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 »  Home  »  Endodontic Articles 1  »  Quantitative analysis of substance P, neurokinin A and calcitonin gene-related peptide in pulp tissue from painful and healthy human teeth
Quantitative analysis of substance P, neurokinin A and calcitonin gene-related peptide in pulp tissue from painful and healthy human teeth
Results.



All patients in the pain group reported a VAS score of 5 or more at their initial appointment and then reported a score of 0 on their second visit, indicating total relief of pain following pulpectomy regardless of the intracanal treatment. This also confirmed the diagnosis of pulpal pain.

Neuropeptide levels in pulp tissue samples.
Both SP-Ir and CGRP-Ir were present in all samples with NKA-Ir in 96% of the 66 pulp samples. The mean concentrations of SP-Ir, NKA-Ir and CGRP-Ir were significantly higher in pulp tissue from painful teeth compared with non-painful teeth (Table 1, Fig. 1). Notably, the concentration of NKA was more than four times higher in painful teeth than in non-painful teeth. The mean concentration of CGRP was much higher than both SP-Ir and NKA-Ir in both painful and non-painful teeth.

Neuropeptide concentration (ngg-1) in pulp tissue from painful and non-painful teeth
Figure 1.
Neuropeptide concentration (ngg–1) in pulp tissue from painful and non-painful teeth.


There were moderate but statistically significant correlations between the levels of the three neuropeptides in both painful and non-painful teeth. In painful teeth, Pearson’s product moment correlation coefficient ( r ) for SP-Ir/NKA-Ir was r = 0.60 ( P < 0.0001), SP-Ir/CGRP-Ir was r = 0.54 ( P < 0.0001) and NKA-Ir/CGRP-Ir was r = 0.42 ( P = 0.004). The correlations were stronger in non-painful teeth; SP-Ir/NKA-Ir was r = 0.59 ( P = 0.006), SP-Ir/CGRP-Ir was r = 0.72 ( P < 0.0001) and NKA-Ir/CGRP-Ir was r = 0.61 ( P = 0.004).
The effect of age, gender, tooth location, tooth type (incisor, canine, premolar and molar) and smoking on levels of SP-Ir, NKA-Ir and CGRP-Ir in the pulp tissue was studied. Smoking was the only variable, apart from pain, which emerged from the stepwise regression analysis as having a relationship with neuropeptide concentration. Bivariate analysis indicated that the levels of CGRP-Ir, but not SP-Ir or NKA-Ir, were significantly ( P = 0.02) higher in smokers compared with non-smokers (Table 2).

Mean concentrations of SP-Ir, NKA-Ir and CGRP-Ir in painful teeth from smokers and non-smokers
Table 2. Mean (SD) concentrations of SP-Ir, NKA-Ir and CGRP-Ir in painful teeth from smokers and non-smokers.

Regression analysis showed a significant association between the severity of pain recorded using the VAS and the levels of SP-Ir ( P = 0.036) and NKA-Ir ( P < 0.001) but not CGRP-Ir ( P = 0.313).