Medios de almacenamiento para dientes avulsionados. Una revisión / Media storage for avulsed teeth. A review

Resumen La avulsión dental es el desplazamiento completo del diente de su alvéolo que puede ser causado por un traumatismo, en el que se produce la ruptura de las fibras del ligamento periodontal; además puede estar acompañado de lesiones que comprometan el cemento, el hueso alveolar y los tejidos periodontales. Las células del ligamento periodontal, luego de la avulsión, crecen óptimamente en un pH neutro; los medios de almacenamiento deben tener características ideales para que haya crecimiento celular, como: ser líquidos estériles, poseer componentes que nutran las células del ligamento periodontal, estar disponibles en el lugar del accidente, ser de larga duración y vida útil. El índice de trauma dentoalveolar ha aumentado en nuestro país y la principal causa son los accidentes en motocicleta y deportes. Se pierden muchos dientes avulsionados por desconocimiento de colocar este diente en un medio favorable antes de que sea reimplantado por el odontólogo; existen muchos medios y cada día se experimentan más, pero ¿cuáles de estos son realmente benéficos para mejorar el pronóstico de los dientes avulsionados? El propósito de esta revisión es describir los diferentes medios de almacenamiento para dientes avulsionados investigados hasta la fecha, con el fin de determinar cuál es el medio de elección para la conservación de las células del ligamento periodontal en los dientes que serán reimplantados. Se realizó una revisión de la literatura de estudios publicados en idioma inglés y español en la bibliografía médica, utilizando el buscador Pubmed/Medline, Lilacs, BBO y Scielo. La leche fresca pasteurizada sigue siendo el medio de elección, pero teniendo en cuenta que el tiempo extraoral es importante, si no se tiene la leche, los nuevos medios, como la clara de huevo, propóleo, aloe vera y agua de coco, son una buena alternativa en casos de ser los disponibles en el lugar del accidente. Las cajas de rescate son el medio ideal y deben estar disponibles en todos los países.

Abstract Dental avulsion is the complete displacement of a tooth from its alveolus that may be caused by trauma, producing the rupture of fibers from the periodontal ligament and other lesions involving cement, alveolar bone and periodontal tissues. After the avulsion, cells from the periodontal ligament grow optimally in a neutral pH, therefore the storage media must have ideal characteristics for cellular growth, such as: Sterile liquids, periodontal ligament cell nutrients, availability at the place of the accident and long lasting life. In our country, dento-alveolar trauma index has increased and the main cause are accidents in motorcycles and sports. Many avulsed teeth are lost because of the ignorance of placing the tooth in a favorable storage media before the dentist replaces it. There are many storage media and every day other, more are experimented, so then, which of these are beneficial for the outcome of avulsed teeth? The purpose of this review of literature is to describe the different storage media for avulsed teeth to determine which is the best storage media for the conservation of periodontal ligament cells in teeth that will be re-implanted. A literature review was done of articles published in English and Spanish using Pubmed/ Medline, Lilacs, BBO and Scielo. Conclusion: Fresh pasteurized milk is still the storage media of choice, taking into consideration the importance of extraoral time. Other storage media such as egg yolk, propolis, aloe vera and coconut water should be considered as alternatives in case there's no milk available in the place of the accident. Rescue boxes should be available in every country.

Decoronation management of the replacement resorption after delayed replantation of avulsed teeth-case report with 4-year follow-up / 华西口腔医学杂志

Replacement resorption is the most frequent complication after delayed replantation of avulsed teeth. The resorption can interfere with the development of the alveolar ridge and lead to tilt of the adjacent teeth in growing patients. However, there is no means of arresting or reversing the process. Recently decoronation is recommended by International Assocaition of Dental Traumatology as the optimal choice to manage it. This paper demonstrates the procedure and effectiveness of the decoronation by literature review and a case report with 4-year follow-up.

Dental trauma and replantation of avulsed teeth.

