Study on the Relationship between Melatonin and PTX3 in Gingival Crevicular Fluid and Inflammatory Factors and Therapeutic Effects in Elderly Patients with Cracked Teeth and Chronic Pulpitis
Objective:To explore the relationship between melatonin(Melatonin)and pentameric protein 3(PTX3)in gingival crevicular fluid and inflammatory factors and therapeutic effects in elderly patients with cracked teeth and chronic pulpitis(CP).Methods:165 elderly patients with cracked teeth and CP who were admitted to our hospital from June 2021 to June 2022 were selected as study group,and 100 healthy subjects who underwent orthodontic tooth extraction in our hospital during the same period were selected as control group.The levels of Melatonin,PTX3 and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL-6),C-reactive protein(CRP)]in gingival crevicular fluid were compared between two groups.The correlation between Melatonin,PTX3 levels and inflammatory factors in gingival crevicular fluid of elderly patients with cracked teeth and CP were analyzed by Pearson test.165 elderly patients with cracked teeth and CP were followed up for 1 year after root canal therapy+full crown restoration.Patients were divided into effective group and ineffective group according to the treatment effect,the clinical data of two groups were compared.The influencing factors of ineffective treatment in elderly patients with cracked teeth and CP were analyzed by multivariate logistic regression model.The predictive value of Melatonin and PTX3 in gingival crevicular fluid for ineffective treatment in elderly patients with cracked teeth and CP were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with control group,the level of Melatonin in gingival crevicular fluid in study group decreased(P＜0.05),and the levels of PTX3,TNF-α,CRP and IL-6 increased(P＜0.05).Pearson test showed that,PTX3 in gingival crevicular fluid was positively correlated with TNF-α,CRP and IL-6 in elderly patients with cracked teeth and CP(P＜0.05),and Melatonin in gingival crevicular fluid was negatively correlated with TNF-α,CRP and IL-6(P＜0.05).A total of 165 elderly patients with cracked teeth and CP were followed up for 1 year after root canal therapy+full crown restoration,3 patients were lost to follow-up,and a total of 162 patients completed follow-up.Of the 162 patients,122 were successful,26 were improved,and 14 were failed,the inefficiency rate was 8.64％(14/162).Compared with effective group,the proportion of cracks reaching the pulp floor,the proportion of probing depth＞5 mm,and the level of PTX3 in ineffective group were significantly increased(P＜0.05),and the level of Melatonin was significantly decreased(P＜0.05).The results of multivariate Logistic regression model showed that,the crack depth reaching the pulp floor,the probing depth＞5 mm,and the increase of PTX3 level were the risk factors for the ineffective treatment of elderly patients with cracked teeth and CP(P＜0.05),and the increase of Melatonin level was the protective factor(P＜0.05).The ROC curve showed that,the area under the curve(AUC),sensitivity and specificity of Melatonin combined with PTX3 in gingival crevicular fluid for predicting ineffective treatment in elderly patients with cracked teeth and CP were 0.803,0.857 and 0.777 respectively.Conclusion:The decrease of Melatonin level and the increase of PTX3 level in gingival crevicular fluid are relate to the inflammatory response of elderly patients with cracked teeth and CP,and the lower the Melatonin level and the higher the PTX3 level,the worse the treatment effect,Melatonin combine with PTX3 detection has a high predictive value for the effect of root canal therapy+full crown restoration.
Gingival crevicular fluidMelatoninPentameric protein 3ElderlyCracked teethChronic pulpitisInflammatory factorsEffects
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