Viability Of Periodontal Ligament Cells Research Articles

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.

Recombinant human dentin matrix protein 1 (DMP1) induces the osteogenic differentiation of human periodontal ligament cells

The study aimed to produce recombinant human dentin matrix protein 1 (DMP1) and to test, whether the recombinant DMP1 produced in Escherichia coli possesses functional activity. A gene construction comprising a gene encoding for DMP1 protein with polyhistidine sequence at its C-terminus was created using the pET22b plasmid and expressed in E. coli. The optimization of cultivation conditions has enabled the induction of the gene expression with 0.5 mM isopropyl β-D-1-thiogalactopyranoside (IPTG) and DMP1 recombinant protein production at 37 °C for 6 h. The recombinant protein was purified using Ni affinity chromatography. DMP1 influence on the viability, osteogenic differentiation and calcification of human periodontal ligament (PDL) cells was examined. The purified DMP1 could induce the expression of osteogenesis related genes and calcium deposition in PDL cells. These findings indicate that DMP1 produced in E. coli can induce the osteogenic differentiation of human PDL cells, leading to improved tooth repair and regeneration.

Effects of several storage media on viability and proliferation capacity of periodontal ligament cells.

The purpose of this study was to investigate the effect of different storage media on viability and proliferation capacity of periodontal ligament cells. Plates with periodontal ligament fibroblasts (PDLF) cells were incubated in skimmed and whole milk, recently prepared Hank's balanced salt solution (HBSS), Save-A-Tooth system's, coconut water, propylene glycol with 20% propolis, egg white, tap water (negative control) at 5°C and 20°C, for 24h. In one of the plates of each temperature, cell viability was determined by MTT assay. In the remaining plates, the wells were filled and incubated with Minimum Essential Medium (MEM) at 37°C for 24, 48, 72, 96, and 120h. The proliferation capacity of PDFL cells was also evaluated by MTT assay. Data were statistically analyzed by Kruskal-Wallis, Scheffé and Mann-Whitney tests (α = 5%). At 5°C, milk maintained more viable cells than other storage media immediately after exposure (0h) and allowed greater proliferation capacity. At 20°C, milk and HBSS had similar and allowed similar proliferation ability at 24 and 48h. From 72h onwards, capacity to maintain cell viability the proliferation rate of cells incubated in HBSS was superior than milk. At both temperature and experiments, Save-A-Tooth system was similar to tap water. Milk and HBSS were more effective in maintaining cellular viability and proliferation capacity than any other storage media. At 5°C, the most viable alternative was milk. At 20°C, HBSS had better results.

Evaluation of preserving the viability of sheep's teeth PDL cells according to the different times and storage medias

Introdution: Vitality of periodontal ligament (PDL) cells is very critical for replantation of complete avulsion teeth due to traumatic injuries. This is important for transferring an avulsed tooth to clinic for replantation that which Medias used for storage.This study aimed to compare the vitality of PDL cells of sheep teeth cultured in different storage medias including α-Minimum Essential Medium (αMEM), Dulbecco’s Modified Eagle’s Medium (DMEM), Hank’s Balanced Salt Solution (HBSS), and mint extract
 Methods: In this lab trial study, PDL cells were obtained from 124 healthy anterior and posterior sheep teeth and cultured in αMEM, DMEM, HBSS, and mint extract for periods of 2, 6, 24, 48, 72, or 96 hours (24 groups). For each solution, positive control group were PDL cells without incubation in any storage media. For each group, there was a negative control considered cells growing in dry plate with no medium. After exposure of PDL cells to scheduled solution for scheduled incubation time, centrifuge was performed for 10 minutes at rate of 2000G. Then cell percipitates were added into the solution of collagenase (3mgr/ml) and Dispase (4mgr/ml to cell precipitates, which were incubated at 37° C for 60 minutes. After washing cellular suspension in PBS, vitality of the cells was assessed by Trypan blue exclusion, on a neobar slide by magnification of 200X. The data were analyzed statistically using 2-way ANOVA test by SPSS version 15.
 Results: Statistically significant differences in efficacy of different medias were obtained at least between two media (P=0.0001). PDL cells cultured in αMEM and mint extract showed 90% and 52.22% vitality representing, respectively, the best and the weakest storage media.
 Conclusion: αMEM can be a suitable transport medium up to 96 hours to preserve the vitality of the PDL cells of avulsed teeth. There is a reverse correlation between the viability of PDL cells and incubation time, increasing the time decreases the viability.

