Application of Silver Nanoparticles to Improve the Antibacterial Activity of Orthodontic Adhesives: An In Vitro Study.

There is a significant change in the bacterial plaque populations in the oral cavity during and after orthodontic treatment. Numerous studies have demonstrated that 2−96% of patients could increase the risk of white spot lesions. Streptococcus mutans and Lactobacilli ssp. are responsible for these white spot lesions. In this work, silver nanoparticles (AgNPs) with a diameter of 11 nm and dispersed in water were impregnated onto three different commercial orthodontic adhesives at 535 µg/mL. The shear bond strength (SBS) was assessed on 180 human premolars and metallic brackets. The premolars were divided into six groups (three groups for the commercial adhesives and three groups for the adhesives with AgNPs). All the groups were tested for their bactericidal properties, and their MIC, MBC, and agar template diffusion assays were measured. After adding AgNPs, the SBS was not significantly modified for any adhesive (p > 0.05), and the forces measured during the SBS did not exceed the threshold of 6 to 8 MPa for clinical acceptability in all groups. An increase in the bactericidal properties against both S. mutans and L. acidophilus was measured when the adhesives were supplemented with AgNPs. It was concluded that AgNPs can be supplement commercial orthodontic adhesives without modifying their mechanical properties with improved bactericidal activity.

Identification of Gingival Microcirculation Using Laser Doppler Flowmetry in Patients with Orthodontic Treatment-A Longitudinal Pilot Study.

Background and Objectives: Orthodontic tooth movement is associated with inflammatory responses. The aim of this study was to identify gingival microcirculation using laser Doppler flowmetry in patients with orthodontic treatment. Materials and Methods: A longitudinal pilot study was performed. The participants were selected using a non-probability consecutive sampling. Of the twenty-five subjects, a total of six (four women and two men) complied with the criteria. Before and during the treatment, the oral hygiene index, gingival index, probing depth, level of epithelial attachment, and gingival microcirculation were evaluated with laser Doppler flowmetry (integrated parameters: 1. integrated primary basal flow (IPBF), 2. integrated total secondary real flow (ITSRF), and 3. difference between integration (DBI)) in all of the participants). Results: (a) An increase in gingival blood flow was identified at all time intervals with different arches during orthodontic treatment. (b) The IPBF and ITSRF (with treatment) identified after 20 min (treatment initial stage) were compared with the different time intervals, and we observed an increase in gingival perfusion at the 24th, 48th, and 72nd hours in some arches. (c) In the DBI, we found statistically significant differences (p < 0.005) in the Nitinol group of 0.016 inches among all the time intervals (24 h, 48 h, and 72 h) within the 30-day interval, observing a flow increase three times greater than the basal flow after 30 days. Conclusions: Healthcare professionals must identify the inflammatory processes in treatment to observe and discontinue use of harmful methods in clinical practice.

Determination of sialic acid levels by using surface-enhanced Raman spectroscopy in periodontitis and gingivitis.

OBJECTIVES: To compare the sialic acid (SA) levels in saliva among periodontitis-affected, gingivitis and control patients. METHODS: The study involved 93 subjects. The participants were divided into three groups: (1) 30 subjects without periodontal disease (control group); (2) 30 subjects with gingivitis; and (3) 33 subjects with periodontitis. The oral parameters examined were as follows: (a) Simplified Oral Hygiene Index; (b) Calculus Index; (c) Gingival Index; (d) probing pocket depth; and (e) level of epithelial attachment. SA levels in saliva were measured by means of surface-enhanced Raman spectroscopy (SERS). This method has demonstrated the capacity to detect extremely low concentrations of molecules. The spectrum was calibrated using analytical reagent SA. RESULTS: The obtained median values for SA concentrations were 5.98, 7.32, and 17.12 mg/dl for control, gingivitis, and periodontitis patients, respectively. CONCLUSIONS: Our measurements by SERS corroborate that in periodontitis-affected patients, the SA concentration is larger than their concentrations in either control or gingivitis patients. This confirms previous reports and opens the possibility of using SERS as a diagnostic tool.

Diagnostic accuracy of three placement sites for the cold test in subjects amongst different age groups.

