Estimation Of Substance P Level In Normal Pulpal Condition Compared To Pulpal And Periapical Diseases
Main Article Content
Keywords
Substance P, Pulp, Irreversible pulpitis, CGRP, neuropeptides, Pulpal inflammation, Medical, Health
Abstract
Introduction: Pulp can be inflamed due to physiologic, pathogenic or iatrogenic factors. The stimulation of the peripheral nerve ending in the pulp causes the release of neuropeptides such Substance P, Calcitonin Gene Receptor Peptide (CGRP), Neurokinin A and Neurokinin B. These neuropeptides mediate neurogenic inflammation. Substance P is the first neuropeptide to be isolated in the dental pulp and is reported to be associated with the pulpal pain experienced by the patient.
Aim: To Determine and compare the level of Substance P in diseased pulpal conditions and healthy pulpal conditions.
Materials and Method: The search was performed in various electronic databases (i.e. Pubmed Central, Sciencedirect, Cochrane, Web Of Science and Lilac) till 1,February 2022. Studies were selected if it compared the level of Substance P in diseased and healthy pulpal conditions.
Results: Search from the database showed 67 studies out of which 5 studies were included for the systematic review based on the inclusion criteria. The level of SP was measured either in GCF, pulp tissue, root canal exudate or saliva. There was a statistically significant increase in Substance P level in teeth with diseased pulpal conditions.
Conclusion: SP, NKA, and CGRP are eminent neurotransmitters in the propagation of moderate to severe pain signals and are increased in case of pupal disease. Substance P is significantly increased in diseased pulpal conditions when compared to healthy and intact teeth.
References
1. Renton T. Dental (Odontogenic) Pain [Internet]. Vol. 5, Reviews in Pain. 2011. p. 2–7. Available from: http://dx.doi.org/10.1177/204946371100500102
2. Rhodes JS. Advanced Endodontics: Clinical Retreatment and Surgery. CRC Press; 2005. 218 p.
3. S DPA, Solete P, Jeevanandan G, Syed AA, Almahdi S, Alzhrani M, et al. Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study. Eur J Dent. 2023 Feb;17(1):57–61.
4. Wakisaka S. Neuropeptides in the dental pulp: Distribution, origins, and correlation [Internet]. Vol. 16, Journal of Endodontics. 1990. p. 67–9. Available from: http://dx.doi.org/10.1016/s0099-2399(06)81566-9
5. Berman LH, Hargreaves KM. Cohen’s Pathways of the Pulp Expert Consult - E-Book. Elsevier Health Sciences; 2015. 928 p.
6. Kulkarni S, Wahane K, Daokar S, Patil K, Patel K, Thorat T. An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study. Endodontology. 2021;33(1):20.
7. Azim AA, Wang HH, Tarrosh M, Azim KA, Piasecki L. Comparison between Single-file Rotary Systems: Part 1—Efficiency, Effectiveness, and Adverse Effects in Endodontic Retreatment [Internet]. Vol. 44, Journal of Endodontics. 2018. p. 1720–4. Available from: http://dx.doi.org/10.1016/j.joen.2018.07.022
8. Rodrigues CT, Duarte MAH, de Almeida MM, de Andrade FB, Bernardineli N. Efficacy of CM-Wire, M-Wire, and Nickel-Titanium Instruments for Removing Filling Material from Curved Root Canals: A Micro–Computed Tomography Study [Internet]. Vol. 42, Journal of Endodontics. 2016. p. 1651–5. Available from: http://dx.doi.org/10.1016/j.joen.2016.08.012
9. Divya S, Jeevanandan G, Sujatha S, Subramanian EMG, Ravindran V. Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial. Indian J Dent Res. 2019 Nov-Dec;30(6):904–8.
10. Bowles W, Withrow J, Lepinski A, Hargreaves K. Tissue Levels of Immunoreactive Substance P are Increased in Patients with Irreversible Pulpitis [Internet]. Vol. 29, Journal of Endodontics. 2003. p. 265–7. Available from: http://dx.doi.org/10.1097/00004770-200304000-00009
11. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. 1985. J Endod. 2004 Jul;30(7):476–81; discussion 475.
