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Belal RM, Yousef DA, Elgendy E, Belal MH. Dentin Collagen versus Er:YAG Laser as Surface Biomodifiers for Intact Root Slices Simulating Delayed Replanted Roots. Photobiomodul Photomed Laser Surg 2025; 43:41-49. [PMID: 38836755 DOI: 10.1089/pho.2023.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Objective: To evaluate effects of dentin collagen versus Er:YAG laser application through enhancing human periodontal ligament fibroblast (PDLF) cells to attach to intact root surfaces imitating delayed replanted roots. Background Data: Accidental traumatic injuries with teeth avulsion are managed by replantation. Root resorption, poor conditioning, and non-viable fibroblasts are factors responsible for failure. Methods: Thirty six human healthy single-rooted premolars were collected. Six teeth were used for PDLF, six teeth used for dentin collagen, whereas the remaining 24 teeth (48 root slices) were used for PDLF cell density and morphology. Each root was soaked in 5.25% NaOCl. Three groups (n = 16 slices/each) were planned as follows: I: Control (untreated); II: dentin collagen application; III: Er:YAG laser irradiation (4 mm distance, 40 mJ/pulse, under coolant). Following incubation, cell density and morphology of PDLF were investigated under SEM. Statistical analysis was performed using analysis of variance with Scheffé's test, and p < 0.05 was considered significant. Results: All groups showed increased cultured PDLF following incubation. Regarding cell density, attached PDLFs were significantly lower in untreated controls (36.5 ± 6.36) (p < 0.00001 i.e., <0.05) in negative empty and/or light cellular areas, compared with dentin collagen (65 ± 6) and laser-irradiated (66.75 ± 5.77) groups that did not show significant differences (p = 0.940 i.e., >0.05) and showed intermediate and/or heavy cellular areas. Regarding cell morphology, controls showed round and/or oval appearance with less lamellipodia, whereas dentin collagen and laser groups showed flat morphology with cytoplasmic processes. Conclusions: Both dentin collagen and Er:YAG laser showed comparable effectiveness as biomodification tools with good biocompatibility for human PDLF cell attachment on intact root slices imitating delayed replantation. Dentin collagen as a natural bioactive material is considered an alternative to Er:YAG laser to enhance the regenerative effects.
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Affiliation(s)
- Reham M Belal
- Health Administration of Kafr El-Zayat, Ministry of Health & Population, Kafr El-Zayat, Egypt
| | - Doaa A Yousef
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology.Faculty of Dentistry, Tanta, Egypt
| | - Enas Elgendy
- Faculty of Oral and Dental Medicine, Kafr Elsheikh University, Kafr El-Shaikh, Egypt
| | - Mahmoud Helmy Belal
- Department of Oral Medicine, Periodontology, Oral Diagnosis & Radiology, Faculty of Oral & Dental Medicine, Damanhour University, Damanhour, Egypt
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Pini Prato G, Franceschi D, Pace R, Di Gianfilippo R. Translational approach to tooth autotransplantation: A 27-year case study. Clin Adv Periodontics 2024; 14:165-171. [PMID: 37983628 DOI: 10.1002/cap.10272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The aim of this case report was to present a translational approach to tooth autotransplantation using jiggling forces to enlarge the periodontal ligament (PDL) space before autotransplantation, with the goal of improving treatment success and long-term survival. METHODS A 23-year-old patient, undergoing orthodontic therapy and with an unrestorable maxillary first molar, was proposed to have a healthy and fully-erupted maxillary third molar transplanted in the socket of the first molar. Jiggling forces were applied to the third molar to enlarge the PDL space and facilitate the preservation of PDL fibers on the root surfaces during the extraction. RESULTS Jiggling forces induced hypermobility and widened PDL space of the third molar. The autotransplantation was successful and the patient was followed regularly over a 27-year period. At the 27-year visit, the patient showed optimal chewing function, oral plaque control, and absence of gingivitis. The transplanted molar exhibited periodontal health and absence of mobility. Probing depth of 5 mm and radiographic external root resorption was noted on a localized area of the transplanted tooth which had experienced traumatic and unintentional removal of PDL fibers during the extraction. CONCLUSIONS A translational approach was proposed by integrating knowledge from the fields of orthodontics, trauma from occlusion, and replantation. It validated the crucial importance of maintaining healthy PDL fibers on the root surface and demonstrated clinically the successful autotransplantation of a fully formed third molar into the socket of a first molar with a retention of 27 years. KEY POINTS Why is this case new information? This case provided evidence of successful autotransplantation of a molar with complete root formation. It reported the longest-term follow-up (27 years) present in the literature. Most importantly, it used a translational medicine approach to apply concepts from the fields of orthodontics and traumatic occlusion to improve the success of the autotransplantation procedure. What are the keys to the successful management of this case? Jiggling forces induced tooth hypermobility and increased the PDL space of the tooth planned for autotransplantation. In turn, they facilitated the atraumatic extraction and preservation of the PDL fibers on the transplanted tooth, improving the success of the reattachment of periodontal fibers. What are the primary limitations to success in this case? Traumatic extraction resulting in the unintended removal of PDL fibers from the tooth planned for autotransplantation, or intentional removal of PDL fibers with root planing are expected to decrease the success rate of the autotransplantation procedure. This is due to the lack of viable PDL cells necessary for reattachment.
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Affiliation(s)
| | - Debora Franceschi
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Riccardo Pace
- Department of Endodontics, The University of Florence, Florence, Italy
| | - Riccardo Di Gianfilippo
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Pacific Academy of Periodontal and Implant Research (PAPIR), Issaquah, Washington, USA
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Kabra SP, Deshkar M, Thosar NR, Khubchandani M. Successful Replantation of an Anterior Tooth in an 11-Year-Old Child: A Case Report. Cureus 2024; 16:e65794. [PMID: 39219927 PMCID: PMC11362117 DOI: 10.7759/cureus.65794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Avulsion occurs when the tooth is completely knocked out of its alveolar socket. The maxillary central incisors are more vulnerable to avulsion due to their prominent position in the dental arch. This case report describes a successful permanent maxillary incisor replantation in an 11-year-old child. The replanted tooth was stabilized in the socket using orthodontic wire, followed by root canal treatment and composite restoration within a two-week interval. Clinical and radiographic follow-up was done at one and six months. Successful management of an avulsed tooth requires educating the patient about different storage mediums and emergency management after an avulsion. This case report concluded that the avulsed tooth result is highly dependent on the patient's understanding of avulsion and how to approach it.
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Affiliation(s)
- Sakshi P Kabra
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Mrunali Deshkar
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Nilima R Thosar
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Monika Khubchandani
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Herr L, Ye JR, Kang SW, Ro ST, Chae YK, Lee KE, Kim MS, Jih MK, Lee C, Choi SC, Nam OH. Effect of intra-alveolar delivery of Frondoside A on inflammatory response of delayed tooth replantation. Dent Traumatol 2024; 40:178-186. [PMID: 37731288 DOI: 10.1111/edt.12891] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND/AIM Frondoside A is a sea cucumber extract which is well known for its anti-inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. MATERIALS AND METHODS Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell-counting kit-8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti-inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague-Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra-oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. RESULTS 0.5 μM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p < .05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p < .05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p < .05). CONCLUSIONS Within the limits of this study, intra-alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth.
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Affiliation(s)
- Lar Herr
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ju Ri Ye
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
| | - Sang Wook Kang
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Sang Tae Ro
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
| | - Ko Eun Lee
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
| | - Mi Sun Kim
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Myeong Kwan Jih
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju, South Korea
| | - Chunui Lee
- Department of Oral and Maxillofacial Surgery, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - Sung Chul Choi
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee Universtiy Medical Center, Seoul, South Korea
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
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Figueiredo LR, Bento VAA, Sonoda CK, Pellizzer EP. Efficacy of photobiomodulation in the treatment of avulsed teeth: A systematic review of animal studies. Lasers Med Sci 2024; 39:50. [PMID: 38280099 DOI: 10.1007/s10103-024-03998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (i.e., "PRISMA") statement 2020 and was registered in the International Prospective Register of Systematic Reviews (i.e., PROSPERO) with number CRD42022362198. The participants, intervention, comparison, outcomes, and study design (i.e., PICOS) for the present study considered the following question: "Does the use of laser PBM in the treatment of teeth with avulsion influence tissue repair performance?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest databases until January 2023. The SYRCLE's RoB tool (Systematic Review Center for Laboratory Animal Experimentation) for animal studies were used for quality assessment. A total of 7 in vivo studies published between 2011 and 2018 were included in this systematic review for qualitative analysis. All studies used Wistar rats, totaling 368 specimens that simulated tooth avulsion trauma. The effect of photodynamic therapy in the treatment of avulsed teeth was positive in 5 studies (significant increase in tissue repair) and negative in 2 studies, in which both studies with negative results kept teeth in saline solution before reimplantation and showed the longest time and power of laser application. PBM appears to be effective for tissue repair in the treatment of avulsed teeth, depending on the means of conservation of the avulsed tooth and the laser application protocol.
