Dent Res. 2000. 79:77–84.

7. Avellan NL, Sorsa T, Tervahartiala T, Mäntylä P, Forster C, Kemppainen P. Painful tooth stimulation elevates matrix metalloproteinase-8 levels locally in human gingival crevicular fluid. J Dent Res. 2005. 84:335–339.

8. Awawdeh LA, Lundy FT, Linden GJ, Shaw C, Kennedy JG, Lamey PJ. Quantitative analysis of substance P, neurokinin A and calcitonin gene-related peptide in gingival crevicular fluid associated with painful human teeth. Eur J Oral Sci. 2002. 110:185–191.

9. Wahlgren J, Salo T, Teronen O, Luoto H, Sorsa T, Tjäderhane L. Matrix metalloproteinase-8 (MMP-8) in pulpal and periapical inflammation and periapical rootcanal exudates. Int Endod J. 2002. 35:897–904.

10. Figueredo CM, Areas A, Miranda LA, Fischer RG, Gustafsson A. The short-term effectiveness of non-surgical treatment in reducing protease activity in gingival crevicular fluid from chronic periodontitis patients. J Clin Periodontol. 2004. 31:615–619.

11. Apajalahti S, Sorsa T, Railavo S, Ingman T. The in vivo levels of matrix metalloproteinase-1 and -8 in gingival crevicular fluid during initial orthodontic tooth movement. J Dent Res. 2003. 82:1018–1022.

12. Emingil G, Afacan B, Tervahartiala T, Töz H, Atilla G, Sorsa T. Gingival crevicular fluid and serum matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 levels in renal transplant patients undergoing different immunosuppressive therapy. J Clin Periodontol. 2008. 35:221–229.

13. Ingman T, Tervahartiala T, Ding Y, Tschesche H, Haerian A, Kinane DF, Konttinen YT, Sorsa T. Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients. J Clin Periodontol. 1996. 23:1127–1132.

14. Mäntylä P, Stenman M, Kinane DF, Tikanoja S, Luoto H, Salo T, Sorsa T. Gingival crevicular fluid collagenase-2 (MMP-8) test stick for chair-side monitoring of periodontitis. J Periodontal Res. 2003. 38:436–439.

15. Okuda K, Miyazaki A, Momose M, Murata M, Nomura T, Kubota T, Wolff LF, Yoshie H. Levels of tissue inhibitor of metalloproteinases-1 and matrix metalloproteinases-1 and -8 in gingival crevicular fluid following treatment with enamel matrix derivative (EMDOGAIN). J Periodontal Res. 2001. 36:309–316.

16. Passoja A, Ylipalosaari M, Tervonen T, Raunio T, Knuuttila M. Matrix metalloproteinase-8 concentration in shallow crevices associated with the extent of periodontal disease. J Clin Periodontol. 2008. 35:1027–1031.

17. Munjal SK, Prescher N, Struck F, Sorsa T, Maier K, Netuschil L. Evaluation of immunoassay-based MMP-8 detection in gingival crevicular fluid on a point-of-care platform. Ann N Y Acad Sci. 2007. 1098:490–492.