Storage Of Teeth Research Articles

TREATMENT OF TOOTH AVULSION: A CASE REPORT

Dental trauma (DT) refers to injuries caused by impacts to the teeth and/or the hard and soft tissues within or outside the oral cavity. Among the various types of DT, avulsion, characterized by the complete displacement of the tooth from its socket. The success of treatment depends on timely management and proper professional care during and after reimplantation in preserving the tooth in the oral cavity. This study describes a case report of an avulsion of the upper left central incisor (21) that underwent reimplantation. The patient, a 10-year-old boy, had a history of bicycle fall, presenting with extraoral injuries to the cheek and chin, lip abrasions, and avulsion of tooth 21. The tooth was stored in milk and reimplanted 30 minutes after the accident. Clinical and radiographic examinations showed no bone fractures but revealed mobility of teeth 11 and 12 and avulsion of tooth 21. Treatment included cleaning, repositioning of the avulsed tooth, stabilization with a semi-flexible splint, and administration of antibiotics and analgesics. Endodontic therapy with mechanical instrumentation was successfully initiated after 20 days. This case highlights the importance of proper tooth storage and timing of reimplantation, leading to the restoration of patient’s aesthetics, chewing function, and self-esteem.

Assessment of Parental Awareness on the Management of Avulsed Teeth: A Survey Study

This study assessed parental awareness of avulsed tooth management among 300 participants at Kamineni Institute of Dental Sciences, Nalgonda. Results revealed significant gaps in understanding, with only 0.66% indicating they would replant an avulsed tooth, and 87.3% disagreed that it could be replanted. Most participants were uncertain about key aspects, such as replantation and tooth storage. These findings emphasize the need for targeted educational interventions to improve parental preparedness for dental emergencies. Addressing these knowledge gaps can empower individuals to provide appropriate first aid and seek timely professional care, ultimately improving outcomes for dental trauma patients.

Efficacy of Natural Coconut Water, Pre-packaged Coconut Water, and Hank’s Balanced Salt Solution as Storage Media in Maintaining Periodontal Ligament Cell Viability: An In-vitro Study

Introduction: Avulsion of teeth is one of the most complex forms of dental injury, and the selection of an appropriate storage medium greatly influences the preservation of Periodontal Ligament (PDL) cell viability, which is crucial for the successful re-implantation of avulsed teeth. Therefore, identifying effective storage options such as natural coconut water and prepackaged coconut water holds significant promise in improving outcomes for this challenging dental injury. Aim: To evaluate the efficacy of natural coconut water, prepackaged coconut water, and Hank’s Balanced Salt Solution (HBSS) as storage media in maintaining PDL cell viability. Materials and Methods: A total of 32 non-carious freshly extracted human premolars were randomly divided into four study groups (n=8) and stored in the following storage media respectively: Group I-Natural coconut water group, Group IIPre-packaged coconut water group, Group III-Bench dry group, and Group IV-HBSS groups for 30 minutes. The PDL cells were collected and incubated in phosphate buffer saline for 30 minutes and then centrifuged at 800 rpm for five minutes. Following this, the cells were stained with trypan blue to observe their viability. The Analysis of Variance (ANOVA) with Tukey’s post-hoc test was used for analysing the data. Results: The mean percentage of viable cells in natural coconut water (80.6250) was higher than in HBSS (79.8750), prepackaged coconut water (79.2500), and the bench dry group (6.1250). Meanwhile, the mean percentage of non-viable cells was highest in the bench dry group (93.8750), followed by the pre-packaged coconut water (20.7500), HBSS (20.1250), and natural coconut water (19.3750). Conclusion: Natural coconut water and pre-packaged coconut water are equally effective in maintaining the viability of PDL cells. Therefore, pre-packaged coconut water can be used as a substitute for natural coconut water for tooth storage, depending upon availability.