BACKGROUND: The cold test is a specific test of pulp sensitivity and is part of the endodontic diagnosis. The aim of this study was to identify the diagnostic accuracy including sensitivity, specificity, accuracy, positive predictive value and negative predictive value in three sites for the cold test in teeth with a need for endodontic treatment within different age groups from both genders. METHODS: A cross-sectional study was performed, evaluating 425 subjects. Two hundred and fifty-eight subjects from both genders from the ages of 17-27, 28-39, 40-50, and 51-65 years-old participated in the study. The cold test studied was 1, 1, 1, 2-tetrafluoroethane, and the gold standard was established through direct pulp inspection. The sites evaluated in the study were: The sites evaluated in the study were: a) the middle third of the buccal surface; b) the cervical third of the buccal surface, and c) the middle third of the lingual surface. RESULTS: The highest diagnosted accuracy was observed on the middle third buccal surface with an accuracy of = 0.97, a sensitivity of = 1.00, a specificity of 0.95, a predictive value of = 0.95 and a negative predictive value of = 1.00. This was in the female group aged from 40 to 50 years old. CONCLUSION: The tables of this study can be used as an auxiliary for pulp sensitivity tests.

Impact of socio-demographic, socioeconomic, and water variables on dental fluorosis in adolescents growing up during the implementation of a fluoridated domestic salt program.

The objective of this study is to determine the impact of socio-demographic, socioeconomic, and other risk indicators on dental fluorosis (DF) among Mexican adolescents. A cross-sectional study was carried out in 1,538 adolescents 12 and 15 years of age in semi-rural communities located at high altitude (>2,000 m) and with high concentration of fluoride in water (1.38-3.07 ppm) in Hidalgo, Mexico. DF was determined by means of Dean's Index and all teeth were examined. Remaining variables were collected using a questionnaire. The adjusted final model was performed using ordered logistic regression. After adjusting for sex, the variables associated with DF were (p < 0.05): being 12 years old (OR = 1.10) versus 15 years old; having lived the first 6 years of life in El Llano (3.07 F ppm) (OR = 3.19) or San Marcos (1.38 F ppm) (OR = 1.63) versus Tula (1.42 F ppm); having public (OR = 1.35) or private health insurance (OR = 1.36) versus those without insurance; belonging to the lower quartiles of socioeconomic position (SEP) [1st quartile (OR = 2.48), 2nd quartile (OR = 1.81), 3rd quartile (OR = 1.49)] versus the highest quartile; having drunk tap water (OR = 1.83) or from a well or spring (OR = 2.30) versus those who drank water purchased in large containers or bottles. Demographic and socioeconomic variables were associated with DF. While better SEP appeared to play an important role in DF, a pattern of water intake associated with water purchased in large containers or bottles (which have different connotations to the use of bottled water in industrialized Western countries) did reduce DF risk in these high fluoride content, high altitude communities.

[Evaluation of dental treatment impact in a northwestern Mexican school children population]. / Evaluación del impacto del tratamiento odontológico en una población escolar del noroeste de México.

OBJECTIVE: To evaluate through functional teeth index, the impact in schoolchildren in communities with and without dental community support. MATERIAL AND METHODS: A cross-sectional study was carried out in communities with dental care provided by dental clinics of Sinaloa State University. The study sample was 2,083 schoolchildren. We used the criteria proposed by WHO for the index of decayed, missing-teeth (DMFT) for permanent dentition, index for prima- ry teeth (dmft) and the rate of functional teeth (RFT). For bivariate analysis, the nonparametric tests Pearson f and Mann-Whitney U were used. RESULTS: The comparisons of DMFT (0.20) and RFT (13.95) of children with and DMFT (0.43) and RFT (14.82) of children without community dental support showed statistical significant difference (p < 0.05). There was a statistically significant difference in DMFT and RFT between samples with and without community dental support (p < 0.05). The age showed a statistically significant difference between the DMFT and dmft (p < 0.05). Primary dentition required more dental care than permanent dentition. There was access for dental treatment, but it is not used for the population. CONCLUSIONS: The RFT provided precise information than DMFT, mainly due to register the changes of actions focused to recover the teeth function in the oral cavity.

Changes in oral pH before and after placing preformed metal crowns in primary dentition of Mexican children.

BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment. OBJECTIVE: To evaluate the pH variations before and after placement of PMCs. METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one month after placement. ANOVA and Pearson correlation were performed in SPSS. RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p< 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p= 0.001) and one month (p= 0.002). CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact.