12. Bhagavaldas MC, Diwan A, Kusumvalli S, Pasha S, Devale M, Chava DC. Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative study. J Conserv Dent. 2017 Jan-Feb;20(1):12–6.
13. Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An study. J Conserv Dent. 2022 Sep 12;25(5):547–54.
14. Seybold VS. The role of peptides in central sensitization. Handb Exp Pharmacol. 2009;(194):451–91.
15. Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of Gutta percha from the root canal. J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1682–5.
16. Hima Sandeep A, Senior Lecturer, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences. Prevalence and associated factors of root canal treated mandibular anterior teeth with and without post endodontic crowns. Int J Dent Oral Sci. 2019 Nov 30;87–91.
17. Al-Negrish ARS, Habahbeh R. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital [Internet]. Vol. 34, Journal of Dentistry. 2006. p. 635–40. Available from: http://dx.doi.org/10.1016/j.jdent.2005.12.007
18. Burgener B, Ford AR, Situ H, Fayad MI, Hao JJ, Wenckus CS, et al. Biologic Markers for Odontogenic Periradicular Periodontitis [Internet]. Vol. 36, Journal of Endodontics. 2010. p. 1307–10. Available from: http://dx.doi.org/10.1016/j.joen.2010.04.018
19. Rhodes JS. Advanced Endodontics: Clinical Retreatment and Surgery. CRC Press; 2005. 218 p.
20. Antony D, Subramanian A, Nivedhitha M, Solete P, Balasubramaniam A. Post-endodontic pain with different engine-driven endodontic instruments in multi-visit root canal therapy: A systematic review and meta-analysis. J Int Oral Health. 2022;14(1):1.
21. Siqueirajr J, Rocas I, Favieri A, Machado A, Gahyva S, Oliveira J, et al. Incidence of Postoperative Pain After Intracanal Procedures Based on an Antimicrobial Strategy [Internet]. Vol. 28, Journal of Endodontics. 2002. p. 457–60. Available from: http://dx.doi.org/10.1097/00004770-200206000-00010
22. Khayat B, Jouanny G. Microsurgical Endodontics. Quintessence Publishing (IL); 2019.
23. Pratheebha C, Gayathri R, Veeraraghavan VP, Kavitha S. Knowledge, awareness, and perception on root canal treatment among South Indian population - A survey. J Adv Pharm Technol Res. 2022 Nov;13(Suppl 1):S302–7.
24. Jacinto RC, Gomes BP, Shah HN, Ferraz CC, Zaia AA, Souza-Filho FJ. Quantification of endotoxins in necrotic root canals from symptomatic and asymptomatic teeth. J Med Microbiol. 2005 Aug;54(Pt 8):777–83.
25. Nasim I, Professor and Head, Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai - 600077, India. Effect of nanoparticles based root canal disinfectants on Enterococcus faecalis - A systematic review. Int J Dent Oral Sci. 2021 Jun 30;2898–904.
26. Bamini L, Anand Sherwood I, Abbott PV, Uthandakalaipandian R, Velu V. Influence of anti-inflammatory irrigant on substance P expression for single-visit root canal treatment of teeth with irreversible pulpitis. Aust Endod J. 2020 Apr;46(1):73–81.
27. Kulkarni S, Wahane K, Daokar S, Patil K, Patel K, Thorat T. An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study. Endodontology. 2021;33(1):20.
28. Azim AA, Wang HH, Tarrosh M, Azim KA, Piasecki L. Comparison between Single-file Rotary Systems: Part 1—Efficiency, Effectiveness, and Adverse Effects in Endodontic Retreatment [Internet]. Vol. 44, Journal of Endodontics. 2018. p. 1720–4. Available from: http://dx.doi.org/10.1016/j.joen.2018.07.022
29. Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of Gutta percha from the root canal. J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1682–5.
30. Janani K, Teja KV, Ajitha P, Sandhya R. Evaluation of tissue inflammatory response of four intracanal medicament - An animal study. J Conserv Dent. 2020 Dec 4;23(3):216–20.
31. Shimauchi H, Miki Y, Takayama S, Imai T, Okada H. Development of a quantitative sampling method for periapical exudates from human root canals. J Endod. 1996 Nov;22(11):612–5.
32. Evaluation of an Ultrasonic Technique to Remove Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals:
Clinical Cases. J Endod. 2003 Nov 1;29(11):764–7.