Cytotoxicity of solutions recommended for the storage of avulsed teeth in cultures with periodontal ligament cells

Cytotoxicity of solutions recommended for the storage of avulsed teeth in cultures with periodontal ligament cells

The Effect of Using an Educational Poster on Mothers’ Knowledge of Emergency Management of Dental Avulsion

Introduction: Mothers are commonly the first ones who encounter the dental avulsion in children. High knowledge of them could greatly affect the success rate of treatment. The purpose of this study was to evaluate the effect of educational poster on the mother’s knowledge about management of dental avulsion.Materials and Methods: This study was conducted at the Department of Pediatric Dentistry, Guilan University of Medical Sciences from November 2020 to February 2021. After obtaining the informed consent, a questionnaire containing the mothers’ socio-demographic information and 8 questions regarding knowledge about dental avulsion was responded alone by 262 mothers (131 in the study group and 131 in control group) before educational poster presentation in the study group. After three months, the participants of both groups were re-evaluated using the same questionnaire. McNemar’s test and Generalized Estimating Equations (GEE) was used to analyze the data. Results with P < 0.05 were considered statistically significant. Results: Use of an educational poster improved the knowledge of participants of study group about dental avulsion, although this improvement was statistically significant in questions regarding immediate emergency action (P=0.003), appropriate time for replantation (P<0.001), cleaning before replantation of a dirty tooth(P=0.022) and suitable storage medium for transferring an avulsed tooth (P<0.001). It was found that variables like age, level of education, employment status and previous training had no significant effect on participants knowledge(P>0.05).Conclusion: Results showed that the use of posters as an educational method can effectively improve mothers’ knowledge about management of children’s dental avulsion.

Emergency management of avulsion injuries: from home to clinic: A multicentre cross-sectional survey among medical doctors and general public.

The objective of this multi-centre study was to analyse the knowledge of parents as compared to medical-doctors regarding avulsion-injuries. A validated and piloted questionnaire was circulated among two equal groups (130 participants each) of medical-doctors and the general public. Data was analysed using SPSS version 19. A total of 131 (89%) participants had a university degree and 185 (71%) had a full time employment. One hundred and eighty-seven (72%) participants reported having no previous information regarding avulsion injuries, 195 (75%) considered their level of knowledge inadequate, and 63 (24%) had a previous history of dental trauma. A statistically significant number had information regarding avulsed permanent-teeth replantation (p=0.02) but not deciduous-teeth (p=0.26), whereas only 39 (15%) were aware of the right medium for tooth storage. Having seen or sustained an avulsion-injury and a higher qualification were statistically related to correct responses for some questions. A total of 106 (41%) of the participants wanted to be educated through written-material. In conclusion, the first-aid knowledge regarding tooth avulsion injuries in our population, irrespective of their level of academic education, is poor and needs supervised training.

Knowledge and skills of emergency physicians in managing traumatic dental injuries

PurposeEmergency departments are frequently confronted with traumatic dental injuries (TDIs). The prognosis of the injured tooth is related to early dental trauma management. For this reason, physicians must be familiar with the appropriate management of TDI. This study aimed to investigate the knowledge and skills of German emergency physicians regarding TDI.MethodsAn electronic questionnaire was sent to 438 emergency departments throughout Germany. Four hundred and twenty seven questionnaires were evaluated and included in the analysis. The survey contained questions about physician characteristics and assessed their knowledge and skills of managing dental trauma. For statistical analysis, the Kruskal–Wallis, Mann–Whitney U test or ANOVA test was used as appropriate. Rank correlations were performed with the Spearman’s rank correlation.ResultsOut of 427 participants, 256 (59.95%) stated they had no or insufficient knowledge, and 266 (71.12%) stated they had no skills in dental trauma management. Almost 76% of the participants had no previous knowledge of dentistry. Only 7.28% knew the right procedure for replanting an avulsed tooth. Just 26.06% would choose the right medium for temporary tooth storage. Having a dentist in the family (p = 0.0074) or clinical exposure to patients with dental trauma (p = 0.0384) influenced the results of the knowledge score.ConclusionThe knowledge and skills in dental trauma management among German emergency physicians are generally inadequate. Targeted training courses are necessary to ensure early and adequate TDI treatment to reduce the resulting medical and societal costs as much as possible.