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Affiliation(s)
- Leonardo Raniel Figueiredo
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 Jose Bonifacio St - Centro, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 Jose Bonifacio St - Centro, Araçatuba, SP, Brazil.
| | - Celso Koogi Sonoda
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 Jose Bonifacio St - Centro, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, 1193 Jose Bonifacio St - Centro, Araçatuba, SP, Brazil
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Elhakim A, Kim S, Shin SJ, Jung HS, Kim E. Effect of icariin surface treatment on the resorption of denuded roots after replantation in rat. Int Endod J 2023; 56:1550-1558. [PMID: 37787769 DOI: 10.1111/iej.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
AIM Limiting the incidence of resorption associated with delayed replantation of avulsed teeth is critical for long-term tooth survival. In this study, we assessed whether icariin, a natural product with anti-osteoclastic properties, could reduce root resorption in a rat model of tooth replantation. METHODOLOGY Cytocompatibility of icariin (10, 20, 40 and 80 μM) was evaluated by CCK-8 proliferation assay in vitro, and an osteoclastogenesis assay was performed to evaluate the effect of icariin on the differentiation of rat bone marrow macrophages and human peripheral blood monocytes into tartrate-resistant acid phosphatase-stained (TRAP+ ) multinucleated giant cells (MNGCs). Differentiation of human periodontal ligament stem cells (hPDLSCs) treated with icariin (10 μM) was also evaluated at 5, 10 and 21 days of osteogenic induction. The first maxillary molars of five-week-old male Sprague-Dawley rats were extracted, denuded of PDL, then treated either with neutralized collagen solution (Carrier control) or icariin in collagen (3 μg/μL) before replantation into their sockets. The animals were euthanized 2 weeks post-surgery for micro-computed tomography (micro-CT) imaging and histological analyses. RESULTS Icariin was cytocompatible and significantly reduced the differentiation of TRAP+ MNGCs in a dose-dependent manner compared to the control. Moreover, icariin enhanced alkaline phosphatase activity, expression of osteogenic marker genes and proteins, and calcium deposition in hPDLSCs. Micro-CT imaging of the replanted samples demonstrated a significantly higher volume of remaining roots in the icariin-treated group than in the control group. Histological analysis revealed a marked number of resorptive lacunae with TRAP activity in the control group, whereas icariin-treated samples showed signs of functional healing and reduced osteoclastic activity. CONCLUSIONS Icariin was biocompatible and demonstrated potent anti-osteoclastic and pro-osteogenic properties that reduced resorption and promoted functional healing of denuded roots in a rat maxillary first molar model of replantation. These findings indicate that root surface treatment with icariin may be a clinically relevant and practical method for improving the retention and survival of teeth with compromised PDL after delayed replantation following traumatic avulsion.
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Affiliation(s)
- Ahmed Elhakim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Han-Sung Jung
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Taste Research center, Oral Science Research Center, BK21 FOUR project, Yonsei University College of Dentistry, Seoul, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
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Plotino G, Abella Sans F, Bastos JV, Nagendrababu V. Effectiveness of intentional replantation in managing teeth with apical periodontitis: A systematic review. Int Endod J 2023; 56 Suppl 3:499-509. [PMID: 35294790 DOI: 10.1111/iej.13727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intentional replantation (IR) to treat disease of endodontic origin remains controversial. While IR has been advocated by some clinicians as another valid treatment option, others consider it as a treatment procedure of last resort. OBJECTIVE To systematically review and critically evaluate the effectiveness of IR compared with nonsurgical root canal treatment/retreatment or apical surgery in terms of clinical and patient-related outcomes in managing permanent teeth with apical periodontitis (AP). METHODS A literature search of five databases (PubMed, Embase, Scopus, Web of Science and Cochrane Central register of Controlled Trials), and the grey literature (Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, DART-Europe E-theses Portal, British Library E-Theses Online Service), from inception to November 2021, was conducted. Randomised clinical trials, comparative clinical trials (CCTs), nonrandomised, retrospective, and prospective comparative cohort and case-control two arm studies which evaluated clinical and/or patient-related outcomes of permanent teeth with AP treated with IR compared with nonsurgical root canal treatment/retreatment or apical surgery were identified. The quality of the studies was appraised using the Cochrane risk of bias tool for randomized trials (RoB 2.0), the Robins-I for nonrandomized controlled clinical trials and the Newcastle-Ottawa scale for observational studies. Two independent reviewers were involved in the literature selection, performed the data extraction and the appraisal of the studies identified; disagreements were resolved in conjunction with a third reviewer. RESULTS No comparative study was identified from the literature search. Four longitudinal studies (one prospective and three retrospective) were identified during the screening of titles and abstracts but were excluded after reading the full text, because only IR was evaluated (single arm studies). DISCUSSION The available evidence on IR is mainly based on observational studies, which reported high overall mid- to long-term survival, and low complication rates. The results suggest that IR may represent an alternative treatment procedure to solve problems of endodontic origin. However, in the absence of high-quality evidence from CCTs, clinical decision-making should be on a case-by-case basis and in accordance with the clinician's experience and the patient's preference. CONCLUSION Clinical studies showed that IR may be a treatment modality to manage problems of endodontic origin. However, clinical trials comparing the effectiveness of IR with nonsurgical root canal treatment/retreatment or apical surgery are still required given the paucity of evidence.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Juliana Vilela Bastos
- Department of Restorative Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Kadulkar N, Kataki R, Deka A, Thonai S. Replantation of an Avulsed Tooth: A Case Report. Cureus 2023; 15:e39198. [PMID: 37332457 PMCID: PMC10276759 DOI: 10.7759/cureus.39198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Avulsion is a rare and serious traumatic dental injury that needs immediate and complex management. This case report highlights the successful management of an avulsed maxillary central incisor by replantation after a lapse of 120 minutes of being in an extra-oral environment and preserved in milk. A female patient aged 17 years presented with a traumatic dental injury sustained to the anterior maxillary region due to an accidental fall. Clinical examination revealed an avulsed tooth 21 that was replanted according to the International Association of Dental Traumatology (IADT) guidelines and stabilised in place with splinting. Conventional root canal therapy was initiated one week post-replantation. The root canal treatment was completed two weeks post-replantation followed by removal of the splint. Follow up done at regular intervals of one, three, six, and 12 months showed a lack of clinical signs and symptoms and no resorption on radiographic interpretation.
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Affiliation(s)
- Nishad Kadulkar
- Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, IND
| | - Rubi Kataki
- Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, IND
| | - Adrija Deka
- Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, IND
| | - Salouno Thonai
- Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, IND
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Yang Y, Liu YL, Jia LN, Wang JJ, Zhang M. Rescuing “hopeless” avulsed teeth using autologous platelet-rich fibrin following delayed reimplantation: Two case reports. World J Clin Cases 2023; 11:635-644. [PMID: 36793624 PMCID: PMC9923869 DOI: 10.12998/wjcc.v11.i3.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Tooth avulsion is one of the most severe types of dental trauma. Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis. The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin (PRF).
CASE SUMMARY Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department. The diagnoses were avulsion of tooth 21, lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21. In case 2, a 17-year-old boy fell 2 h prior to his presentation to the hospital, and his left upper lateral incisor was completely knocked out of the alveolar socket. The diagnoses included avulsion of tooth 22, complicated crown fracture of tooth 11 and complicated crown-root fracture of tooth 21. The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch. The root canals of the avulsed teeth were filled with calcium hydroxide paste, and root canal filling was performed 4 wk after reimplantation. The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-, 6-, and 12-mo follow-up examinations after reimplantation with autologous PRF. In addition to the avulsed teeth, the other injured teeth were treated using corresponding conventional treatment methods.
CONCLUSION These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth, and the application of PRF may provide new healing opportunities for traditionally “hopeless” avulsed teeth.
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Affiliation(s)
- Yang Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yan-Li Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Lie-Ni Jia
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Jun-Jun Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Min Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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Kumar N, Maher N, Amin F, Ghabbani H, Zafar MS, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Biomimetic Approaches in Clinical Endodontics. Biomimetics (Basel) 2022; 7:biomimetics7040229. [PMID: 36546929 PMCID: PMC9775094 DOI: 10.3390/biomimetics7040229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.
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Affiliation(s)
- Naresh Kumar
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
| | - Nazrah Maher
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Faiza Amin
- Department of Science of Dental Materials, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Ricardo E. Oñate-Sánchez
- Department of Special Care in Dentistry, Hospital Morales Meseguer, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
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Kohsar AH, Yousefi MJ, Hali H. The Effects of Different Regenerative Treatments after Tooth Avulsion. CURRENT STEM CELL REPORTS 2022. [DOI: 10.1007/s40778-022-00218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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12
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Massingham S, Power RK. Interventive dental therapy in Ancient Egypt (ca. 2686 BCE - AD 323): A critical review. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 38:64-75. [PMID: 35816771 DOI: 10.1016/j.ijpp.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This paper critically reviews the history of research concerning ancient Egyptian interventive dental therapy between the Old Kingdom - Graeco-Roman Period (c. 2686 BCE-AD 323), concentrating on the published osteological evidence. MATERIALS Eight osteological examples reportedly exhibiting markers of interventive dental therapy, including a mandible presenting purported evidence for a drilling procedure for the relief of an abscess; four dental bridges; a maxilla with multiple teeth extracted; and two carious lesion fillings. METHODS Previous claims are critically reviewed using a qualitative research method involving collecting and critiquing published data, both primary evidence and relevant secondary literature. CONCLUSIONS Without further scientific analysis, only four specimens can currently be plausibly attributed to ancient Egyptian interventive dental therapy including the Tura el-Asmant Bridge, the enucleation described for a Graeco-Roman child, and two carious lesion fillings identified in the mummified individuals known as the 'Redpath Mummy' (RM2718) and 'Sekhem' (AIG3343). SIGNIFICANCE Several enduring historiographical and museological problems within the discourse are identified, revising our understanding of the nature and scope of ancient Egyptian interventive dental therapy based on currently known osteological evidence. LIMITATIONS This review relies on the published documentation for each osteological example, namely images, which in several cases are poor quality. SUGGESTIONS FOR FURTHER RESEARCH There is significant opportunity for further scientific analysis of the osteological evidence discussed. In each case, specific potential methods to improve our understanding and interpretation have been identified.
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Affiliation(s)
- Sarah Massingham
- Department of History and Archaeology, Macquarie University, Sydney, NSW 2109, Australia.
| | - Ronika K Power
- Department of History and Archaeology, Macquarie University, Sydney, NSW 2109, Australia.