33. Natanasabapathy V, Durvasulu A, Krithikadatta J, Namasivayam A, Deivanayagam K, Manali S, et al. Current Trends in the Use of Irrigant Activation Techniques Among Endodontists & Post-Graduate Dental Students in India -A Knowledge, Attitude and Practice Based Survey. Eur Endod J. 2020 May 22;5(2):73–80.
34. Caviedes-Bucheli J, Lombana N, Azuero-Holguín MM, Munoz HR. Quantification of neuropeptides (calcitonin gene-related peptide, substance P, neurokinin A, neuropeptide Y and vasoactive intestinal polypeptide) expressed in healthy and inflamed human dental pulp. Int Endod J. 2006 May;39(5):394–400.
35. Heidari A, Shahrabi M, Rokouei M, Amirzargar A, Rahbar P. Comparative study of substance P and neurokinin A in gingival crevicular fluid of healthy and painful carious permanent teeth. Dent Res J . 2017 Jan;14(1):57–61.
36. Sattari M, Mozayeni MA, Matloob A, Mozayeni M, Javaheri HH. Substance P and CGRP expression in dental pulps with irreversible pulpitis. Aust Endod J. 2010 Aug;36(2):59–63.
37. Ruff MR, Wahl SM, Pert CB. Substance P receptor-mediated chemotaxis of human monocytes. Peptides. 1985;6 Suppl 2:107–11.
38. Nandakumar M, Nasim I. Effect of intracanal cryotreated sodium hypochlorite on postoperative pain after root canal treatment - A randomized controlled clinical trial. J Conserv Dent. 2020 Nov 5;23(2):131–6.
39. Rosell S, Olgart L, Gazelius B, Panopoulos P, Folkers K, Hörig J. Inhibition of antidromic and substance P-induced vasodilatation by a substance P antagonist. Acta Physiol Scand. 1981 Mar;111(3):381–2.
40. Ma J, Al-Ashaw AJ, Shen Y, Gao Y, Yang Y, Zhang C, et al. Efficacy of ProTaper Universal Rotary Retreatment system for gutta-percha removal from oval root canals: a micro-computed tomography study. J Endod. 2012 Nov;38(11):1516–20.
41. Indi S, Desai SR, Hambire A, Mustafa M, Almokhatieb AA, Abuelqomsan MAS, et al. Comparison of the Time Required by Six Different Retreatment Techniques for Retrieval of Gutta-Percha: An In Vitro Study [Internet]. European Journal of General Dentistry. 2022. Available from: http://dx.doi.org/10.1055/s-0042-1750089
42. Siddique R, Nivedhitha MS, Ranjan M, Jacob B, Solete P. Comparison of antibacterial effectiveness of three rotary file system with different geometry in infected root canals before and after instrumentation-a double-blinded randomized controlled clinical trial. BDJ Open. 2020 Jun 8;6:8.
43. Kim S. Neurovascular interactions in the dental pulp in health and inflammation. J Endod. 1990 Feb;16(2):48–53.
44. Lopes HP, Elias CN, Vedovello GAF, Bueno CES, Mangelli M, Siqueira JF. Torsional Resistance of Retreatment Instruments [Internet]. Vol. 37, Journal of Endodontics. 2011. p. 1442–5. Available from: http://dx.doi.org/10.1016/j.joen.2011.06.004
45. Endodontic retreatment—Case selection and technique. Part 2: Treatment planning for retreatment. J Endod. 1988 Dec 1;14(12):607–14.
46. Kim S. Color Atlas of Microsurgery in Endodontics. 2001. 200 p.
47. Teja KV, Kaligotla AV, Gummuluri S. Antibacterial Efficacy of Conventional Versus Herbal Products on Streptococcus mutans in Adult Population- a Systematic Review & Meta-analysis. BDS. 2020 Sep 30;23(4):18p – 18p.
48. Hargreaves KM, Goodis HE, Tay FR. Seltzer and Bender’s Dental Pulp. Quintessence Publishing Company; 2012. 501 p.
49. Olgart L, Kerezoudis NP. Nerve-pulp interactions. Arch Oral Biol. 1994;39 Suppl:47S – 54S.
50. Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent. 2019 Mar-Apr;22(2):114–22.