Network Meta-Analysis of 10 Storage Mediums for Preserving Avulsed Teeth.

Many storage mediums are available for the storage of avulsed teeth to preserve the viability of periodontal ligament (PDL) cells before replantation; however, it is unclear which medium is the optimal option. We performed this network meta-analysis to answer this question. A comprehensive search was conducted in PubMed, EMBASE, and the Cochrane library to capture eligible studies investigating the comparative efficacy of Hank's balanced salt solution (HBSS), aloe vera gel (AVG), oral rehydration solution (ORS), coconut water, egg white, green tea, propolis, saline, milk, and water. Statistical analysis was conducted using Review Manager v5.3 and ADDIS v1.16.8. In total, 20 RCTs involving 31 reports were included finally. Direct meta-analysis suggested that HBSS was superior to ORS, milk, saline, and water, ORS was superior to milk but inferior to coconut water and propolis, egg white was superior to milk but inferior to AVG and propolis, propolis was superior to AVG, milk, and saline, and coconut water and water was inferior to saline and milk, respectively. Network meta-analysis suggested that AVG was inferior to the other nine mediums, and propolis was superior to HBSS (SMD, −5260.24; 95% CrI, −10447.39 to −70.37) and milk (SMD, −5461.11; 95% CrI, −10574.99 to −328.51). Moreover, ranking probabilities indicated the highest probability for propolis, followed by saline, ORS, HBSS, milk, egg white, water, green tea, and AVG successively. Propolis may be the optimal media for storing avulsed teeth before replantation. However, given the availability of propolis and HBSS and the hypotonic properties of saline, ORS or milk should also be preferentially selected.

The Influence of Dental Trauma Education on Undergraduate Students at Ajman University, United Arab Emirates: An Interventional Study.

Background and ObjectivesThe main objective of this study was to assess the impact of a lecture on dental trauma on the knowledge of undergraduate dental students at Ajman University in the United Arab Emirates (UAE).MethodsFourth-year dental students were asked to attend a lecture on dental trauma and then respond to an online questionnaire containing 10 close-ended questions related to their approach to managing dental trauma cases and tooth avulsion before (T0) and directly after (T1) the lecture. They were given 5 min for filling the questionnaire either time. McNemars test was used to compare the accuracy of their answers based on the correct or incorrect response for each question. The level of significance was set at p < 0.05.ResultsThe questionnaire was sent to 164 students, out of which 157 responded, giving a response rate of 95.7%. After receiving the educational intervention, the students showed a significant improvement in their knowledge on managing permanent tooth avulsion, especially regarding the handling of an avulsed tooth before replantation, extra-alveolar time, and media used for the storage and transportation of avulsed teeth (< 0.001).ConclusionThe study reveals that the lecture on dental trauma had an excellent outcome on the knowledge of the students. Therefore, it is essential to emphasize the importance of this information among undergraduate dental students in order to save teeth exposed to trauma and to reduce the social burden of such cases. This study contributes to better understanding of the effect of dental trauma education on undergraduate dental students’ knowledge of the subject.