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13
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Oka K. Fibrillin protein, a candidate for creating a suitable scaffold in PDL regeneration while avoiding ankylosis. Genesis 2022; 60:e23486. [PMID: 35678273 DOI: 10.1002/dvg.23486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 05/14/2022] [Indexed: 11/11/2022]
Abstract
The tooth is stabilized by fiber-rich tissue called the periodontal ligament (PDL). The narrow space of the PDL does not calcify in the physiological state even thought it exists between two calcified tissues, namely, the cementum of the root and alveolar bone. Two situations that require PDL regeneration are periodontitis and dental trauma. Periodontitis induces the loss of PDL and alveolar bone due to inflammation related to infection. Conversely, in PDLs damaged by dental trauma, accelerating bone formation as an overreaction of the healing process is induced, thereby inducing dentoalveolar ankylosis at the tooth root surface. PDL regeneration following dental trauma must therefore be considered separately from periodontitis. Therefore, PDL regeneration in dental trauma must be considered separately from periodontitis. This review focuses on the components involved in avoiding dentoalveolar ankylosis, including oxytalan fibers, aggregated microfibrils, epithelial cell rests of Malassez (ERM), and TGF-β signaling. During root development, oxytalan fibers produced by PDL cells work in collaboration with the epithelial components in the PDL (e.g., Hertwig's root sheath [HERS] and ERM). We herein describe the functions of oxytalan fibers, ERM, and TGF-β signals which are involved in the avoidance of bone formation.
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Affiliation(s)
- Kyoko Oka
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Oral Medicine Research Center, Fukuoka Dental College, Fukuoka, Japan
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14
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Parthasarathy R, Srinivasan S, C V, Thanikachalam Y, Ramachandran A. An Interdisciplinary Management of Avulsed Maxillary Incisors: A Case Report. Cureus 2022; 14:e23891. [PMID: 35530845 PMCID: PMC9075823 DOI: 10.7759/cureus.23891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
The current case report presents a case of a road traffic accident comprising dental avulsion of maxillary incisors. A 30-year-old male reported missing teeth following trauma in his upper front tooth region. The avulsion of maxillary right central and lateral incisors along with laceration in upper and lower lips was evident. The avulsed teeth were stored in milk after a brief extra-oral dry time of one hour and were carried to the department with a one-hour delay. After clinical and radiographic investigations, no mobility or fractures were apparently noticed. The avulsed 11 and 12 had closed apices with intact crown and root surfaces. Following an extra-oral endodontic therapy, immediate replantation was scheduled. Subsequently, the alveolar sockets were irrigated with saline to dislodge the clot and any gross debris that was present. Teeth were reimplanted into the socket after placement of PRF membrane around the root surface. A semi-rigid wire and composite splinting were done for a span of two weeks and antibiotics were prescribed. An exploratory CBCT taken revealed a cortical bone loss in the buccal region of 12 and 11. An interdisciplinary approach to regenerate the osseous defect was then carried out. A follow-up of two weeks, four weeks, three months, six months, and a year was done. Evaluation performed after a year revealed the absence of clinical symptoms and satisfactory healing with no signs of resorption radiographically.
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Affiliation(s)
- Revathy Parthasarathy
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Srividhya Srinivasan
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Vikram C
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Yashini Thanikachalam
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Anupama Ramachandran
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
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15
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Aksel H, Zhu X, Gauthier P, Zhang W, Azim AA, Huang GTJ. A new direction in managing avulsed teeth: stem cell-based de novo PDL regeneration. Stem Cell Res Ther 2022; 13:34. [PMID: 35090556 PMCID: PMC8796335 DOI: 10.1186/s13287-022-02700-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023] Open
Abstract
Management of avulsed teeth after replantation often leads to an unfavorable outcome. Damage to the thin and vulnerable periodontal ligament is the key reason for failure. Cell- or stem cell-based regenerative medicine has emerged in the past two decades as a promising clinical treatment modality to improve treatment outcomes. This concept has also been tested for the management of avulsed teeth in animal models. This review focuses on the discussion of limitation of current management protocols for avulsed teeth, cell-based therapy for periodontal ligament (PDL) regeneration in small and large animals, the challenges of de novo regeneration of PDL on denuded root in the edentulous region using a mini-swine model, and establishing a prospective new clinical protocol to manage avulsed teeth based on the current progress of cell-based PDL regeneration studies.
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Affiliation(s)
- Hacer Aksel
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, USA
| | - Xiaofei Zhu
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.,VIP Dental Service and Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Philippe Gauthier
- Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.,Département d'endodontie, Faculté de Médecine Dentaire, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Wenjing Zhang
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Adham A Azim
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, USA.,Department of Endodontics, Arthur A Dugoni School of Dental Medicine, University of Pacific, San Francisco, California, USA
| | - George T-J Huang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA. .,Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA. .,Cancer Research Building, University of Tennessee Health Science Center, 19 S. Manassas St. Lab Rm 256, office 255, Memphis, TN, 38163, USA.
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16
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Abella Sans F, Ribas March F, Zubizarreta-Macho Á, Boschini L, Roig Cayón M, Durán-Sindreu Terol F. Guided autotransplant of a first premolar to replace a maxillary ankylosed incisor using a custom-designed osteotome. J Am Dent Assoc 2021; 153:265-272. [PMID: 34930574 DOI: 10.1016/j.adaj.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autotransplantation is a highly successful technique to replace ankylosed teeth. The authors propose a modified therapeutic approach to guide the autotransplant of an immature maxillary premolar using a tooth-shaped osteotome. CASE DESCRIPTION A 9-year-old boy reported an avulsion of his maxillary permanent left central incisor with a delayed replantation. An autotransplant of the immature maxillary right first premolar into the position of the affected tooth was planned. A surgical 3-dimensional guiding template and a tooth-shaped osteotome were manufactured to prepare the neo-alveolus (referring to the creation or modification of an alveolus to house the tooth) modification. Although the donor tooth was placed in the recipient socket with the buccal side of the root fully exposed, the transplant outcome was successful. PRACTICAL IMPLICATIONS The use of 3-dimensionally designed surgical osteotome could improve accuracy and surgical handling of a donor tooth autotransplant, even with substantial bone defects in the recipient site.
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17
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Deferoxamine Reduces Inflammation and Osteoclastogenesis in Avulsed Teeth. Int J Mol Sci 2021; 22:ijms22158225. [PMID: 34360988 PMCID: PMC8348439 DOI: 10.3390/ijms22158225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/28/2022] Open
Abstract
Replacement and inflammatory resorption are serious complications associated with the delayed replantation of avulsed teeth. In this study, we aimed to assess whether deferoxamine (DFO) can suppress inflammation and osteoclastogenesis in vitro and attenuate inflammation and bone resorption in a replanted rat tooth model. Cell viability and inflammation were evaluated in RAW264.7 cells. Osteoclastogenesis was confirmed by tartrate-resistant acid phosphatase staining, reactive oxygen species (ROS) measurement, and quantitative reverse transcriptase–polymerase chain reaction in teeth exposed to different concentrations of DFO. In vivo, molars of 31 six-week-old male Sprague–Dawley rats were extracted and stored in saline (n = 10) or DFO solution (n = 21) before replantation. Micro-computed tomography (micro-CT) imaging and histological analysis were performed to evaluate inflammation and root and alveolar bone resorption. DFO downregulated the genes related to inflammation and osteoclastogenesis. DFO also reduced ROS production and regulated specific pathways. Furthermore, the results of the micro-CT and histological analyses provided evidence of the decrease in inflammation and hard tissue resorption in the DFO group. Overall, these results suggest that DFO reduces inflammation and osteoclastogenesis in a tooth replantation model, and thus, it has to be further investigated as a root surface treatment option for an avulsed tooth.
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18
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Chew JRJ, Tan BL, Lu JX, Tong HJ, Duggal MS. Cell-Based Therapy for Tooth Replantation Following Avulsion: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:351-363. [PMID: 33593127 DOI: 10.1089/ten.teb.2021.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The management of avulsed teeth undergoing delayed replantation remains a clinical challenge as there are currently no effective interventions that can improve periodontal healing and prevent replacement root resorption. While several preclinical studies have reported varied success using cell-based tissue engineering to improve periodontal healing, a consensus is required before further clinical translation. Therefore, this systematic review seeks to evaluate the efficacy of cell-based therapy in promoting periodontal healing following delayed replantation in animal models. MEDLINE (PubMed) and Embase were searched on September 27, 2020. Ten studies involving rodent and dog models met the inclusion criteria. Cell sources included gingiva, periodontal ligament (PDL), bone marrow, and adipose tissues. Generally, cell-based therapy had increased the proportion of root surfaces displaying periodontal healing and concomitantly reduced the proportion presenting with replacement root resorption and ankylosis. The best outcomes were observed following treatment with PDL-derived cells of various potency. Future preclinical studies will benefit from adopting measures to minimize bias during the conduct of animal experiments and the standardization of the outcome measures reporting. This will facilitate future reviews with possible pooling of results in the form of meta-analyses, allowing a consensus to be obtained from the literature. In addition, further research will be required to shed light on the implications of using allogeneic cells as well as the optimization of cell delivery protocols. The findings of this systematic review demonstrated the therapeutic potential of certain cell-based therapies in promoting periodontal healing following delayed replantation, thus highlighting their prospective clinical benefits and translational value.
