COMPREHENSIVE INSIGHTS INTO PULP INFLAMMATION: FROM PATHOGENESIS TO TREATMENT

Abstract

The dental pulp, a highly specialized connective tissue encased within mineralized structures, plays a critical role in tooth vitality and sensory function. Pulp inflammation (pulpitis) arises due to microbial invasion, mechanical trauma, chemical irritation, or orthodontic interventions, triggering complex immune responses that can lead to pain, tissue degeneration, and necrosis. This study aims to comprehensively analyze the clinical manifestations, molecular mechanisms, and therapeutic approaches related to pulp inflammation to enhance diagnostic accuracy and treatment efficacy. A multidisciplinary approach was employed, integrating in vivo and in vitro experimental models, including animal studies and human dental pulp stem cell (DPSC) assays, to investigate inflammatory cascades at cellular and molecular levels. Techniques such as real-time RT-PCR, confocal microscopy, and immunohistochemistry were utilized to quantify pro-inflammatory cytokines (TNF-α, IL-6, IL-8) and neuropeptides (substance P, calcitonin gene-related peptide). Clinical data from patients exhibiting symptomatic and asymptomatic pulpitis were also examined. Results demonstrated that activation of pattern recognition receptors (PRRs), including Toll-like receptors and nucleotide-binding oligomerization domain-like receptors, initiates a cascade of inflammatory mediators that recruit immune cells and amplify neurogenic inflammation. The balance between inflammation and repair was found to be crucial; anti-inflammatory peptides like GV1001 showed potential in modulating immune responses while promoting pulp regeneration. Notably, asymptomatic inflammation was associated with elevated neuropeptide levels, emphasizing the importance of early detection. Discussion highlights that while inflammation contributes to pulp pathology, it also facilitates reparative dentin formation and tissue healing, underscoring the dual role of inflammatory processes. Advances in regenerative endodontics and immunomodulatory therapies offer promising strategies to preserve pulp vitality and improve patient outcomes.