Store in nature - A medium for avulsed tooth

Avulsion of tooth is complete displacement of tooth out of its socket that leads to mutilation of periodontal ligaments. The desirable treatment option is replantation of the tooth. However, unsuccessful replantation is a matter of great discontentment. Protection of teeth from desiccation (drying of the periodontal ligament tissue), by keeping it in storage media can improve the result of the treatment. Ability to maintain periodontal cell viability for a longer time is warranted in cases of major accidents, where teeth can be replanted only after other major surgeries. This paper reviews the different storage media that have been used for avulsed teeth based on full-length research papers retrieved from GOOGLE search using the key words ‘storage medium’, ‘avulsion’, ‘tooth avulsion’, ‘replantation’, ‘tooth replantation’, ‘milk’ , ‘propolis’, ‘coconut water’, ‘pomegranate’ and natural products. Natural products have easy availability, greater efficacy and longer storage time as compared to Hank’s balanced salt solution which has been recommended by the International Association of Dental Traumatology as standard solution for storage of avulsed teeth. In case of emergency, it is important for dentists to consider the circumstances of the accident, the location and suggest an appropriate Natural transport/storage medium for the avulsed tooth which score better over the Hank’s Balance Salt Solution, based on their storage time, ease of availability and economical price. Keywords: Avulsion, Storage media, Natural products, Propolis, Coconut water, Pomegranate.

MODERN APPROACHES TO DIAGNOSTICS AND TREATMENT OF DENTAL TRAUMA

Relevance of the topic. Disruption of the anatomical integrity of the dentition, occurring as a result of dental trauma, not only impairs the patient’s appearance, but can also affect the functional properties of the entire maxillofacial area. Therefore, the choice of optimal methods for treatment of dental traumas remains an urgent problem of dentistry and requires further development.&#x0D; The aim of this study was to offer the most effective methods for treatment of dental traumas, with a view to preserve and restore the damaged structures of teeth and provide positive long-term outcomes.&#x0D; Materials and methods. The research relied on the study and generalization of modern scientific literature.&#x0D; Results and discussion. To diagnose dental traumas and, accordingly, to determine the ways to eliminate their consequences, its classification is of great importance. In this context, the classification by Andreason gained the strongest support in the world dental community. The approaches to the diagnostics and treatment of dental traumas, which have become established in the world of dentistry, largely rely on this classification.&#x0D; In modern conditions, computed tomography provides the opportunity to obtain maximum information about the condition of the injured tooth and bone damage. Cone-beam computer devices are used to study the maxillofacial area, providing high image quality at low radiation exposure. Essential diagnostic methods also include pulp vitality tests (cold test and electroodontodiagnostics). In this case, to exclude the diagnosis of pulp necrosis, it is recommended to check its vitality repeatedly.&#x0D; Currently, as an alternative to classical restoration in case of fracture of the tooth crown, specialists consider the fixation of the proper fragment of the tooth. Recently, this method of eliminating the effects of fractures of the dental crown is becoming increasingly popular due to the significant improvement in quality and enhanced technological properties of adhesive systems and materials.&#x0D; The search for ways to improve medical care in cases of tooth avulsion is mainly associated with the introduction of replantation and autotransplantation of teeth in the clinical practice. It is recommended to replant a tooth with an open apex without its depulpation due to the high ability of the germinal zone and periodontium to revascularize. Immediately after returning the tooth to the alveolus, a flexible splint is applied for a period of 3-4 weeks. Further endodontic treatment is performed only in cases when revascularization does not occur and signs of apical periodontitis appear. When the root apex is formed, the tooth is replanted in the alveolus, splinted for up to 2 weeks. Endodontic treatment should begin before the splint is removed, 7-10 days after replantation.&#x0D; Experts suggest replanting permanent teeth with both open and closed root apices, even in cases where the tooth has been in a dry environment for more than 60 minutes. However, not always after the injury the tooth can be found or it can be destroyed so that replantation becomes impossible. Nevertheless, in modern conditions, having received an in-depth biological justification of the process of engraftment of the transplanted tooth, it becomes possible to widely use the method of autotransplantation in the clinical practice.&#x0D; Conclusions. Thus, based on the study of a significant array of scientific publications, we can conclude that the problems of dental trauma are increasingly attracting the attention of researchers due to the prevalence of this pathology, the complexity of its diagnostics and treatment. The current approach to the treatment of dental trauma is focused on less invasive and more biologically oriented methods of treatment of hard dental tissues, pulp, periodontal ligament and alveolar bone.&#x0D; Research prospects. It is important to develop the best conditions for tooth storage before replantation in order to improve the periodontal regeneration, the quality of the revascularization process, offer better types of splinting, which will ensure the regeneration of periodontal and pulp tissues, prevent inflammatory complications.

