Abstract
The authors of this narrative review aimed to address various experimental methods and make recommendations for how research should move forward in the context of studying biomarkers in clinical Endodontic research. The approach adopted is exemplified using two prominent clinical problems, namely (a) the ‘reversible’ versus ‘irreversible’ pulpitis conundrum and (b) persistent idiopathic dentoalveolar pain (PIDAP). Pulpitis under deep caries or dentinal cracks is understood from a histological perspective, but clinical assessment tools to indicate irreversibly inflamed aspects of the dental pulp are elusive. PIDAP, on the other hand, is a diagnosis of exclusion; its pathophysiology is complex and not understood sufficiently to avoid unnecessary dental treatments. This review addresses how diagnostic biomarkers could further our understanding of those and other clinical problems, and how issues can be tackled from a methodological point of view. Hence, different methodological approaches to identify suitable diagnostic biomarker(s) or use known biomarkers are presented. The importance of asking a relevant research question, collecting the most suitable fluid and using the ideal collection vehicle for the research question under investigation is discussed based on the defined clinical problems.
Highlights
The authors of this narrative review aimed to address various experimental methods and make recommendations for how research should move forward in the context of studying biomarkers in clinical Endodontic research
Pulpitis under deep caries or dentinal cracks is understood from a histological perspective, but clinical assessment tools to indicate irreversibly inflamed aspects of the dental pulp are elusive
This review addresses how diagnostic biomarkers could further our understanding of those and other clinical problems, and how issues can be tackled from a methodological point of view
Summary
The term biomarker has been defined as a characteristic that is objectively measured and evaluated as an indicator of normal biological and pathogenic processes, or pharmacologic responses to a therapeutic intervention (Atkinson & Colburn, 2001). The term ‘biomarker’ is used in the context of imaging, and describes a biological feature or set of features in a diagnostic image, that can be analysed using specific algorithms (Smith et al, 2003) This is beyond the scope of this text, but represents an interesting and timely. For the sake of simplicity and focus, this text will follow the main topic of diagnostics, and how body fluid-derived biomarkers can be used in that context in endodontic research. These methods focus on measurable host elements (e.g. biomarkers) that can be invariably linked to a disease or the outcome of a treatment (Naylor, 2003). The current text will use two clinical conditions to exemplify individual research topics that could further our understanding
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