Impact of COVID-19 on Dental Practices in El Salvador and Mexico: A Comprehensive Survey Analysis.

BACKGROUND AND OBJECTIVES: This study aimed to identify the relationship between prevention measures and protective barriers in dental practice in El Salvador and Mexico during the COVID-19 pandemic in 2020 and 2021. MATERIALS AND METHODS: A longitudinal study was conducted from June 2020 to December 2021, involving 1,719 dentists divided into four groups based on location and year. A 20-question survey in Spanish was utilized and validated with a Cronbach's alpha value of 0.84. RESULTS: The use of phone triage (OR = 1.3), thermometers (OR = 1.4), physical distancing (OR = 1.7), and face shields (OR = 2.6) was significantly associated with dental practice in both countries during the pandemic. CONCLUSIONS: During 2020 and 2021, dental care in El Salvador and Mexico was significantly linked to COVID-19 preventive measures. Phone triage, thermometers, distancing, and face shields positively correlated with dental services. National health agencies should promote the use of minimum preventive measures in dental care, preparing for potential reinfections or new pandemics from emerging virus variants.

Association Between Gender, Age, and Skeletal Class With Mandibular Condyle Morphology: A Retrospective Study.

OBJECTIVES: This study aimed to examine the impact of demographic variables on mandibular condyle morphology, a critical factor in orthodontic treatment and maxillofacial surgery. The investigation focuses on the relationship between gender, age, and skeletal class with the morphological dimensions of the condyle, utilizing panoramic radiography as a diagnostic tool. METHODOLOGY: A retrospective analysis was conducted on 150 panoramic radiographs from individuals stratified into six groups according to gender and skeletal class. Skeletal classes were determined using Steiner and McNamara cephalometry. The Kodak Carestream software (Rochester, NY: Carestream Health) was employed to measure condylar height, width, and morphology. Statistical evaluations included ANOVA, correlation assessments, and multivariate binary logistic regression to discern the differences and associations among the variables studied. RESULTS: The findings revealed notable differences in condylar dimensions between genders across different skeletal classes, with males typically presenting larger condylar dimensions than females. The data also showed a moderate positive correlation between condyle height and width. Round-shaped condyles were the most common form found, with significant gender differences observed in certain skeletal classes. Additionally, logistic regression analysis identified significant associations between gender, age, and condylar width and shape. CONCLUSIONS: The study concludes that demographic factors, such as gender and age, significantly affect mandibular condyle morphology. These factors should be carefully considered in clinical evaluations using panoramic radiography to enhance the precision of diagnoses and the effectiveness of subsequent orthodontic and maxillofacial treatments. The results provide valuable insights for healthcare professionals in regions where more advanced imaging techniques may not be readily available.

Comparison of oral streptococci biofilm in caries-free and caries-affected preschool Mexican children.

Interaction of oral streptococci biofilm is the main etiological factor for dental caries. The aim of the study was to compare oral streptococci (OS) distribution in the biofilm of primary dentition from caries-free and caries-affected preschool Mexican children. This cross-sectional study involved 40 caries-free and 40 caries-affected children with primary dentition. Each child was examined using the dmfs index, DNA was extracted from saliva and presence of OS was determined by PCR. Data obtained showed no statistical difference regarding age and gender (P > 0.05). Streptococcus mutans (Smut), Streptococcus sobrinus (Ssob) and their combination showed significant statistical differences between groups (P < 0.05). Smut, Streptococcus sanguinis and Streptococcus gordonii had an inverse relation with dmfs index and Ssob had a direct relation similar to combined with Smut. Smut-Ssob combined with other OS showed statistical differences (P < 0.05). In free-caries group Streptococcus gordonii was more frequently identified than Smut. The ratio Smut/Streptococcus sanguinis could represent a high risk of dental caries development; this ratio was higher in the caries-affected (1.18) than in the caries-free group (0.32). In conclusion, OS play an important role in dental caries predisposition and severity, not only the presence of Smut and Srob, but also the complexity and distribution of OS in the biofilm.

Traumatic dental injuries in 6 to 12 years old schoolchildren: a multicenter cross-sectional study in Mexico.