51. Iqbal A, Karobari MI, Alam MK, Khattak O, Alshammari SM, Adil AH, et al. Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study. BMC Oral Health. 2022 May 10;22(1):171.
52. Harrison S, Geppetti P. Substance p. Int J Biochem Cell Biol. 2001 Jun;33(6):555–76.
53. Sujith IL, Teja KV, Ramesh S. Assessment of irrigant flow and apical pressure in simulated canals of single-rooted teeth with different root canal tapers and apical preparation sizes: An study. J Conserv Dent. 2021 Jul-Aug;24(4):314–22.
2. Rhodes JS. Advanced Endodontics: Clinical Retreatment and Surgery. CRC Press; 2005. 218 p.
3. S DPA, Solete P, Jeevanandan G, Syed AA, Almahdi S, Alzhrani M, et al. Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study. Eur J Dent. 2023 Feb;17(1):57–61.
4. Wakisaka S. Neuropeptides in the dental pulp: Distribution, origins, and correlation [Internet]. Vol. 16, Journal of Endodontics. 1990. p. 67–9. Available from: http://dx.doi.org/10.1016/s0099-2399(06)81566-9
5. Berman LH, Hargreaves KM. Cohen’s Pathways of the Pulp Expert Consult - E-Book. Elsevier Health Sciences; 2015. 928 p.
6. Kulkarni S, Wahane K, Daokar S, Patil K, Patel K, Thorat T. An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study. Endodontology. 2021;33(1):20.
7. Azim AA, Wang HH, Tarrosh M, Azim KA, Piasecki L. Comparison between Single-file Rotary Systems: Part 1—Efficiency, Effectiveness, and Adverse Effects in Endodontic Retreatment [Internet]. Vol. 44, Journal of Endodontics. 2018. p. 1720–4. Available from: http://dx.doi.org/10.1016/j.joen.2018.07.022
8. Rodrigues CT, Duarte MAH, de Almeida MM, de Andrade FB, Bernardineli N. Efficacy of CM-Wire, M-Wire, and Nickel-Titanium Instruments for Removing Filling Material from Curved Root Canals: A Micro–Computed Tomography Study [Internet]. Vol. 42, Journal of Endodontics. 2016. p. 1651–5. Available from: http://dx.doi.org/10.1016/j.joen.2016.08.012
9. Divya S, Jeevanandan G, Sujatha S, Subramanian EMG, Ravindran V. Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial. Indian J Dent Res. 2019 Nov-Dec;30(6):904–8.
10. Bowles W, Withrow J, Lepinski A, Hargreaves K. Tissue Levels of Immunoreactive Substance P are Increased in Patients with Irreversible Pulpitis [Internet]. Vol. 29, Journal of Endodontics. 2003. p. 265–7. Available from: http://dx.doi.org/10.1097/00004770-200304000-00009
11. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. 1985. J Endod. 2004 Jul;30(7):476–81; discussion 475.
12. Bhagavaldas MC, Diwan A, Kusumvalli S, Pasha S, Devale M, Chava DC. Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative study. J Conserv Dent. 2017 Jan-Feb;20(1):12–6.
13. Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An study. J Conserv Dent. 2022 Sep 12;25(5):547–54.
14. Seybold VS. The role of peptides in central sensitization. Handb Exp Pharmacol. 2009;(194):451–91.
15. Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of Gutta percha from the root canal. J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1682–5.
16. Hima Sandeep A, Senior Lecturer, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences. Prevalence and associated factors of root canal treated mandibular anterior teeth with and without post endodontic crowns. Int J Dent Oral Sci. 2019 Nov 30;87–91.
17. Al-Negrish ARS, Habahbeh R. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital [Internet]. Vol. 34, Journal of Dentistry. 2006. p. 635–40. Available from: http://dx.doi.org/10.1016/j.jdent.2005.12.007
18. Burgener B, Ford AR, Situ H, Fayad MI, Hao JJ, Wenckus CS, et al. Biologic Markers for Odontogenic Periradicular Periodontitis [Internet]. Vol. 36, Journal of Endodontics. 2010. p. 1307–10. Available from: http://dx.doi.org/10.1016/j.joen.2010.04.018
19. Rhodes JS. Advanced Endodontics: Clinical Retreatment and Surgery. CRC Press; 2005. 218 p.
20. Antony D, Subramanian A, Nivedhitha M, Solete P, Balasubramaniam A. Post-endodontic pain with different engine-driven endodontic instruments in multi-visit root canal therapy: A systematic review and meta-analysis. J Int Oral Health. 2022;14(1):1.