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Affiliation(s)
- Jacob Ren Jie Chew
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Bing Liang Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Jacinta Xiaotong Lu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Kang CM, Mo S, Jeon M, Jung UW, Shin Y, Shin JS, Shin BY, Lee SK, Choi HJ, Song JS. Intranuclear Delivery of Nuclear Factor-Kappa B p65 in a Rat Model of Tooth Replantation. Int J Mol Sci 2021; 22:ijms22041987. [PMID: 33671455 PMCID: PMC7922502 DOI: 10.3390/ijms22041987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 01/25/2023] Open
Abstract
After avulsion and replantation, teeth are at risk of bone and root resorption. The present study aimed to demonstrate that the intra-nuclear transducible form of transcription modulation domain of p65 (nt-p65-TMD) can suppress osteoclast differentiation in vitro, and reduce bone resorption in a rat model of tooth replantation. Cell viability and nitric oxide release were evaluated in RAW264.7 cells using CCK-8 assay and Griess reaction kit. Osteoclast differentiation was evaluated using quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and tartrate-resistant acid phosphatase (TRAP) staining. Thirty-two maxillary rat molars were extracted and stored in saline (n = 10) or 10 µM nt-p65-TMD solution (n = 22) before replantation. After 4 weeks, specimens were scored according to the inflammatory pattern using micro-computed tomography (CT) imaging and histological analyses. nt-p65-TMD treatment resulted in significant reduction of nitric oxide release and osteoclast differentiation as studied using PCR and TRAP staining. Further, micro-CT analysis revealed a significant decrease in bone resorption in the nt-p65-TMD treatment group (p < 0.05). Histological analysis of nt-p65-TMD treatment group showed that not only bone and root resorption, but also inflammation of the periodontal ligament and epithelial insertion was significantly reduced. These findings suggest that nt-p65-TMD has the unique capabilities of regulating bone remodeling after tooth replantation.
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Affiliation(s)
- Chung-Min Kang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (S.M.); (M.J.)
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - Seunghan Mo
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (S.M.); (M.J.)
| | - Mijeong Jeon
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (S.M.); (M.J.)
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - Ui-Won Jung
- Department of Periodontology, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - Yooseok Shin
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea
| | - Jin-Su Shin
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Korea; (J.-S.S.); (B.-Y.S.); (S.-K.L.)
| | - Bo-Young Shin
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Korea; (J.-S.S.); (B.-Y.S.); (S.-K.L.)
| | - Sang-Kyou Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Korea; (J.-S.S.); (B.-Y.S.); (S.-K.L.)
| | - Hyung-Jun Choi
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (S.M.); (M.J.)
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Correspondence: (H.-J.C.); (J.S.S.); Tel.: +82-2-2228-3175 (H.-J.C.); +82-2-2228-3170 (J.S.S.); Fax: +82-2 365-7420 (H.-J.C.); +82-2 365-7420 (J.S.S.)
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (S.M.); (M.J.)
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Correspondence: (H.-J.C.); (J.S.S.); Tel.: +82-2-2228-3175 (H.-J.C.); +82-2-2228-3170 (J.S.S.); Fax: +82-2 365-7420 (H.-J.C.); +82-2 365-7420 (J.S.S.)
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20
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Stojanović S, Tijanić M, Burić K, Burić N, Spasić M, Todorović K, Stojković B, Jovanović M, Petrović M, Mitić D. Permanent tooth avulsion in children and adults: Therapeutic options for longer survival. ACTA STOMATOLOGICA NAISSI 2021. [DOI: 10.5937/asn2183213s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Permanent tooth avulsions (traumatic extraction; total luxation) are one ofthe most severe permanent tooth injuries and can occur as single injuries or associated with other dental injuries or injuries to the face and jaws region. They are defined as the luxation of teeth from the alveoli with complete rupture of periodontal fibres, or with one part attached to the rootcementum and the other to the alveolar bone, thus compromising the dental pulp, root cementum,and alveolar bone. The high prevalence and numerous negative consequences on the stomatognathic systems they have suggest permanent tooth avulsions should be regarded as an important public health problem. The aim: is to point out the therapeutic possibilities of permanent tooth avulsion that can ensure their longer survival in the oral cavity. Conclusion: The treatment strategy for avulsed permanent teeth is always based on limiting root canal infection and periradicular inflammation, shifting the balance from unfavourable (replacement resorption) to favourable (periodontal) healing. The success of therapy and periodontal healing depend on the duration and conditions of extraoral tooth preservation, the degree of damage to the periodontal ligament, and the condition of the pulp.
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21
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Ding QW, Lin M, Zhang X, Gong Y. Geomorphologic study of human tooth root surfaces following simulated avulsion by scanning electron microscopy. Dent Traumatol 2020; 37:457-463. [PMID: 33369075 DOI: 10.1111/edt.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIMS Tooth avulsion is the most severe traumatic tooth injury. Immediate replantation after avulsion provides the highest success rate, whereas delayed replantation with dehydration for >1 h always results in ankylosis, replacement resorption, and eventual tooth loss. The aim of this study was to investigate the geomorphologic change of ultrastructure on tooth root surfaces due to dehydration. MATERIAL AND METHODS Twenty-four sound human premolars and fully developed third molars without periodontitis were selected for the experiment. Roots were separated into 6-7 pieces with an intact root surface area (3 × 3 mm2 ) and then divided into the following groups: fresh group, prolonged dehydration groups (air drying for 1, 2, 4, 12, or 24 h), and dehydrated teeth (air drying for 2 h) treated with acid (Tris-HCl buffer or citric acid buffer). More than six pieces of root from each group were subjected to scanning electron microscopy (SEM) observation. Captured images were exported to ImageJ software to quantitatively analyze the areas covered with fibers. Statistical significance was determined by comparing the means of the different groups using t-testing or one-way analysis of variance followed by post hoc testing. RESULTS Fibrous "vegetation" covering the cementum was observed on the fresh root surface by SEM. This was destroyed by dehydration (>1 h), resulting in a root surface resembling the "Gobi Desert." The difference was statistically significant (p < .001). Root surface deteriorated by dehydration could be recovered by the re-use of the fibers embedded in the cementum as acid demineralization of the outer layer of cementum exposed the embedded fibers to simulate the geomorphology of fresh root surface. CONCLUSIONS Dehydrated teeth had deteriorated geomorphology of the root surface, which could be reversed by the re-use of the fibers embedded in the cementum using citric acid. Direct evidence from SEM gives new insights into the replantation of dehydrated avulsed teeth.
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Affiliation(s)
- Qian-Wen Ding
- Emergency Department, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Mei Lin
- Department of Stomatology, Beijing Chao-Yan Hospital, Capital Medical University, Beijing, China
| | - Xin Zhang
- Emergency Department, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Yi Gong
- Emergency Department, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
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22
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Deepthi K, Borthakur BJ, Swathika B, Ganesan S. Assessment of the viability of human periodontal ligament cells in black tea, lime juice, and passion fruit concentrate - A comparative in vitro study. J Conserv Dent 2020; 23:42-45. [PMID: 33223640 PMCID: PMC7657423 DOI: 10.4103/jcd.jcd_253_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/07/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
Background Tooth avulsion is considered as a severe form of dental trauma, causing damage to the periodontium. Hence, the preservation of healthy periodontal ligament (PDL) cells in the storage medium are pivotal for the success of replantation. Aim and Objective The aim of this study is to assess the viability of human PDL cells in black tea, lime juice, and passion fruit concentrate. Methods Human periodontal cells were cultured and stored in three experimental media - black tea, lime juice, and passion fruit concentrate and subjected to 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay for 1 h and the cell viability was determined. Mean and standard deviation were statistically analyzed using one-way analysis of variance to identify the significant groups. Results The human PDL cells showed 100% viability in lime juice and passion fruit concentrate, followed by 98% viability in black tea. Conclusion Black tea, lime juice, and passion fruit concentrate can be used effectively as storage media for maintaining PDL cells viability in avulsed teeth, with 100% viability exhibited by lime juice and passion fruit concentrate.
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Affiliation(s)
- K Deepthi
- Junior Resident, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
| | - Bikash Jyoti Borthakur
- Professor and Head of Department, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
| | - B Swathika
- Professor, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
| | - S Ganesan
- Professor, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
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23
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da Silva LAB, Longo DL, Stuani MBS, de Queiroz AM, da Silva RAB, Nelson-Filho P, Vieira HAO, Pucinelli CM, Paula-Silva FWG. Effect of root surface treatment with denusomab after delayed tooth replantation. Clin Oral Investig 2020; 25:1255-1264. [PMID: 32728940 DOI: 10.1007/s00784-020-03430-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate denosumab, a human monoclonal antibody that mimics the effects of osteoprotegerin in bone metabolism, as a topical treatment of root surface to be used prior to delayed tooth replantation. MATERIALS AND METHODS Thirty-six rats' right incisors were used. Teeth were extracted and divided into: delayed replantation without root surface treatment (control); delayed replantation with root surface treatment with denosumab 60 mg/mL and 30 mg/mL, respectively, for 10 min both experimentals groups. After that, the root canals were filled with calcium hydroxide and replanted. After 15 and 60 days, the animals were euthanized, and the samples were collected and processed for microscopic analysis. Histological sections were performed, and stained with HE to describe the dental characteristics, measure ankylosis, replacement resorption, and dental resorption by conventional microscopy. Also, was performed Brown & Brenn staining and immunohistochemistry for RANKL, OPG, and periostin. RESULTS Denosumab 60 mg/mL reducted ankylosis (p < 0.0001), replacement resorption (p < 0.0001), and tooth resorption, 60 days after replantation, compared to untreated replanted teeth (p < 0.005). Lower bacterial contamination in root surface in the denosumab treatment groups was found, regardless of the concentration used (p < 0.001). Also, denosumab treatment inhibited the expression of RANKL without modulating OPG. Periostin was observed in periodontal ligament of replanted tooth, although this labelling was absent in the ankylosis areas, in both experimental periods. CONCLUSION Treatment of the root surface with denosumab at 60 mg/mL of rat teeth before delayed replantation reduced dental root resorption compared with the untreated teeth after 60 days. CLINICAL RELEVANCE Survival of a replanted tooth has been a challenge in clinical practice. The use of a medication, such as denosumab, to limit dental root resorption represents an important therapeutical approach.
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Affiliation(s)
- Léa Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | | | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Alexandra Mussolino de Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil.
