Biomarkers of inflammatory external root resorption as a result of traumatic dental injury to permanent teeth in children.

OBJECTIVE: External inflammatory root resorption (EIRR) is a common complication of traumatic dental injury (TDI) that can be detected radiologically. During EIRR, various proteins are released into gingival sulcus fluid (GCF). The aim of the study was to monitor the levels of selected proteins in GCF in children (8-16 years of age) in order to assess their utility in the early diagnosis of EIRR. DESIGN: Twenty five children who experienced TDI to permanent incisors with ended root development were enrolled. GCF was collected from injured and control teeth with paper strips within seven days after TDI and on three visits during six-month follow-up. Concentrations of IL-1alpha, IL-1beta, IL-6, IL-8, TNFalpha, RANKL and MMP-9 in GCF were measured using enzyme-linked immunosorbent assays. EIRR was confirmed by radiological imaging techniques. RESULTS: Of all analyzed proteins, only the levels of IL-1alpha, Il-1beta and TNFalpha in GCF from the injured teeth with resorption were higher than in GCF from control teeth on the visit during which the EIRR was diagnosed. In univariate logistic regression model, the concentration of IL-1alpha in GCF was found as the strongest risk factor for the occurrence of EIRR. CONCLUSIONS: The composition of GCF may be indicative of EIRR after TDI. The monitoring of selected biomarkers in GCF may help to detect EIRR at its early stage and might be useful in reducing radiological exposure in children after TDI. IL-1alpha can be considered as a potential marker of the EIRR in children after TDI to the permanent teeth.