Salivary microRNA profile as a predictor of irreversible pulpitis and postoperative pain

Abstract

Irreversible pulpitis is a common inflammatory condition of the dental pulp that presents significant
diagnostic and therapeutic challenges in endodontic practice. Conventional diagnostic approaches,
including clinical examination, pulp sensibility tests, and radiographic assessment, often provide indirect
information regarding pulpal status and may not accurately reflect the underlying biological processes.
Consequently, there is growing interest in identifying objective molecular biomarkers capable of improving
diagnostic precision and predicting treatment outcomes. Salivary microRNAs have emerged as promising
candidates due to their stability, non-invasive accessibility, and regulatory roles in inflammation, immune
responses, and tissue repair. Alterations in salivary microRNA expression have been associated with
inflammatory changes within the dental pulp and may provide valuable information for distinguishing
irreversible pulpitis from healthy or reversibly inflamed pulp tissues. Furthermore, specific microRNA
expression patterns have shown potential for predicting postoperative pain intensity, enabling clinicians
to identify high-risk patients and implement personalized pain management strategies. Advances in
molecular diagnostics, biosensor technology, and artificial intelligence have further enhanced the feasibility
of integrating salivary microRNA profiling into routine clinical practice. Although additional large-scale
clinical validation and standardized analytical protocols are required, current evidence suggests that
salivary microRNA profiling represents a promising approach for improving diagnostic accuracy, prognostic
assessment, and personalized endodontic care while supporting the broader transition toward precision
dentistry.