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Heloisa Aparecida Orsini Vieira
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Carolina Maschietto Pucinelli
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Francisco Wanderley Garcia Paula-Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil
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Mittmann CW, Kostka E, Ballout H, Preus M, Preissner R, Karaman M, Preissner S. Outcome of revascularization therapy in traumatized immature incisors. BMC Oral Health 2020; 20:207. [PMID: 32664918 PMCID: PMC7362656 DOI: 10.1186/s12903-020-01193-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this retrospective analysis was to evaluate the clinical and radiological outcome of revascularization therapy in traumatized permanent incisors to determine whether this approach could be implemented into clinical routine. Methods A total of 16 traumatized incisors (either avulsion or severe luxation/intrusion) with open apices (> 1 mm) that underwent revascularization following a standardized protocol were analyzed with a mean follow-up of 22 months. Radiographs and clinical parameters (such as root length, pulp space, dentin wall width, apical foramen, alveolar bone loss, ankylosis/mobility, supra−/infraposition, discoloration, probing depth) were compared pre- and postoperatively and statistically analyzed. Results Over the follow-up period, 81.3% of the teeth survived revascularization and regained sensitivity, while 18.7% failed, as they had to be extracted due to serious root resorption. Regarding radiographic outcomes a significant difference could only be found in the decrease of apical foramina (p = 0.04). The other parameters showed no significant difference between pre- and postoperative measurements. More than half of the teeth (56.3%) developed root resorptions and 31.3% displayed signs of ankylosis and 92.9% developed discolorations during follow-up. However, 85.7% of the teeth maintained the bone level and outcomes of mobility showed a significant solidification. Conclusions Revascularization is a promising approach for the treatment of immature incisors to regain sensitivity and to enhance apical closure and at least to maintain alveolar bone in terms of a socket preservation. Further studies have to be performed to determine ideal conditions (type of trauma, age, width of apical foramen) for a revascularization.
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Affiliation(s)
- Carolina W Mittmann
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Eckehard Kostka
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Husam Ballout
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Mareike Preus
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Robert Preissner
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115, Berlin, Germany
| | - Murat Karaman
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115, Berlin, Germany
| | - Saskia Preissner
- Department Oral, Maxillary and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin. Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
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Comparative Evaluation of Efficacy of Platelet-Rich Fibrin and Hank's Balanced Salt Solution as a Storage Medium for Avulsed Teeth: An In Vitro Study. Eur Endod J 2020; 4:118-121. [PMID: 32161897 PMCID: PMC7006589 DOI: 10.14744/eej.2019.24633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/17/2019] [Indexed: 11/20/2022] Open
Abstract
Objective To compare the efficacy of platelet-rich fibrin (PRF) and Hank's balanced salt solution (HBSS) in the preservation of the periodontal ligament (PDL) cells viability of avulsed teeth. Methods A total of 30 non-carious third molars with healthy periodontium, indicated for extraction for orthodontic reasons or chronic pericoronitis, were selected for the study. Samples were divided into four groups: one standard group and one experimental group in addition to two control groups (positive and negative). The positive and negative control group corresponded to immediate and 2-hour dry time respectively. The experimental teeth were bench dried for 40 minutes and then immersed in one of the two storage media: HBSS (standard storage media) and PRF (experimental storage media) for 45 minutes. The teeth in each group were treated with dispase II and collagenase for 30 minutes and later centrifuged for 4 minutes at 1000 rpm. The supernatant was removed with sterile micropipette, the cells were labeled with 0.4% trypan blue, and the number of viable PDL cells was counted with a hemocytometer under a light microscope. One-way Kruskal-Wallis test and Mann-Whitney U test with Boneferroni correction were used for statistical analysis. Results Results did not demonstrate any statistically significant differences in the viability of PDL cells between the groups with standard and experimental storage media. Group 1 showed a statistically significant difference of mean compared to Groups 2, 3 and 4. When Group 2 was compared with Groups 3 and 4, a P-value>0.05 suggested no statistical significance. Conclusion Within the parameters of this study, HBSS and PRF demonstrated a similar number of viable PDL cells. Hence, PRF could be a used as a good substitute of HBSS as a storage media for avulsed teeth.
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Müller DD, Bissinger R, Reymus M, Bücher K, Hickel R, Kühnisch J. Survival and complication analyses of avulsed and replanted permanent teeth. Sci Rep 2020; 10:2841. [PMID: 32071357 PMCID: PMC7028940 DOI: 10.1038/s41598-020-59843-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/10/2020] [Indexed: 12/02/2022] Open
Abstract
This retrospective clinical study investigated the survival probability of avulsed and replanted permanent teeth in relation to functional healing, replacement and inflammatory resorption. The explorative data analysis included data from 36 patients and 49 replanted permanent teeth with a minimum observation time of 60 days; the patients were generally treated according to the current guidelines of the International Association of Dental Traumatology at the university hospital in Munich, Germany, between 2004 and 2017. The mean observation period was 3.5 years. Functional healing was observed in 26.5% (N = 13/49) of the included avulsion cases. In comparison, replacement resorption affected 51.0% (N = 25/49) of the replanted teeth, of which 24.0% (N = 6/25) were lost over the course of years (mean, 6.1 years). In contrast, inflammatory resorption resulted in the early loss of all replanted teeth (mean, 1.7 years) and affected 22.5% (N = 11/49) of all the monitored teeth. Therefore, it can be concluded that tooth avulsion remains a severe dental injury with an unpredictable prognosis. This topic demands further fundamental research aiming to maintain and/or regenerate the periodontal ligament after tooth avulsion, particularly in association with non-physiological tooth rescue.
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Affiliation(s)
- Daniel David Müller
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany
| | - Ricarda Bissinger
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany
| | - Marcel Reymus
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany
| | - Katharina Bücher
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians Universität, München, Munich, Germany.
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Xu M, Wei X, Fang J, Xiao L. Combination of SDF-1 and bFGF promotes bone marrow stem cell-mediated periodontal ligament regeneration. Biosci Rep 2019; 39:BSR20190785. [PMID: 31789340 PMCID: PMC6923350 DOI: 10.1042/bsr20190785] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 09/04/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023] Open
Abstract
Stromal cell derived factor-1 (SDF-1) and basic fibroblast growth factor (bFGF) were reported to induce the differentiation of bone marrow stem cells (BMSCs) into cells with characteristics of periodontal ligament fibroblasts. Thus SDF-1 and bFGF may play a positive role in BMSCs-mediated periodontal ligament regeneration. Here, the methylthiazolyldiphenyl tetrazolium bromide (MTT) assay was used to investigate the effect of scaffolds, SDF-1 and bFGF on BMSCs proliferation. RT-PCR and Western blot were used to evaluate gene and protein expression. Beagle dogs were used to establish an animal model of tooth reimplantation and to investigate the effects of scaffolds, BMSCs, SDF-1 and bFGF on periodontal ligament regeneration. X-ray images and micro computed tomography (micro CT) were used to assess morphological changes in replanted teeth and surrounding alveolar bone. H&E staining and Masson's staining were also performed. BMSCs from Beagle dogs growth on scaffolds consisted of dense structured collagens. SDF-1 and bFGF effectively promoted the differentiation of BMSCs into fibroblasts, periodontal membrane reconstruction, and cell proliferation in vitro. SDF-1 and bFGF also stimulated the expression of type I collagen (Col I), type III collagen (Col III), CXC family chemokine receptor 4 (CXCR4), and S100 calcium binding protein A4 (S100A4), and decreased the expression of alkaline phosphatase (ALP). In our experimental Beagle dog model of tooth extraction and replantation, application of SDF-1 and bFGF significantly elevated periodontal membrane reconstruction and thus supported the survival of replanted teeth. In conclusion, the findings from the present study demonstrated that SDF-1 and bFGF enhance the process of periodontal ligament reconstruction, and provide a basis and reference for the use of stem cell tissue engineering in promoting periodontal membrane regeneration.
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Affiliation(s)
- Mengting Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xing Wei
- Department of Orthodontics, Stomatological Center, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong
| | - Jie Fang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Xiao
- Department of Stomatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Sichuan, China
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Liu J, Zhou Z, Zhang S. Effects of Er:YAG Laser on the Attachment of Human Periodontal Ligament Fibroblasts to Denuded Root Surfaces Simulating Delayed Replantation Cases: An In Vitro Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:145-150. [PMID: 31742487 DOI: 10.1089/photob.2019.4699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To investigate the effects of Er:YAG laser on the attachment of human periodontal ligament fibroblasts (hPDLFs) to denuded root surfaces simulating delayed replantation cases. Background data: Dental avulsion is one of the most severe dental traumas, which is often treated with replantation. In delayed replantation scenarios, poor prognosis, including root resorption, usually occurs due to poor root surface conditioning and nonviable hPDLF attachment. Methods: Thirty-six root fragments (5 × 5 × 2 mm) were obtained from periodontium tissue-free premolar root surfaces. Specimens were randomly and equally assigned to the following: Group A, untreated control; Group B, 25 J/cm2 and 10 Hz of Er:YAG laser irradiation; and Group C, 50 J/cm2 and 10 Hz of Er:YAG laser irradiation. Some specimens in each group were then prepared for surface topography visualization under SEM, others were subjected to coculture with hPDLF suspension, and cell adhesion was further evaluated by SEM. Results: Group A presented homogenous smooth root surface, with fewer and round-shaped cells attached; Group B and C exhibited rather rough and irregular morphologies, and spindle-shaped fibroblasts were firmly attached by numerous lamellipodia and extensions. After a 3-day coculture, the number of fibroblasts attached in Group A was significantly lower compared with the other two laser-treated groups (p = 0.008 < 0.05). No significant alterations were observed between the two laser groups (p = 0.135 > 0.05). Conclusions: Er:YAG laser-treated root surfaces are compatible for the attachment of PDLFs, which suggests that Er:YAG laser irradiation may be used as a promising strategy for root surface conditioning in delayed replantation cases.