21. Siqueirajr J, Rocas I, Favieri A, Machado A, Gahyva S, Oliveira J, et al. Incidence of Postoperative Pain After Intracanal Procedures Based on an Antimicrobial Strategy [Internet]. Vol. 28, Journal of Endodontics. 2002. p. 457–60. Available from: http://dx.doi.org/10.1097/00004770-200206000-00010
22. Khayat B, Jouanny G. Microsurgical Endodontics. Quintessence Publishing (IL); 2019.
23. Pratheebha C, Gayathri R, Veeraraghavan VP, Kavitha S. Knowledge, awareness, and perception on root canal treatment among South Indian population - A survey. J Adv Pharm Technol Res. 2022 Nov;13(Suppl 1):S302–7.
24. Jacinto RC, Gomes BP, Shah HN, Ferraz CC, Zaia AA, Souza-Filho FJ. Quantification of endotoxins in necrotic root canals from symptomatic and asymptomatic teeth. J Med Microbiol. 2005 Aug;54(Pt 8):777–83.
25. Nasim I, Professor and Head, Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai - 600077, India. Effect of nanoparticles based root canal disinfectants on Enterococcus faecalis - A systematic review. Int J Dent Oral Sci. 2021 Jun 30;2898–904.
26. Bamini L, Anand Sherwood I, Abbott PV, Uthandakalaipandian R, Velu V. Influence of anti-inflammatory irrigant on substance P expression for single-visit root canal treatment of teeth with irreversible pulpitis. Aust Endod J. 2020 Apr;46(1):73–81.
27. Kulkarni S, Wahane K, Daokar S, Patil K, Patel K, Thorat T. An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study. Endodontology. 2021;33(1):20.
28. Azim AA, Wang HH, Tarrosh M, Azim KA, Piasecki L. Comparison between Single-file Rotary Systems: Part 1—Efficiency, Effectiveness, and Adverse Effects in Endodontic Retreatment [Internet]. Vol. 44, Journal of Endodontics. 2018. p. 1720–4. Available from: http://dx.doi.org/10.1016/j.joen.2018.07.022
29. Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of Gutta percha from the root canal. J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1682–5.
30. Janani K, Teja KV, Ajitha P, Sandhya R. Evaluation of tissue inflammatory response of four intracanal medicament - An animal study. J Conserv Dent. 2020 Dec 4;23(3):216–20.
31. Shimauchi H, Miki Y, Takayama S, Imai T, Okada H. Development of a quantitative sampling method for periapical exudates from human root canals. J Endod. 1996 Nov;22(11):612–5.
32. Evaluation of an Ultrasonic Technique to Remove Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals:
Clinical Cases. J Endod. 2003 Nov 1;29(11):764–7.
33. Natanasabapathy V, Durvasulu A, Krithikadatta J, Namasivayam A, Deivanayagam K, Manali S, et al. Current Trends in the Use of Irrigant Activation Techniques Among Endodontists & Post-Graduate Dental Students in India -A Knowledge, Attitude and Practice Based Survey. Eur Endod J. 2020 May 22;5(2):73–80.
34. Caviedes-Bucheli J, Lombana N, Azuero-Holguín MM, Munoz HR. Quantification of neuropeptides (calcitonin gene-related peptide, substance P, neurokinin A, neuropeptide Y and vasoactive intestinal polypeptide) expressed in healthy and inflamed human dental pulp. Int Endod J. 2006 May;39(5):394–400.
35. Heidari A, Shahrabi M, Rokouei M, Amirzargar A, Rahbar P. Comparative study of substance P and neurokinin A in gingival crevicular fluid of healthy and painful carious permanent teeth. Dent Res J . 2017 Jan;14(1):57–61.
36. Sattari M, Mozayeni MA, Matloob A, Mozayeni M, Javaheri HH. Substance P and CGRP expression in dental pulps with irreversible pulpitis. Aust Endod J. 2010 Aug;36(2):59–63.
