Abstract
Dental avulsion from alveolar socket is the most severe type of traumatic tooth injuries. Immediate replantation after avulsion provides the highest success, whereas delayed replantation in storage of long time dehydration always results in ankylosis, absorption and loss of teeth eventually. Maintaining the vitality of periodontal ligament (PDL) cells on root surface is regarded as a crucial step deciding the long term survival of avulsed teeth. In present study, the geomorphology on the root surface from immediate to delayed replantation of avulsed teeth was inspected by scanning electron microscopy (SEM). Fibrous “vegetation” covering cementum was observed in fresh wound of PDL, that was transformed into “Gobi desert” on root surface because of the extinguishment of the fibers in long time air dry storage. Reutilization of the PDL embedded in the cementum was attempted to simulate the fresh root surface to improve prognosis of delayed replantation. Fibers protected by mineralized stroma were decalcificated and exposed again that reversed the deteriorated geomorphology for the regeneration of PDL on root surface. The direct evidences from SEM give a new sight for the etiology and therapy to delayed replantation of tooth avulsion. Funding Statement: This study was supported by grants from the National Nature Science Foundation of China (Nos. 81100765, 81570990). Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: his study was approved by the Local research ethics committee number CMUSH-IRB-KJ-PJ-2019-17.
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