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Affiliation(s)
- Jingyi Liu
- Department of Stomatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Zhixiong Zhou
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
| | - Sun Zhang
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
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Physician Confidence in Dental Trauma Treatment and the Introduction of a Dental Trauma Decision-Making Pathway for the Pediatric Emergency Department. Pediatr Emerg Care 2019; 35:745-748. [PMID: 29698338 PMCID: PMC7153725 DOI: 10.1097/pec.0000000000001479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to (1) survey and report the awareness and confidence of pediatric emergency medicine physicians in the management of dental trauma and (2) determine the prevalence of dental trauma decision-making pathway utilization in the pediatric emergency department. METHODS A survey was distributed through e-mail to the pediatric emergency medicine discussion list via Brown University LISTSERV. The survey study included 10 questions and was multiple-choice. The survey contained questions about physician confidence and their use of a dental trauma decision-making pathway. RESULTS A total of 285 individuals responded to the survey. Somewhat confident was the most common response (61%) followed by not confident (20%) and confident (19%) by respondents in treating dental trauma. Forty-one percent of respondents felt comfortable, 39% somewhat comfortable, 19% not comfortable, and 1% not sure in replanting an avulsed tooth. Only 6% of respondents reported that their pediatric emergency department always or sometimes uses a dental trauma decision-making pathway, whereas 78% of pediatric emergency departments do not. CONCLUSIONS We believe that the adoption of a decision-making pathway will provide timely management, improve emergency physician comfort, and enhance outcomes for pediatric patients presenting with a dental trauma. A future multicenter review will aim to evaluate these goals based on the utilization of our dental trauma decision-making pathway.
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Zare Jahromi M, Kalantar Motamedi MR. Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review. Restor Dent Endod 2019; 44:e32. [PMID: 31485428 PMCID: PMC6713075 DOI: 10.5395/rde.2019.44.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/25/2019] [Accepted: 06/13/2019] [Indexed: 11/11/2022] Open
Abstract
Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.
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Affiliation(s)
- Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Mohamed RN, Basha S, Al-Thomali Y, Tawfik Enan E. Enamel matrix derivative (Emdogain) in treatment of replanted teeth - a systematic review. Acta Odontol Scand 2019; 77:168-172. [PMID: 30422034 DOI: 10.1080/00016357.2018.1519197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The main purpose of the present systematic review was to evaluate the efficacy of enamel matrix derivative Emdogain in healing of replanted teeth in humans. MATERIALS AND METHODS This review conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42017062736. We graded the methodological quality of the studies by means of Cochrane's tool of risk of bias in non-randomized studies - of interventions (ROBINS-I). RESULTS In total, 65 studies were identified for screening, and five studies were eligible. The uneventful healing of replanted teeth was varied from 20% to 75%. Two controlled trials found Emdogain treatment significantly reduced resorption of replanted teeth and improved the healing of periodontal ligament compared with controls. Two studies showed high recurrent resorption in Emdogain treated teeth. CONCLUSIONS To conclude, the number of publications that met all inclusion criteria were limited and did not allow for drawing evidence for Emdogain being effective in supporting healing of replanted teeth.
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Affiliation(s)
| | - Sakeenabi Basha
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Taif University, Taif, KSA
| | - Yousef Al-Thomali
- Department of Orthodontics, Faculty of Dentistry, Taif University, Taif, KSA
| | - Enas Tawfik Enan
- Department of Dental Biomaterials, Faculty of Dentistry, Taif University, Taif, KSA
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Wang HH, Sarmast ND, Shadmehr E, Angelov N, Shabahang S, Torabinejad M. Application of Enamel Matrix Derivative (Emdogain) in Endodontic Therapy: A Comprehensive Literature Review. J Endod 2018; 44:1066-1079. [DOI: 10.1016/j.joen.2018.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/25/2018] [Accepted: 02/10/2018] [Indexed: 01/28/2023]
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Maslamani M, Joseph B, Gabato S, Andersson L. Effect of periodontal ligament removal with gauze prior to delayed replantation in rabbit incisors on rate of replacement resorption. Dent Traumatol 2018; 34:182-187. [PMID: 29573129 DOI: 10.1111/edt.12398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Delayed (dry storage > 60 minutes) replantation results in ankylosis and replacement resorption. It has been suggested to remove the non-viable periodontal ligament before replantation to possibly reduce the rate of replacement resorption. However there has been no study on the rate of replacement resorption after such measures. The aim of this study was to investigate if there was any difference in the rate of replacement resorption by either removing the periodontal ligament (PDL) with gauze or not removing PDL in teeth subjected to delayed replantation followed by healing for 2 or 6 weeks. MATERIALS AND METHODS Maxillary central incisors were extracted in 8 rabbits. In the right central incisors, the necrotic PDL was removed by dry gauze over the root surface. In the left eight extracted teeth PDL was left on the root surface. All extracted teeth were left to dry for 60 minutes. Extra-oral root canal treatment was performed before replantation. The rabbits were sacrificed after 2 weeks and 6 weeks respectively. Histologic processing and evaluation was done. RESULTS In the 2 weeks group, all teeth showed ankylosis. The cementum was intact, and fusion of the bone and root was generally seen without resorption of the root, whereas in the 6 weeks group regardless of whether PDL had been kept or not, ankylosis and osseous replacement of the dentin was seen. There was no evidence of inflammatory infiltrate in the sections examined. CONCLUSION Removal of PDL prior to delayed replantation may result in some initial protection of the cementum during the first few weeks. However, over longer times there seems to be neither protection of the dentin from ankylosis and osseous replacement, nor any influence on the rate of replacement resorption.
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Affiliation(s)
- Manal Maslamani
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Bobby Joseph
- Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Severino Gabato
- Kuwait Animal Resources Center - Health Sciences Center, Kuwait University, Kuwait, Kuwait
| | - Lars Andersson
- Senior Professor Oral and Maxillofacial Surgery, Faculty of Odontology, Malmö University, Malmö, Sweden
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França MCM, da Silva TM, Silva GO, Valera MC, Camargo CHR. Effect of ethylenediaminetetraacetic acid and hyaluronic acid on the viability and cytokine expression of periodontal ligament fibroblasts. Dent Traumatol 2018; 34:271-277. [PMID: 29665275 DOI: 10.1111/edt.12404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Dental root cell proliferation following tooth avulsion has not been well researched. Understanding the effects of dry time and dentin treatment influences on cell proliferation is essential to provide evidence-based guidelines for tooth replantation. The study evaluated the viability of periodontal ligament fibroblasts (PLF) in contact with roots, submitted to surface treatments with ethylenediaminetetraacetic acid (EDTA) and hyaluronic acid (HA) at different times, including to quantify inflammatory cytokines interleukin (IL)-6, IL-8, IL-1β and TNF-α expressed by PLF. The adhesion of fibroblasts to treated root surfaces was also evaluated. MATERIAL AND METHODS One hundred and eight cementum discs from bovine teeth were randomly divided into groups according to time periods of being dry (n = 12) as follows: (i) fresh discs that were not kept dry, (WD); (ii) dry for 1 hour (1 hd); and (iii) dry for 24 hours (24 hd). The discs were subdivided into 3 subgroups (n = 12) according to surface treatments: (iv) no treatment, (v) treatment with EDTA, (vi) treatment with HA. The discs were placed in 96-well plates, and PLF were seeded and kept in contact with the discs for 48 hours. Cell viability on the surface of the discs was assessed by XTT, and PLF adhesion was evaluated using scanning electron microscopy (SEM). Quantification of cytokines was performed using enzyme-linked immunosorbent assay (ELISA). Data were submitted to ANOVA and Tukey's test (α = .05). RESULTS Surface treatment had a statistically significant effect on the cell viability in groups WD (P = .03), 1 hd (P = .01) and 24 hd (P = .048). PLF in contact with dried root surfaces expressed more cytokines without treatment with IL-6 decreasing the expression when treated with HA for 24 hours. SEM also showed adhesion of PLF to the surface of all discs at all time periods. CONCLUSION EDTA + HA is an alternative treatment for cases of avulsed teeth as it promoted adhesion and increased viability of PLF.
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Affiliation(s)
- Monique Costa Moreira França
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University (Unesp), São Paulo, Brazil
| | - Tânia Mara da Silva
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University (Unesp), São Paulo, Brazil
| | | | - Márcia Carneiro Valera
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University (Unesp), São Paulo, Brazil
| | - Carlos Henrique Ribeiro Camargo
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University (Unesp), São Paulo, Brazil
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Hasan MR, Takebe H, Shalehin N, Obara N, Saito T, Irie K. Effects of tooth storage media on periodontal ligament preservation. Dent Traumatol 2017; 33:383-392. [PMID: 28544606 DOI: 10.1111/edt.12351] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIMS An easily available tooth storage medium is required to preserve a tooth after avulsion. Milk and Hank's balanced salt solution (HBSS) are recommended as tooth storage media, and egg white is also reported to be comparable with milk. The aim of this study was to histologically and immunohistochemically evaluate the effect of different tooth storage media on the periodontal ligament (PDL) of extracted teeth. MATERIALS AND METHODS This experiment used HBSS, milk, and egg white as tooth storage media. A total of ninety-six 6-week-old male Sprague-Dawley rats were used in these experiments. In each experiment, six rats were used for each medium and for the control group. Extracted rat molar teeth were immersed in these three different storage media for 1 hour. In each medium, six samples (n=18) were fixed immediately, and the remaining samples (n=54) were subcutaneously transplanted. In the control group (n=24), the extracted teeth were fixed or transplanted immediately after extraction. At day 4, 1 and 2 weeks after transplantation, the teeth were examined by radiographic, histological, and immunohistochemical methods. The number of PDL cells in the storage media was also counted. RESULTS Teeth immersed for 1 hour in milk showed the thinnest PDL. Immunohistochemistry of periostin and CD68 labeling suggested degradation of the extracellular matrix in the PDL. In the media used for immersion, more PDL cells were observed in milk than in the other solutions. After transplantation, the HBSS and egg white groups maintained adequate thickness of PDL but in the milk group, thinner PDL and ankylosis were observed. CONCLUSION Adequate thickness of PDL was maintained in the egg white group, whereas the milk group showed disturbance in the PDL, which may lead to ankylosis.