Preservation of the viability and gene expression of human periodontal ligament cells by Thai propolis extract.

Success of tooth replantation depends on the quality and quantity of periodontal ligament (PDL) cells. The aims of this study were to evaluate Thai propolis extract as a storage medium for maintaining PDL cell viability and preserving gene expressions in PDL tissues. PDL cells from human premolars were tested for cytotoxicity of the extract by PrestoBlue assay to determine a non-toxic concentration. Subsequently, 96 freshly extracted premolars were allocated into different treatment groups. Control groups were freshly extracted premolars or they had been stored dry for 12hours. Experimental avulsed teeth were created by leaving them air-dried for 30minutes immediately after extraction, then they were immersed in Thai propolis extract, HBSS or milk for 3, 6 and 12hours. After tooth storage, the remaining PDL cells were determined for their cell viability. RNA isolated from PDL tissues of three premolars treated similarly was analysed for periostin and S100A4 expressions using RT-qPCR. Thai propolis extract at 0.625mgmL-1 promoted the greatest PDL cell viability. Tooth storage in 0.625mgmL-1 Thai propolis extract, HBSS or milk showed no difference in maintaining cell viability. Periostin mRNA level was preserved by Thai propolis extract. Expression of S100A4 mRNA in PDL tissues stored in all tested media was dampened. PDL cells from mock avulsed teeth stored in 0.625mgmL-1 Thai propolis extract for 3, 6 and 12hours remained viable and the expression of periostin was preserved. This study suggests this extract as an alternative for a tooth storage medium for up to 12hours. However, transporting an avulsed tooth in a storage medium for extended extra-oral time might affect the PDL cell phenotypes.

Knowledge of tooth avulsion first aid management among parents residing in UAE

Aim: This study aimed to evaluate the knowledge of parents visiting a specialized dental center in Ajman on permanent tooth avulsion and the required first aid procedure to achieve better prognoses. Methods: A cross-sectional study was conducted in Ajman Emirate, UAE. Three hundred eighty-eight parents from three nationalities (Emirati, Egyptian and Indian) residing in UAE answered a constructed questionnaire that included demographic information related to the participants and questions related to permanent tooth avulsion and the required first steps for its management. Results: Study findings reflect deficiencies in the following areas. Of the 388 parents, (236, 60.8%) had poor knowledge about permanent tooth avulsion. Parents who had previous knowledge obtained information from unsupported sources, such as friends (145, 37.4%). Out of 388 parents, (324, and 83.5%) would not replant the tooth. Finally, the majority of the participants did not know the proper media to store the avulsed permanent tooth with one-third of parents choosing cotton or water (142, 36.6%). Conclusion: This study showed a lack of knowledge regarding permanent tooth avulsion among parents from the major nationalities residing in UAE. However, the respondents represent major differences regarding related to knowledge, replant, and storage of avulsed permanent teeth.

Replantation of two avulsed teeth after 1 h of storage in adverse extraoral dry conditions: A thought-provoking outcome after a 15-month follow-up

This article reports a clinical case of an 8-year-old boy who sustained avulsion of the maxillary right central incisor and the maxillary left lateral incisor. The avulsed teeth were kept in adverse extraoral dry conditions for 1 h from the moment of trauma until their replantation.The prognosis of tooth replantation is dependent on multiple factors such as methods of teeth storage in vitro, endodontic intervention, extra-oral time, and type of retention employed. The main reasons for root resorption in this case may be the extra-oral time, the initial replantation, or the delayed endodontic treatment.