Avulsion of tooth or teeth is defined as displacement of tooth from its socket. An avulsed permanent tooth is one of the few real emergency situations in dentistry. Avulsion of teeth occurs most often in children between 7 and 9 years of age. It requires quick emergency intervention for favourable healing followed by evaluation and possible treatment at decisive times during the healing phase. Replantation is the first line of treatment for avulsed teeth when extraoral time is less and minimal damage to the PDL. It includes stabilization of teeth in its normal position which helps in reattachment and reorganization of the periodontal ligament. Every possible effort should be made to replant it in order to avoid esthetic, masticatory, phonetic difficulties and avoid arch length discrepancy.

Soy milk as a storage medium to preserve human fibroblast cell viability: an in vitro study

Soy milk (SM) is widely consumed worldwide as a substitute for cow milk. It is a source of vitamins, carbohydrates and sugars, but its capacity to preserve cell viability has not been evaluated. The purpose of the present study was to investigate the efficacy of SM to maintain the viability of human fibroblasts at short periods compared with different cow milks. Human mouth fibroblasts were cultured and stored in the following media at room temperature: 10% Dulbecco's Modified Eagle Medium (DMEM) (positive control group); long shelf-life ultra-high temperature whole cow milk (WM); long shelf-life ultra-high temperature skim cow milk (SKM); powdered cow milk (PM); and soy milk (SM). After 5, 15, 30 and 45 min, cell viability was analyzed using the MTT assay. Data were analyzed statistically by the Kruskal-Wallis test with post-analysis using the Dunn's method (α=0.05). SKM showed the lowest capacity to maintain cell viability in all analyzed times (p<0.05). At 30 and 45 min, the absorbance levels in control group (DMEM) and SM were significantly higher than in SKM (p<0.05). Cell viability decreased along the time (5-45 min). The results indicate that SM can be used as a more adequate storage medium for avulsed teeth. SKM was not as effective in preserving cell viability as the cell culture medium and SM.

O leite de soja (LS) é largamente consumido em todo o mundo como substituto para o leite bovino. Este é uma fonte de vitaminas, carboidratos e açúcares, mas a sua capacidade para preservar a viabilidade celular não foi avaliada. A finalidade do estudo foi investigar a eficácia do LS em manter a viabilidade de fibroblastos humanos em períodos curtos em comparação com diferentes leites bovinos. Fibroblastos de boca humanos foram cultivados e armazenados nos seguintes meios à temperatura ambiente: 10% de meio Dulbecco's Modified Eagle (DMEM) (grupo controle positivo); leite bovino integral longa vida (LI); leite bovino desnatado longa vida - LD; leite em pó - LP; leite de soja - LS. Depois de 5, 15, 30 e 45 min, a viabilidade celular foi analisada usando o método de MTT. Os dados foram analisados estatisticamente pelo teste de Kruskal-Wallis e posteriormente usando o método de Dunn (α=0,05). O grupo LD apresentou a menor capacidade para manter a viabilidade celular em todos os tempos analisados (p<0,05). Aos 30 e aos 45 min, os níveis de absorbância no grupo controle (DMEM) e LS foram significativamente maiores que no grupo LD (p<0,05). A viabilidade celular diminuiu ao longo do tempo (5-45 min). Os resultados indicaram que LS pode ser usado como meio de armazenamento mais adequado para dentes avulsionados. LD não foi eficaz na preservação da viabilidade das células como o meio de cultura de células e o LS.

Effects of platelet-rich plasma (PRP) on the periodontal healing of replanted teeth / 实用口腔医学杂志

Objective:To evaluate the influence of platelet-rich plasma(PRP) on periodontal healing of replanted teeth in 6 Beagle dogs.Methods:The second incisors were pulled out and re-implanted after 60 min dry storage.In group A,PRP were applied before replantation,and 7days later the teeth received root canal treatment.In group B,PRP were applied before replantation either,but without root canal treatment.In group C,PRP were not applied and 7 days later,the teeth received root canal treatment.In group D,no PRP were applied and no root canal treatment.All the dogs were sacrificed after 12 weeks and the histological parameters were observed.Results:There were no significant differences between group A and C.Group B showed a lower incidence of ankylosis,and higher incidence of healed PDL compared with group D.Conclusion:Under the definite condition,PRP can help to decrease the incidence of ankylosis and increase the incidence of healed PDL in groups that the pulps were not removed.