The aim of this study was to determine the prevalence of dental trauma in schoolchildren 6 to 12 years of age and associated clinical, sociodemographic, and socioeconomic variables. A cross-sectional study was conducted in 477 children from public elementary schools in four locations in Mexico. The dependent variable was dental trauma, which was dichotomized in 0 = without dental trauma and 1 = with dental trauma. For the statistical analysis, a multivariate binary logistic regression model was generated in Stata. Average age was 9.06±1.94 years and 51.1% were girls. The prevalence of dental trauma was 18.2%. Falls, automobile accidents and sports had the highest number of instances (p < 0.01). In the multivariate model, it was observed that the risk of dental trauma increased with age (OR = 1.28) and among boys (OR = 1.45). Schoolchildren with decreased overjet (OR = 0.38) had lower dental trauma. Father's age (OR = 1.03) and educational level (OR = 1.78) were associated with dental trauma. Schoolchildren without health insurance (OR = 0.62) presented dental trauma less often. This study provided important information regarding the association of different sociodemographic, socioeconomic and clinical variables with dental trauma in Mexican schoolchildren. Identifying factors associated with dental trauma may support health promotion opportunities to ameliorate the prevalence of dental trauma.

Clinical evaluation of the accuracy of conventional radiography and apex locators in primary teeth.

PURPOSE: The purpose of this study was to clinically evaluate the accuracy of conventional radiography and 2 apex locators (Root ZX and ProPex) in determining the working length of root canals in primary teeth and to compare the results with scanning electron microscopy (SEM). METHODS: A general medical and oral history was obtained from 1,600 children and 50 children were selected. The working lengths of the primary teeth root canals were determined with conventional radiography and 2 apex locators (Root ZX and ProPex). These results were compared with the ideal standard using SEM. To determine the difference among means of the different methods, the Wilcoxon test was applied. To determine the accuracy of the methods with the ideal standard (SEM), the Lin interclass correlation coefficient (ICC) was used. RESULTS: Sixty-one canals were evaluated and there were no significant difference in the 3 techniques in accuracy of determination of the working length of the canals. The most accurate method of determining the working length of the root canals in primary teeth was the Root ZX (ICC=0.72), followed by the ProPex (ICC=0.70), and the least accurate was conventional radiography (ICC=0.67). CONCLUSION: The apex locators were more accurate than conventional radiography in determining the working length.

How Dentists Face the COVID-19 in Mexico: A Nationwide Cross-Sectional Study.

Background: on 7 January 2020, a new type of coronavirus was isolated, the Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2), the organism causing the outbreak that has affected the lives of all humans and has modified the rules of coexistence around the world. In Mexico, from 3 January 2020 to 9 January 2021, there have been 1439, 569 confirmed cases of COVID-19 with 131,031 deaths. The World Health Organization reported that Mexico was ranked twelfth, in terms of confirmed cases of COVID-19 by country. Aim: the objective of this study was to determine what modifications dentists from the Mexican Republic have made to their dental practice during theCOVID-19 pandemic. Methods: the study was conducted based on a questionnaire to evaluate the dentists' response and knowledge on the modifications in their dental practice to combat the new coronavirus's cross-transmission. The questionnaire was piloted before it was distributed. The questionnaire was disseminated through the social network Facebook. The questionnaire was distributed to groups of dentists on Facebook, in each of the Mexican Republic states. The survey was carried out during June 2020. Results and Conclusions: from the 32 states of the Mexican Republic, 29 participated with at least one respondent. The results of the applied survey suggest that dentists, at least the population of surveyed ones, have proper knowledge of detection methods of patients suspected of COVID-19, preventive measures that must be applied in the dental office to decrease the risk of infection, and the appropriate procedures and solutions for dental office disinfection.

Dental pain prevalence associated with caries experience in pediatric patients in a clinical sample in Mexico.

The aim of this study was to identify if the prevalence of dental pain (past and / or present) is associated with caries experience in Mexican children, as well as to characterize factors associated with dental pain. A cross-sectional study was conducted in a consecutive sample of 309 children 2 to 12 years old who were patients at a dental school clinic in Toluca, Mexico. Data were collected from clinical records. The dependent variable had three categories: 0 = have never had dental pain, 1 = had dental pain before the appointment, and 2 = current dental pain. Non-parametric statistical tests were used in the analysis. A multivariate multinomial logistic regression model was generated in Stata 11.0. Average age was 5.71 ± 2.43 years and 50.8% were boys. The joint dmft+DMFT index was 9.11 ± 4.19. It was observed that 56.6% of children did not report having experienced dental pain, 30.7% reported having previously had dental pain, and 12.6% had pain when the clinical appointment took place. In the multivariate model, variables associated (p < .05) with previous dental pain were age (OR = 1.13); the dmft + DMFT index (OR = 1.13), having had a last dental visit for curative/emergency reasons (OR = 2.41) and prior experience of dental trauma (OR = 2.59). For current pain, only the joint dmft + DMFT index (OR = 1.10, p < 0.05) had significant associations. Almost half of the children had experienced dental pain in their lifetime. Since caries experience is a factor associated with dental pain, decreasing caries levels may ameliorate suffering from dental pain in children.