Survival of Replanted Permanent Teeth after Traumatic Avulsion

IntroductionTooth replantation is the treatment of choice for avulsion, even though its long-term prognosis shows great variability and few studies have adopted survival analysis to evaluate the fate of such teeth. The present study aimed to evaluate both the survival rate of replanted permanent teeth after traumatic avulsion as well as its clinical and demographic determinants. MethodsRecords from 576 patients treated at the Dental Trauma Clinic at the Federal University of Minas Gerais, Brazil, were analyzed to collect clinical and radiographic data. Kaplan-Meier curves and a multivariate Cox regression model were used to estimate the probability of replanted teeth remaining functional in the mouth and to determine prognostic factors. ResultsThe post-replantation survival rate was 50% after 5.5 years. Immature teeth presented an increase of 51.3% in the loss rate (P = .002). Each additional year in the patient's age at the time of trauma, up to the limit of 16 years, reduced the loss rate of replanted teeth by 15% (P < .001). The storage of the avulsed teeth in milk decreased the loss rate of replanted teeth by 56.4% (P = .015) when compared with those kept dry. ConclusionsThe overall survival rate after replantation of permanent teeeth was 50% after 5.5 years. Advanced stages of root development, together with the increase in the patient's age at the moment of trauma, up to the limit of 16 years, were good prognostic factors for tooth survival. The storage of avulsed teeth in milk was also associated with enhanced tooth survival after replantation.

REPLANTATION OF AVULSED TOOTH: A STEP-BY-STEP REPORT

Introduction: Avulsion is a serious injury that causes damage to dental and supportive tissues, and is characterized by complete displacement of a tooth from its socket. In most situations, replantation is the treatment of choice for permanent tooth avulsion, and appropriate management is critical for a goodprognosis in these cases. Previous studies have shown that the level of knowledge of dentists regarding the management of an avulsed tooth is deficient and have underscored the importance of continuing dental education to further the knowledge of general dentists in the urgency management of permanent avulsedteeth. Objective: This report aims to present a step-by-step clinical sequence involving the reimplantation of a mature permanent tooth that suffered avulsion, following the CARE guide. Case report: Tooth 21, stored in milk, was reimplanted 2 hours after avulsion and stabilized with flexible containment. The clinical steps were carried out according to the recommendations of the International Association of Dental Traumatology. Endodontic treatment was started five days after reimplantation, with periodic changes of intracanal medication. The patient is currently under follow-up, with no negative signs or symptoms related to avulsion.Conclusion: Dental reimplantation after avulsion should be performed after a thorough systemic and oral diagnosis and tooth storage conditions, with a clinical protocol based on scientific evidence of associations of dentoalveolar trauma.

Avaliação do conhecimento de alunos de graduação em Odontologia sobre avulsão dentária

Objetivo: avaliar, através de um questionário, o conhecimento dos alunos de graduação do curso de Odontologia na Universidade Veiga de Almeida sobre avulsão dentária. Material e métodos: um questionário estruturado com formação acadêmica, experiências prévias no assunto, e questões de múltipla escolha sobre o conhecimento de avulsão dentária foi aplicado nos alunos do 2° ao 8° período. Resultados: verificou-se que 98,2% sabem o que é avulsão dentária e 54,5% já estudaram ou tiveram algum tipo de instrução sobre o assunto, 92% responderam que o reimplante dental é o melhor procedimento em caso de avulsão. No entanto, apenas 31% sabem como proceder e o correto cuidado com o dente avulsionado (41%). Em relação ao armazenamento do dente, 61% armazenariam em frasco com leite fresco. 81% dos participantes acreditam que o dente avulsionado, após reimplantado, deve ser imobilizado. Conclusão: os alunos de graduação em Odontologia da Universidade Veiga de Almeida apresentam conhecimento sobre a definição de avulsão dentária e que o reimplante é a melhor opção para o tratamento. Porém observa-se que diante dos cuidados com o dente avulsionado e o protocolo de atendimento, o conhecimento dos alunos é escasso

Behavior of parents and educators following traumatic injury to young permanent teeth of children in Joinville, Santa Catarina

