Clinical Research Directory

Prognostic Value of Pulpal Blood pH and Oxygen Saturation in Vital Pulp Therapy: Determination of Clinically Relevant Thresholds in a Prospective Clinical Study

The increasing emphasis on biological tissue preservation in contemporary endodontics has positioned vital pulp therapy (VPT) as an important treatment strategy for maintaining pulp vitality and preserving the functional integrity of the pulp-dentine complex. Advances in biomaterials and understanding of pulpal healing have expanded the indications for VPT and contributed to favourable clinical outcomes; however, appropriate case selection remains a critical determinant of treatment success. Currently, the clinical assessment of pulpal status before VPT relies on a combination of patient-reported symptoms, clinical and radiographic findings, pulp sensibility testing and intraoperative assessment of pulpal bleeding. Although clinically valuable, these parameters do not provide a direct and objective measure of the biological status or healing potential of the pulp and may be influenced by clinical interpretation. Consequently, there remains a need for objective biological parameters that provide more direct information on pulpal status and healing potential, thereby supporting case selection and prognostic assessment in VPT. Progressive pulpal inflammation is accompanied by increased production of inflammatory mediators, vascular congestion, enhanced vascular permeability, impaired microcirculation, and reduced tissue perfusion. These vascular alterations may compromise oxygen delivery to the pulp, resulting in reduced pulpal oxygen saturation (SpO2). As oxygen availability decreases, cellular metabolism shifts towards anaerobic pathways, promoting the accumulation of acidic metabolites, which may consequently lead to a reduction in pulpal blood pH. Accordingly, pulpal SpO2 and pulpal blood pH may represent complementary physiological and metabolic indicators of pulpal inflammatory status. Their assessment may provide objective information on the biological condition and healing potential of the pulp that is not directly captured by conventional diagnostic methods. Consistent with these observations, Hosseinzadehfard et al. (2026) reported that pulpal blood pH and SpO2 varied with pulpal diagnostic status, supporting their potential value as objective indicators of pulpal inflammation. However, their study focused on the diagnostic relevance of these parameters rather than their association with VPT success. To date, their association with subsequent treatment outcomes and clinically relevant thresholds for outcome prediction remain to be established. The present prospective clinical study aims to investigate the association of pulpal blood pH and pulpal SpO2, individually and in combination, with the clinical and radiographic outcome of VPT at the 12-month follow-up, and to determine clinically relevant threshold values associated with treatment success. Pulpal blood pH will be assessed both immediately after initial pulp exposure and following pulpotomy in the remaining vital pulp tissue, allowing evaluation of the relationship between the two pH measurements. Systemic oxygen saturation and venous blood pH will additionally serve as physiological reference measures. The findings may provide an evidence-based foundation for a more objective and biologically informed approach to case selection and prognostic assessment in VPT.

The Effect of pH Value of Water Consumed During Bowel Preparation Before Colonoscopy on Colon Cleansing

Colonoscopy is a commonly used minimally invasive method for evaluating the lower gastrointestinal tract. The quality of colonoscopy is assessed by factors such as cecal intubation rate and adenoma detection rate, both of which are affected by bowel preparation. Adequate bowel cleansing is critical for an ideal colonoscopy. Inadequate bowel preparation can prolong the procedure time, miss pathological findings, and increase hospital costs due to repeated procedures. Studies have shown that nearly 25% of patients have inadequate bowel preparation. Several factors influence bowel cleansing, including diet, bowel preparation medication, and a history of gastrointestinal surgery. In a study, male gender, hospitalization, and spring season were reported as independent risk factors for inadequate bowel preparation. A retrospective US study associated age ≥66 with poor colonoscopy preparation, while two Asian studies associated age ≥60. Comorbidities such as diabetes, stroke, and dementia, as well as low socioeconomic status, have also been reported to negatively impact adequate bowel cleansing. The Aronchick scale, Ottawa Bowel Preparation Scale (OBPS), and Boston Bowel Preparation Scale (BBPS) are commonly used in bowel preparation scoring. The BBPS is rated from 0 to 9, with 9 considered excellent bowel preparation. It is applied after cleansing and aspiration of colon segments, which are divided into right, transverse, and left colon. Among the current scoring systems, the BBPS is the most useful and reliable scale. The positive effects of alkaline pH water on the gastrointestinal system are well known. Alkaline mineral water has positive effects on intestinal epithelial regeneration, inflammatory response, improved barrier function, and antioxidant mechanisms. In this study, researchers aimed to investigate the effect of the pH value of water consumed during bowel preparation before colonoscopy on bowel cleansing. Demographic, clinical, and intraoperative data of patients undergoing colonoscopy in investigators hospital's surgical endoscopy unit between July 2026 - July 2027 will be examined. Patients meeting the inclusion criteria will be included in the study. For pre-procedure information, all patients will be given a bowel preparation form by the surgical endoscopy unit, and patients who do not fully adhere to the diet will be excluded from the study. Informed consent will be obtained from the patients or their legal representatives. All procedures will be performed under sedation with the assistance of an anesthesiologist. Bowel cleansing will be assessed according to the Boston Bowel Preparation Scale (BBHS). The pH value and content of the drinking water will be noted when the bowel preparation form is given; no specific instructions will be given regarding this. However, patients will be asked to use the same water throughout the bowel preparation period. Data regarding drinking water will be confirmed on the day of the procedure for a second check. This study will be the first of its kind in this field.

Oral Changes With Caloric and no Caloric Sweeteners

The objective of this clinical trial is to compare the effect that the intake of beverages without sweeteners, added with non-caloric sweeteners (stevioside) and caloric sweeteners (sucrose) on oral pH and dental biofilm microbiome in Mexican adolescents. Participants will drink on different occasions a beverage without sweetener, a beverage added with stevioside or a beverage added with sucrose. The researchers will compare the changes that each one causes in salivary pH, dental biofilm pH, dental biofilm bacterial proliferation and dental biofilm microbiome.