Atomic force microscopy observation of the enamel roughness and depth profile after phosphoric acid etching.

The aim was to compare the enamel surface roughness (ESR) and absolute depth profile (ADP) (mean peak-to-valley height) by atomic force microscopy (AFM) before and after using four different phosphoric acids. A total of 160 enamel samples from 40 upper premolars were prepared. The inclusion criterion was that the teeth have healthy enamel. Exclusion criteria included any of the following conditions: facial restorations, caries lesions, enamel hypoplasia and dental fluorosis. Evaluations of the ESR and ADP were carried out by AFM. The Mann-Whitney U-test was used to compare continuous variables and the Wilcoxon test was used to analyze the differences between before and after etching. There were statistically significant differences (P

Characterization of healthy and fluorotic enamel by atomic force microscopy.

The aim was to characterize the external structure, roughness, and absolute depth profile (ADP) of fluorotic enamel compared with healthy enamel. Eighty extracted human molars were classified into four groups [TFI: 0, control (C); 1-3, mild (MI); 4-5, moderate (MO); 6-9, severe fluorosis (S)] according to the Thylstrup-Fejerskov Index (TFI). All samples were analyzed by atomic force microscopy.The mean values of enamel surface roughness (ESR) in nm were: Group C, 92.6; Group MI, 188.8; Group MO, 246.9; and Group S, 532.2. The mean values of absolute depth profile in nm were: C, 1,065.7; MI, 2,360.7; MO, 2,536.7; and S, 6,146.2. The differences between mean ESR and mean ADP among groups were statistically significant (p < 0.05). This structural study confirms at the nanometer level that there is a positive association between fluorosis severity, ESR, and ADP, and there is an association with the clinical findings of fluorosis measured by TFI as well.

[Epidemiologic study on dental caries and treatment needs in schoolchildren aged six to twelve years from San Luis Potosi]. / Estudio epidemiológico sobre caries dental y necesidades de tratamiento en escolares de 6 a 12 años de edad de San Luis Potosí.

OBJECTIVE: To determine the experience, prevalence and severity of dental caries, as well as the Significant Caries Index (SiC) and the treatment needs (TN) in schoolchildren aged six to twelve years. Equally, to estimate the effect of caries in primary dentition on caries in permanent dentition. MATERIAL AND METHODS: A cross-sectional study was realized in 3865 schoolchildren from San Luis Potosí City, Mexico. Subjects were clinically evaluated by three standardized examiners (kappa > 0.85). For detection of caries was employed the WHO's criteria for primary (dmft) and permanent (DMFT) dentitions. In the statistical analyzes non-parametric test and logistic regression were used. RESULTS: Mean of age was 8.69 +/- 1.79 and 51.3% were women. In the primary dentition: dmft index was 1.88 +/- 2.34 and the caries prevalence (dmft >0) of 56.8%. In account to severity 22.0% and 5.6% have dmft >3 and dmft >6, respectively. In children of six years, the caries prevalence was 56.0% and the SiC of 5.45. In the permanent dentition: DMFT index was 1.11 +/- 2.03 and the caries prevalence (DMFT >0) of 36.8%. In account to severity 11.8% and 2.8% have DMFT >3 and DMFT >6, respectively. In children of twelve years, the DMFT index caries 4.14 +/- 4.15 and the SiC of 9.15. The TN index was of 88.5% for primary dentition and 93.6% for the permanent. In logistic regression we observed associated to caries prevalence in permanent dentition; presence of caries in primary dentition (OR = 6.37; p < 0.001), female sex (OR = 1.33; p < 0.001) and higher age (OR = 1.69; p < 0.001). CONCLUSIONS: Caries prevalence to six years old and DMFT index to twelve years old were highest to values established by WHO. Caries severity in the primary dentition was two times than observed in the permanent dentition. High TN in both dentitions was observed. Presence of caries in primary dentition was a strong risk indicator for to present caries in permanent dentition.