Traumatic dental injuries are a major public health problem, especially in the age range of 7 to 15 years, when young permanent teeth are established. Objective: To evaluate the behavior of parents of children who attend public or private school and their educators, in cases of traumatic injury to young permanent teeth and to evaluate whether they sought emergency guidance, in the city of Joinville, Santa Catarina, Brazil. Evaluation was carried out via a questionnaire for asking the parents and teachers about their knowledge of dental trauma. Material and methods: A total of 248 parents and 22 teachers participated in the study. Out of all the participants that completed the questionnaire with questions on previous trauma experience, avulsion behavior, avulsed tooth storage medium, and time elapsed from dental trauma until care, 49.6% of had higher education. The data were tabulated on a Microsoft Office Excel 365 worksheet, and the chi-square statistical test was applied. Results: The research showed that 91.8% of parents and 8.2% of educators from both public and private schools had minimal knowledge regarding dental trauma. Many of the participants (73.2%) were unaware of what dental reimplantation was and lacked knowledge regarding storage choices for a dental element. Instead, 68% preferred to take the child to a dental surgeon to receive emergency care. Conclusion: The knowledge parents and educators of public and private schools have about dental trauma is limited. Education on this subject needs to be promoted for enabling parents and educators to make informed decisions to ensure the best prognosis after traumatic dental injury.

Behavior of parents and educators following traumatic injury to young permanent teeth of children in Joinville, Santa Catarina

Introduction: Traumatic dental injuries are a major public health problem, especially in the age range of 7 to 15 years, when young permanent teeth are established. Objective: To evaluate the behavior of parents of children who attend public or private school and their educators, in cases of traumatic injury to young permanent teeth and to evaluate whether they sought emergency guidance, in the city of Joinville, Santa Catarina, Brazil. Evaluation was carriedout via a questionnaire for asking the parents and teachers about their knowledge of dental trauma. Material and methods: A total of 248 parents and 22 teachers participated in the study. Out of all the participants that completed the questionnaire with questions on previous trauma experience, avulsion behavior, avulsed tooth storage medium, and time elapsed from dental trauma until care, 49.6% of had higher education. The data were tabulated on a Microsoft Office Excel 365 worksheet, and the chi-square statistical test wasapplied. Results: The research showed that 91.8% of parents and8.2% of educators from both public and private schools had minimalknowledge regarding dental trauma. Many of the participants (73.2%) were unaware of what dental reimplantation was and lacked knowledge regarding storage choices for a dental element. Instead, 68% preferred to take the child to a dental surgeon to receive emergency care. Conclusion: The knowledge parents and educators of public and private schools have about dental trauma is limited. Education on this subject needs to be promoted for enabling parents andeducators to make informed decisions to ensure the best prognosis after traumatic dental injury.

In vitro evaluation of plants as storage media for avulsed teeth: A systematic review.

Dental avulsion is defined as the complete displacement of a tooth from its socket owing to trauma. The treatment outcome depends on storage of the avulsed teeth in media capable of maintaining the viability of periodontal ligament cells, when immediate replantation is not possible. To maintain the viability of periodontal ligament cells, plants can be used as a storage medium because of their pharmacological and phytotherapic properties. The aim of this study was to evaluate the effect of plants on the tissue repair following tooth replantation. This systematic review was conducted according to the PRISMA guidelines and included articles collected in the Cochrane, LILACS, PubMed, Science Direct, Scopus and Web of Science databases, plus articles found in the grey literature. The articles were screened for partial reading using the Endnote and Rayyan platform. The methodology of studies was evaluated by using the OHAT and GRADE. In the initial search, 2361 articles were obtained, only 51 articles were submitted to complete reading, and 35 articles were selected for the qualitative analysis. The evaluated plants had a potential effect on cell viability and proliferation. The articles evaluated mainly the action of plants on cells of the periodontal ligament. Propolis, coconut water and Aloe vera were the most common storage medium. The methodological limitations persist, and the evaluation of the pharmacological potential of plants on dental tissues still requires more research.