Abstract
Replantation is being widely accepted as an effective treatment option for an avulsed tooth. However, the long-term fate of replanted teeth is unpredictable; it is dependent on various factors, such as the time interval between avulsion and replantation, extra-alveolar storage period (dry storage or storage media), the vitality status of pulp or periodontal tissues and the type and period of splinting. The appropriate use of storage media is an important clinical factor affecting the postoperative prognosis of avulsed teeth following replantation. Hank’s balanced salt solution and pasteurized milk are considered to be the most appropriate and clinically recommended storage media for avulsed teeth. The present review discusses the various available storage media for avulsed teeth and their potential maintenance of the vitality of periodontal ligament cells. A brief overview of the effect of clinical factors, such as the storage time, pH, and the osmolar-ity of storage media on their efficacy is included.How to cite this articleKhinda VIS, Kaur G, Brar GS, Kallar S, Khurana H. Clinical and Practical Implications of Storage Media used for Tooth Avulsion. Int J Clin Pediatr Dent 2017; 10(2): 158-165.
Highlights
Tooth avulsion is a complex traumatic injury characterized by the complete dislodgement of the tooth from its socket, which causes severe damage to the supporting tissues, vascular and nerve structures, which requires a prompt and correct emergency management for the good prognosis.[1]
As dry storage is detrimental to the preservation of the periodontal ligament (PDL), the avulsed tooth must be prevented from drying by the use of storage media of ideal osmolality and pH
Hwang and Park investigated the efficacy of Green tea extract (GTE) as a storage medium for avulsed teeth and found that there was no difference in the PDL cell viability between GTE and Hank’s balanced salt solution (HBSS) medium, whereas GTE showed higher viability than milk, water, and commercial green tea
Summary
Tooth avulsion is a complex traumatic injury characterized by the complete dislodgement of the tooth from its socket, which causes severe damage to the supporting tissues, vascular and nerve structures, which requires a prompt and correct emergency management for the good prognosis.[1]. Teeth are usually subjected to a period of desiccation between their avulsion and replantation. It is desirable to replant the avulsed tooth as quickly as possible to ensure the maximal viability of PDL cells (fibroblasts) attached to the root surface. As dry storage is detrimental to the preservation of the PDL, the avulsed tooth must be prevented from drying by the use of storage media of ideal osmolality and pH. In cases where an immediate replantation is not feasible, use of a storage medium is prudent to enhance and preserve the vitality of PDL fibroblasts of an avulsed tooth. A medium should possess certain properties to make it an acceptable storage medium for avulsed teeth.[5]
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