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Affiliation(s)
- Md Riasat Hasan
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan.,Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Hiroaki Takebe
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Nazmus Shalehin
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Nobuko Obara
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Takashi Saito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Kazuharu Irie
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
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36
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Kırzıoğlu Z, Erken Güngör Ö, Erdoğan Y. 16-Year follow-up of an avulsed maxillary central incisor after replantation following 10-h storage: An unusual case. SPECIAL CARE IN DENTISTRY 2017. [PMID: 28627745 DOI: 10.1111/scd.12225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tooth avulsion is a type of dental injury defined as the complete displacement of a tooth out of the alveolar socket, and the lack of prompt treatment measures can result in the loss of function, poor quality of life, and psychological and social problems. However, several factors may not permit the immediate replantation of an avulsed tooth; therefore, delayed replantation has emerged as an alternative to meet the esthetic, functional, and psychological demands of patients. Here it was described that the successful replantation of an avulsed maxillary central incisor in a 9-year-old boy who presented at the clinic with the tooth stored in unfavorable conditions as dry and then in olive oil-milk mixture almost 10 h after the event. The tooth has remained in its socket healthy for 16 years after treatment. The patient was satisfied with both esthetics and function.
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Affiliation(s)
- Zuhal Kırzıoğlu
- Department of Pediatric Dentistry, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Özge Erken Güngör
- Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Yıldırım Erdoğan
- Department of Pediatric Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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37
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Shiga M, Ogawa T, Ekprachayakoon I, Moriyama K. Orthodontic Treatment and Long-Term Management of a Patient with Marfan Syndrome. Cleft Palate Craniofac J 2017; 54:358-367. [DOI: 10.1597/15-068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Marfan syndrome (MFS) is caused by abnormal systemic connective tissue. The main clinical manifestations include long limbs, long slender fingers, lens subluxation, abnormal cardiac valves, and aortic aneurysm. We report the case of an 11-year-old patient with MFS who underwent orthodontic treatment and was followed up until the age of 25 years. We found no significant differences in tooth movement between the patient with MFS and healthy subjects. However, because patients with MFS show characteristic facial growth and an increased risk of developing systemic comorbidities, their dental status requires careful observation over time.
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Affiliation(s)
- Momotoshi Shiga
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan, and Head of Orthodontics, Department of Orthodontics, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Takuya Ogawa
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Issareeya Ekprachayakoon
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiji Moriyama
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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38
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Lin S, Wigler R, Huber R, Kaufman AY. Anaesthetic efficacy of intraligamentary injection techniques on mandibular molars diagnosed with asymptomatic irreversible pulpitis: A retrospective study. AUST ENDOD J 2016; 43:34-37. [PMID: 27558847 DOI: 10.1111/aej.12169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 11/28/2022]
Abstract
The objective of this study was to evaluate the success rate of intraligamentary injections (ILI) using a two- or four-site injection technique. One hundred and fifty-one mandibular molars diagnosed with asymptomatic irreversible pulpitis received ILI at the mesiobuccal and distobuccal aspects of the roots. Patients who experienced pain when the access cavity was performed received additional supplemental ILI in the mesiolingual and distolingual aspects. Pulpal anaesthesia was considered successful when complete analgesia was achieved. The data were analysed by means of the Fisher's exact and Pearson's chi-square tests. IL anaesthesia was successful for 92.1% of the teeth. Forty-eight teeth (31.8%) were sufficiently anaesthetised using the two-site ILI and 91 teeth (60.3%) following supplemental IL anaesthesia in two more sites. The results of this study indicate that the use of four-site IL injections as a primary anaesthetic technique may be considered a favourable alternative to the common IANB.
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Affiliation(s)
- Shaul Lin
- Endodontics and Dental Trauma Department, School of Graduate Dentistry, Rambam Medical Center, Haifa, Israel.,Faculty of Medicine at the Technion, Haifa, Israel
| | - Ronald Wigler
- Endodontics and Dental Trauma Department, School of Graduate Dentistry, Rambam Medical Center, Haifa, Israel
| | - Ronen Huber
- Endodontics and Dental Trauma Department, School of Graduate Dentistry, Rambam Medical Center, Haifa, Israel
| | - Arieh Y Kaufman
- Endodontics and Dental Trauma Department, School of Graduate Dentistry, Rambam Medical Center, Haifa, Israel
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39
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Maslamani M, Almusawi A, Joseph B, Gabato S, Andersson L. An experimental model for studies on delayed tooth replantation and ankylosis in rabbits. Dent Traumatol 2016; 32:443-449. [PMID: 27241941 DOI: 10.1111/edt.12287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/26/2022]
Abstract
AIM To develop an experimental in vivo model to study dentoalveolar ankylosis and osseous replacement resorption after delayed replantation. MATERIALS AND METHODS The maxillary right incisors of eight rabbits were extracted and replanted, while the maxillary left incisors served as controls. A special technique for extraction was used, luxating the incisor laterally prior to extraction. Extra-oral root canal treatment was performed. In four of the eight replanted teeth, periodontal ligament was removed using gauze. All teeth were replanted after one-hour dry storage. A horizontal line was drilled on the labial enamel surface of the incisors to enable registration of possible subsequent infraposition. The rabbits were sacrificed after 1 week or 4 weeks, respectively. Percussion test of the teeth was carried out and infraposition was registered. Histological processing and evaluation were performed. RESULTS Percussion sound was normal after 1 week and high in the 4 week group; infraposition was noted in all replanted teeth in the 4-week group. Fusion between the bone and dentin was seen in some areas on the root already after 1 week, but there was little or no osseous replacement. Larger areas of ankylosis were seen in the 4-week group although not significant, but deeper progressive osseous replacement was noted in this group. There was no significant difference in ankylosis with regard to periodontal ligament removal or not. Pulp and periodontal tissues were normal in all control teeth. CONCLUSION The rabbit tooth model may be useful for experimental in-vivo studies on delayed replantation, subsequent ankylosis, osseous replacement and infraposition.
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Affiliation(s)
- Manal Maslamani
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Ala Almusawi
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Bobby Joseph
- Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Severino Gabato
- Kuwait Animal Resources Center - Health Sciences Center, Kuwait University, Kuwait, Kuwait
| | - Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
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40
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Chafaie A. Luxations partielle et totale des dents permanentes chez l’enfant : la prise en charge clinique. Int Orthod 2016. [DOI: 10.1016/j.ortho.2015.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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41
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Mohammadi Z, C Cehreli Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Management of Root Resorption Using Chemical Agents: A Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:1-7. [PMID: 26843869 PMCID: PMC4731525 DOI: 10.7508/iej.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/28/2015] [Accepted: 10/24/2015] [Indexed: 11/30/2022]
Abstract
Root resorption (RR) is defined as the loss of dental hard tissues because of clastic activity inside or outside of tooth the root. In the permanent dentition, RR is a pathologic event; if untreated, it might result in the premature loss of the affected tooth. Several hypotheses have been suggested as the mechanisms of root resorption such as absence of the remnants of Hertwig's epithelial root sheath (HERS) and the absence of some intrinsic factors in cementum and predentin such as amelogenin or osteoprotegerin (OPG). It seems that a barrier is formed by the less-calcified intermediate cementum or the cementodentin junction that prevents external RR. There are several chemical strategies to manage root resorption. The purpose of this paper was to review several chemical agents to manage RR such as tetracycline, sodium hypochlorite, acids (citric acid, phosphoric acid, ascorbic acid and hydrochloric acid), acetazolamide, calcitonin, alendronate, fluoride, Ledermix and Emdogain.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shaheed Beheshti University of Medical Sciences, and Iranian National Elite Foundation, Tehran, Iran
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | | | - Luciano Giardino
- Department of Periodontology, Endodontology, Pharmacology and Microbiology, Dental School, University of Brescia, Italy
| | - Flavio Palazzi
- Department of Odontostomatological and Maxillofacial Sciences, Federico II University of Naples, Italy
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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42
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Chafaie A. Partial and total luxations of permanent teeth in children: Clinical management. Int Orthod 2016; 14:32-47. [PMID: 26826972 DOI: 10.1016/j.ortho.2015.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dentoalveolar trauma, very frequent during childhood and adolescence, generally results in tooth fracture and/or partial or total luxation. Management of the pulpal and periodontal aspects of these traumatic cases is complex. The prognosis is improved if treatment is initiated promptly. Multidisciplinary management of these situations and regular patient follow-up make it possible to detect complications quickly and take the necessary action to maintain the teeth as long as possible in a healthy periodontal environment that allows harmonious development and the application of appropriate treatment in adulthood.
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Affiliation(s)
- Amir Chafaie
- Odontologie pédiatrique, faculté d'odontologie, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France.