Relationship between overweight-obesity and periodontal disease in Mexico.

The aim of this study was to examine the association between overweight-obesity and periodontal disease in subjects who attended the clinic of Periodontics, Faculty of Dentistry, San Luis de Potosi, México. This was cross-sectional study involving 88 subjects--60 without overweight-obesity and 28 with overweight-obesity. The following clinical parameters were evaluated: dental bacterial plaque, index of calculus, gingivitis, probing depth and periodontal disease index (PDI). When comparing the group of subjects with overweight-obesity to the control, there were statistically significant differences in the variables calculus (p = 0.0015), gingivitis (p = 0.0050) and periodontal disease (p = 0.0154). Regarding the logistic regression analysis, the dependent variable was subjects with and without overweight-obesity and the independent variables were sex, age and periodontal disease. We found statistically significant differences (p = 0.0162) with OR = 3.16 in periodontal disease. Periodontal disease showed statistically significant differences in the group of subjects with overweight-obesity. The oral health of subjects with overweight-obesity should be supervised and checked in order to prevent oral alterations.

Effective control of biofilms by photothermal therapy using a gold nanorod hydrogel.

Biofilms are matrices synthesized by bacteria containing polysaccharides, DNA, and proteins. The development of biofilms in infectious processes can induce a chronic inflammatory response that may progress to the destruction of tissues. The treatment of biofilms is difficult because they serve as a bacterial mechanism of defense and high doses of antibiotics are necessary to treat these infections with limited positive results. It has been demonstrated that photothermal therapy using gold nanorods (AuNRs) is an attractive treatment because of its anti-biofilm activity. The purpose of this work was to generate a novel chitosan-based hydrogel embedded with AuNRs to evaluate its anti-biofilm activity. AuNRs were synthesized by the seed-mediated growth method and mixed with the chitosan-based hydrogel. Hydrogels were characterized and tested against two bacterial strains by irradiating the produced biofilm in the presence of the nanoformulation with a laser adjusted at the near infrared spectrum. In addition, the safety of the nanoformulation was assessed with normal human gingival fibroblasts. Results showed that a significant bacterial killing was measured when biofilms were exposed to an increase of 10°C for a short time of 2 min. Moreover, no cytotoxicity was measured when normal gingival fibroblasts were exposed to the nanoformulation using the bactericidal conditions. The development of the reported formulation can be used as a direct application to treat periodontal diseases or biofilm-produced bacteria that colonize the oral cavity.

Levels of matrix metalloproteinase-8 and cold test in reversible and irreversible pulpitis.

ABSTRACT: Researchers have reported false positive/negative results of the cold test in the diagnosis of pulpitis. Knowledge of the correlation between results of the cold test and proteins could aid in decreasing the frequency of incorrect diagnosis. To associate the levels of matrix metalloproteinase-8 (MMP-8) with the responses (in seconds) to the cold test in teeth diagnosed with reversible and irreversible pulpitis.A cross-sectional study was performed. A total of 150 subjects were evaluated, of which 60 subjects met the selection criteria. The participants were divided into 3 groups: Group 1, healthy pulps, 20 subjects with 20 posterior teeth (premolars) with clinically normal pulp tissue; Group 2, reversible pulpitis, 20 patients with 20 teeth diagnosed with reversible pulpitis; and Group 3, irreversible pulpitis, 20 subjects with 20 teeth diagnosed with irreversible pulpitis. All participants were evaluated based on the following variables: medical and dental history, cold test, and expression of MMP-8 by enzyme-linked immunosorbent assay in dentin samples.Responses to the cold test between 4 to 5 seconds (second evaluation; P < .0001) were associated with high levels of MMP-8 (mean, 0.36 ng/mL) in the reversible pulpitis group. In the irreversible pulpitis group, the responses from 6 to ≥10 seconds (second evaluation; P < .0001) were associated with a higher average of MMP-8 levels (mean, 1.97 ng/mL).We determined that an increase in the duration of response to the cold test was associated with an increase in MMP-8 levels (Rho = 0.81, P < .0001) in teeth with pulpitis. The above correlations can be considered an adjunct to the clinical diagnosis of pulpitis.