37. Ruff MR, Wahl SM, Pert CB. Substance P receptor-mediated chemotaxis of human monocytes. Peptides. 1985;6 Suppl 2:107–11.
38. Nandakumar M, Nasim I. Effect of intracanal cryotreated sodium hypochlorite on postoperative pain after root canal treatment - A randomized controlled clinical trial. J Conserv Dent. 2020 Nov 5;23(2):131–6.
39. Rosell S, Olgart L, Gazelius B, Panopoulos P, Folkers K, Hörig J. Inhibition of antidromic and substance P-induced vasodilatation by a substance P antagonist. Acta Physiol Scand. 1981 Mar;111(3):381–2.
40. Ma J, Al-Ashaw AJ, Shen Y, Gao Y, Yang Y, Zhang C, et al. Efficacy of ProTaper Universal Rotary Retreatment system for gutta-percha removal from oval root canals: a micro-computed tomography study. J Endod. 2012 Nov;38(11):1516–20.
41. Indi S, Desai SR, Hambire A, Mustafa M, Almokhatieb AA, Abuelqomsan MAS, et al. Comparison of the Time Required by Six Different Retreatment Techniques for Retrieval of Gutta-Percha: An In Vitro Study [Internet]. European Journal of General Dentistry. 2022. Available from: http://dx.doi.org/10.1055/s-0042-1750089
42. Siddique R, Nivedhitha MS, Ranjan M, Jacob B, Solete P. Comparison of antibacterial effectiveness of three rotary file system with different geometry in infected root canals before and after instrumentation-a double-blinded randomized controlled clinical trial. BDJ Open. 2020 Jun 8;6:8.
43. Kim S. Neurovascular interactions in the dental pulp in health and inflammation. J Endod. 1990 Feb;16(2):48–53.
44. Lopes HP, Elias CN, Vedovello GAF, Bueno CES, Mangelli M, Siqueira JF. Torsional Resistance of Retreatment Instruments [Internet]. Vol. 37, Journal of Endodontics. 2011. p. 1442–5. Available from: http://dx.doi.org/10.1016/j.joen.2011.06.004
45. Endodontic retreatment—Case selection and technique. Part 2: Treatment planning for retreatment. J Endod. 1988 Dec 1;14(12):607–14.
46. Kim S. Color Atlas of Microsurgery in Endodontics. 2001. 200 p.
47. Teja KV, Kaligotla AV, Gummuluri S. Antibacterial Efficacy of Conventional Versus Herbal Products on Streptococcus mutans in Adult Population- a Systematic Review & Meta-analysis. BDS. 2020 Sep 30;23(4):18p – 18p.
48. Hargreaves KM, Goodis HE, Tay FR. Seltzer and Bender’s Dental Pulp. Quintessence Publishing Company; 2012. 501 p.
49. Olgart L, Kerezoudis NP. Nerve-pulp interactions. Arch Oral Biol. 1994;39 Suppl:47S – 54S.
50. Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent. 2019 Mar-Apr;22(2):114–22.
51. Iqbal A, Karobari MI, Alam MK, Khattak O, Alshammari SM, Adil AH, et al. Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study. BMC Oral Health. 2022 May 10;22(1):171.
52. Harrison S, Geppetti P. Substance p. Int J Biochem Cell Biol. 2001 Jun;33(6):555–76.
53. Sujith IL, Teja KV, Ramesh S. Assessment of irrigant flow and apical pressure in simulated canals of single-rooted teeth with different root canal tapers and apical preparation sizes: An study. J Conserv Dent. 2021 Jul-Aug;24(4):314–22.
Article Sidebar
Published
May 13, 2023
Article Details
How to Cite
Nishitha Arun, & Sindhu Ramesh. (2023). Estimation Of Substance P Level In Normal Pulpal Condition Compared To Pulpal And Periapical Diseases. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 406-412. https://doi.org/10.47750/jptcp.2023.30.10.045
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Nishitha Arun, & Sindhu Ramesh. (2023). Estimation Of Substance P Level In Normal Pulpal Condition Compared To Pulpal And Periapical Diseases. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 406-412. https://doi.org/10.47750/jptcp.2023.30.10.045