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43
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Tamura S, Oka K, Itaya S, Kira-Tatsuoka M, Toda M, Higa A, Ozaki M. Effects of Fibrillin Application on Periodontal Ligament Regeneration in Mouse Model of Tooth Replantation. J HARD TISSUE BIOL 2016. [DOI: 10.2485/jhtb.25.295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Shougo Tamura
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Kyoko Oka
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Satoshi Itaya
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Michiko Kira-Tatsuoka
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Masako Toda
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Arisa Higa
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
| | - Masao Ozaki
- Section of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College
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44
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Zhu W, Zhang Q, Zhang Y, Cen L, Wang J. PDL regeneration via cell homing in delayed replantation of avulsed teeth. J Transl Med 2015; 13:357. [PMID: 26572489 PMCID: PMC4647325 DOI: 10.1186/s12967-015-0719-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/31/2015] [Indexed: 01/10/2023] Open
Abstract
Background This study was aimed to investigate whether regeneration of periodontal ligament (PDL) like tissue could be promoted by stromal cell-derived factor-1 (SDF1) and bone morphogenetic protein-7 (BMP7) induced cell homing in delayed replantation of avulsed teeth. Methods Canine mandibular premolar teeth were first extracted and air-dried for 2 h followed by complete detachment of their PDL tissues. The crown and pulp of the teeth were also removed. Twenty-four roots divided into two groups (n = 12/group) were used for the following in vivo transplantation. The roots of Group A were treated with 17 % EDTA for 24 h to achieve demineralization, and then coated with SDF1 and BMP7 supplemented collagen solution. The roots of Group B were similarly treated except being coated with a pristine collagen solution. The above roots were transplanted in the sockets that formed previously during tooth extraction. At 6 months’ post-operation, PDL-like tissue composed of spindle-shaped cells, capillaries and highly organized collagen fibers was observed in the interstitial space between the avulsed root surface and surrounding alveolar bone in Group A. The neo-fibers inserted deeply and perpendicularly into the cementum and adjacent bone. The periodontium-like characteristics of the neo-tissue was confirmed by immunohistochemical staining for collagen I, fibronectin and osteocalcin. Results A high incidence of PDL re-establishment as 42 % was achieved for samples of Group A. However, no PDL-like tissue was found but root ankylosis and replacement resorption as well as inflammatory resorption was observed in the replanted roots of Group B. Conclusions It can be confirmed that avulsed teeth could be successfully rescued even in delayed transplantation to avoid dentoalveolar ankylosis or replacement resorption via the current developed cell homing method. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0719-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wenting Zhu
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Qian Zhang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Yang Zhang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Lian Cen
- School of Chemical Engineering, East China University of Science and Technology, No. 130, Mei Long Road, Shanghai, 200237, China. .,National Tissue Engineering Center of China, No. 68, East Jiang Chuan Road, Shanghai, 200241, China.
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai, 200011, China.
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45
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Poi WR, Sonoda CK, Martins CM, Melo ME, Pellizzer EP, de Mendonça MR, Panzarini SR. Storage media for avulsed teeth: a literature review. Braz Dent J 2015; 24:437-45. [PMID: 24474282 DOI: 10.1590/0103-6440201302297] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/01/2013] [Indexed: 11/22/2022] Open
Abstract
Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a wide array of types of wet storage media have been evaluated in laboratory studies and clinical reports, including cell and tissue culture solutions like Hank's Balanced Salt Solution (HBSS); medical/hospital products developed specifically for organ storage purposes, such as Viaspan® and Euro-Collins®; culture media, like Minimum Essential Medium (MEM); saline; natural products like water, saliva, bovine milk and its variations, propolis, green tea, Morus rubra (red mulberry), egg white and coconut water; rehydrating solutions, like Gatorade® and Ricetral, and even contact lens solutions. Based on the literature, it could be stated that, so far, apart from Based on the literature, it could be stated that, so far, apart from solutions designed specifically for storage and culture purposes, regular pasteurized whole milk is the most frequently recommended and with the best prognosis among other solutions that are likely to be available at the scene of an accident, such as water, saline or saliva. Its advantages include its high availability, ready accessibility, physiologically compatible pH and osmolality (fluid pressure) with the root-surface adhered PDL cells, presence of nutrients and growth factors. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on.
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46
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Bai J, Qin M, Zhao YM, Huang MW, Ji AP. Chemical removal of necrotic periodontal ligament on delayed replanted teeth by sodium hypochlorite: morphological analysis and microhardness indentation test of cementum. Int Endod J 2015; 49:393-401. [PMID: 26010894 DOI: 10.1111/iej.12467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 05/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J. Bai
- Department of Oral Emergency; Peking University School and Hospital of Stomatology; Beijing China
| | - M. Qin
- Department of Pediatric Dentistry; Peking University School and Hospital of Stomatology; Beijing China
| | - Y. -M. Zhao
- Department of Pediatric Dentistry; Peking University School and Hospital of Stomatology; Beijing China
| | - M. -W. Huang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Beijing China
| | - A. -P. Ji
- Department of Oral Emergency; Peking University School and Hospital of Stomatology; Beijing China
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47
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Tuna EB, Yaman D, Yamamato S. What is the Best Root Surface Treatment for Avulsed Teeth? Open Dent J 2014; 8:175-9. [PMID: 25317212 PMCID: PMC4192837 DOI: 10.2174/1874210601408010175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/07/2014] [Accepted: 08/27/2014] [Indexed: 12/02/2022] Open
Abstract
Dental avulsion is the most severe type of traumatic tooth injuries since it causes damage to several structures and results in avulsion of the tooth from its socket. Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long-term prognosis and survival of these teeth. The prognosis of the treatment as well as the survival of an avulsed tooth depends on intrinsic and extrinsic factors, such as the duration of the tooth's extra-alveolar period, replantation time, the type of storage medium, PDL status and duration of splinting. Recent research has led to the development of storage media. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on. On the other hand in case of delayed replantation, due to the great risk of tooth loss after avulsion, different root surface treatments have been proposed to prevent and delay root resorption before replantation. For this purpose, researchers have applied some different root surface treatment modalities in delayed replantation of avulsed teeth. Several protocols have been used to maintain PDL viability; some involve fluorides, steroids, sodium alendronate, enamel matrix derivatives (EMD) and basic fibroblast growth factor (bFGF, FGF-2). Among these applications, bFGF shows promising results in the regeneration of natural tooth structures and tissues. Better understanding of mechanism of bFGF may help to improve new technologies of regeneration of tooth structures.
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Affiliation(s)
- Elif B Tuna
- DDS, PhD, Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Duygu Yaman
- DDS, PhD, Department of Periodontology, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Seiko Yamamato
- DDS, PhD, Department of Pediatric Dentistry, School of Dentistry, Nihon University at Matsudo, Chiba, Japan
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48
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Zanetta-Barbosa D, Moura CCG, Machado JR, Crema VO, Lima CADP, de Carvalho ACP. Effect of indomethacin on surface treatment and intracanal dressing of replanted teeth in dogs. J Oral Maxillofac Surg 2014; 72:127.e1-9. [PMID: 24331566 DOI: 10.1016/j.joms.2013.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 08/07/2013] [Accepted: 08/19/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH]2). MATERIALS AND METHODS Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)2 (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)2 (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05. RESULTS Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups. CONCLUSIONS The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)2 with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes.
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Affiliation(s)
- Darceny Zanetta-Barbosa
- Professor, Division of Buccal and Maxillofacial Surgery, Department of Oral Surgery, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil.
| | - Camilla Christian Gomes Moura
- Professor, Department of Histology, Federal University of Triângulo Mineiro; and Researcher, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Juliana Reis Machado
- Postdoctoral Student, Department of Pathology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Virginia Oliveira Crema
- Professor, Department of Histology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Cirilo Antônio de Paula Lima
- Professor, Department of Veterinary Surgery, School of Veterinary Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Antônio Cesar Perry de Carvalho
- Professor, Division of Buccal and Maxillofacial Surgery, Department of Oral Surgery, School of Dentistry, State University of São Paulo, Araçatuba, São Paulo, Brazil
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49
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Al-Haj Ali SN, Al-Jundi S, Mhaidat N. Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study. Int J Clin Pediatr Dent 2013; 6:161-5. [PMID: 25206215 PMCID: PMC4086597 DOI: 10.5005/jp-journals-10005-1211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 07/02/2013] [Indexed: 11/23/2022] Open
Abstract
AIM The aim of this study is to assess and compare the efficacy of Jordanian propolis and full concentration mature coconut water in their ability to preserve periodontal ligament (PDL) cell viability after exposure of PDL cells to up to 120 minutes dry storage. MATERIALS AND METHODS PDL cells were obtained from sound permanent first molars which were cultured in Dulbecco's Modified Eagles Medium (DMEM). Cultures were subjected to 0, 30, 45, 60, 90 and 120 minutes dry storage times then incubated with 100% mature coconut water, Jordanian propolis and DMEM for 45 minutes at room temperature (18-26°C). Untreated cells served as controls at each dry storage time tested. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test and the level of significance was 5% ( p < 0.05). RESULTS Up to 60 minutes dry storage, no significant improvement on the percentage of viable cells was found from soaking in all tested media. On the other hand, soaking in mature coconut water only resulted in higher percentages of viable cells at >60 minutes dry storage. However, this improvement was not significant (p > 0.05). CONCLUSION Avulsed teeth which have been left dry for <45 minutes should be replanted immediately, whereas avulsed teeth which have been left dry for >45 minutes may benefit from soaking for 45 minutes in mature coconut water. How to cite this article: Al-Haj Ali SN, Al-Jundi S, Mhaidat N. Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study. Int J Clin Pediatr Dent 2013;6(3):161-165.
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Affiliation(s)
- Sanaa Najeh Al-Haj Ali
- Assistant Professor, Department of Orthodontics and Pediatric Dentistry, Qassim University, PO Box 6666, Qassim, Kingdom of Saudi Arabia, e-mail:
| | - Suhad Al-Jundi
- Professor, Department of Pediatric and Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nizar Mhaidat
- Associate Professor, Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Effect of the treatment of root surface-adhered necrotic periodontal ligament with propolis or fluoride in delayed rat tooth replantation. Clin Oral Investig 2013; 18:1329-1333. [PMID: 24048948 DOI: 10.1007/s00784-013-1103-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 09/09/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the application of 15 % propolis and 2 % acidulated-phosphate sodium fluoride solutions on the root surface-adhered necrotic cemental periodontal ligament in delayed tooth replantation. MATERIALS AND METHODS Thirty Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. After this period, the dental papilla, enamel organ, and pulp tissue were removed, and the animals were randomly assigned to three groups: group I = immersion in saline for 10 min; group II = immersion in a 2 % acidulated-phosphate sodium fluoride solution for 10 min; and group III = immersion in a 15 % propolis and propylene glycol solution for 10 min. The root canals were filled with a calcium hydroxide paste and the teeth were replanted. RESULTS Inflammatory resorption, replacement resorption, and ankylosis were observed in all groups without a statistically significant difference (p > 0.05) among them. CONCLUSIONS Under the tested conditions, the application of fluoride or propolis on root surface-adhered necrotic periodontal ligament did not favor the healing process in delayed tooth replantation.
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