Feasibility of a rapid C-reactive protein chairside point-of-care test for detecting inflammation in exposed dental pulp: a pilot exploratory study

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OBJECTIVE/AIM: Dental pulp inflammation is a critical condition in endodontics. Traditional diagnostic methods, such as patient pain history and percussion tests, often lack accuracy in reflecting the true status of pulp inflammation. This study explores the feasibility of using a rapid C-reactive protein (CRP) chairside point-of-care (POC) test as a potential adjunctive tool for detecting dental pulp inflammation. The findings provide preliminary insights to inform future larger-scale validation studies. MATERIALS AND METHODS: This pilot cross-sectional observational study included 20 patients with deep carious lesions. Blood samples were collected from exposed pulp tissue under sterile conditions and analyzed using the CRP rapid POC test (index test). Patient pain history (clinical reference test) and percussion test outcomes were documented. The study assessed feasibility and preliminary diagnostic trends based on test performance and associations with clinical indicators. RESULTS: The CRP rapid POC test yielded positive results in 55% of cases. Preliminary findings suggest a potential association between CRP levels and percussion test results (p < 0.001), while no significant correlation was observed between CRP levels and patient pain history. The test demonstrated an observed sensitivity of 94.3%, specificity of 87.1%, positive predictive value (PPV) of 90.7%, and negative predictive value (NPV) of 91.9%. However, given the small sample size, these estimates should be interpreted with caution, and further research with larger cohorts is necessary for validation. CONCLUSION: This pilot study suggests that the CRP rapid POC test may have potential as a diagnostic aid for detecting dental pulp inflammation. However, these findings are preliminary, and further validation through larger studies and gold-standard comparisons is necessary before clinical implementation can be considered.

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