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.

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.

Evaluation of the efficacy of neem (Azadirachta indica) and turmeric (Curcuma longa) as storage media in maintaining periodontal ligament cell viability: An in vitro study.

The aim of the study is to evaluate the efficacy of neem and turmeric as storage media in maintaining periodontal ligament (PDL) cell viability. Ninety premolar extracted teeth were randomly selected and divided into three groups, namely milk as a control group and neem and turmeric as experimental groups. The teeth were placed in one of the three storage media for 30 min. Scrapped PDL fibers were collected in Falcon tubes, incubated, and centrifuged for 5 min at 800 rpm. Obtained PDL cells were stained with trypan blue, observed, and counted in a hemocytometer under microscope, which was followed by the calculation of percentages of viable cells. One-way ANOVA was applied for comparison between different groups, and Tukey's test was applied for pair-wise comparison. Mean percentage of viable cells in milk was 89.98 ± 4.11%, whereas in neem and turmeric extracts, it was 88.00 ± 5.85% and 81.63 ± 7.12%, respectively. There was a significant difference between all the three storage media for the viable PDL cells (P = 0.001). Intergroup comparison of the different storage media showed that there was a statistically highly significant difference between milk and turmeric (P ≤ 0.001). There was a statistically significant difference in between turmeric and neem (P ≤ 0.531) for the viable cell percentage, with neem being better storage medium than the turmeric. Within the limitations of the current study, it can be concluded that neem is as efficient as milk in maintaining the PDL cell viability. Turmeric, though is an efficient storage medium, was not as efficient as milk and neem.

Evaluation of the efficacy of neem (Azadirachta indica) and turmeric (Curcuma longa) as storage media in maintaining periodontal ligament cell viability: An in vitro study

Evaluation of the efficacy of neem (Azadirachta indica) and turmeric (Curcuma longa) as storage media in maintaining periodontal ligament cell viability: An in vitro study

Correction: Efficacy of Hank's balanced salt solution compared to other solutions in the preservation of the periodontal ligament. A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.0200467.].

Evaluation of periodontal ligament cell viability in different storage media based on human PDL cell culture experiments-A systematic review.

The best treatment for an avulsed tooth is immediate replantation. If this is not possible, a proper transport medium is required for the maintenance of viability of the periodontal ligament cells (PDL). The aim was to systematically review the efficacy of different storage media used for the survival of PDL cells of avulsed teeth in the in vitro setting. The search strategy was based on the MeSH keywords in PubMed/MEDLINE: "Transport media for avulsed teeth," "Storage media for avulsed teeth," "Knocked out teeth," "Tooth avulsion," "Biological transport of avulsed tooth," "Cell survival of avulsed tooth," "Cell viability of avulsed tooth," "Tooth replantation," and "Periodontal ligament in avulsed teeth." The "AND" and "OR" Boolean operators were applied to combine keywords. Each study was evaluated for eight criteria, including use of human PDL, in vitro cell culture models, the number of passages, types of storage media, percentages of surviving PDL cells, pH and osmolality of storage media, and the type of test used to asses PDL viability. In 15 selected studies, nine storage media (HBSS, tap water, DMEM, milk, saliva, 10% and 20% propolis, Gatorade, and Viaspan) were analyzed at six time points. For storage up to 2hours, HBSS, DMEM, milk, 10% propolis, 20% propolis, and Viaspan conserved more than 80% of PDL viability. For storage at 24hours, Viaspan showed best cell survival at 88.4%, followed by DMEM (70.9%) and 10% propolis (68.3%). Milk and HBSS showed similar PDL survival at 24hours (57.2% and 57.3%, respectively). Milk remains the most convenient, cheapest, and readily available solution in most situations while also being capable of keeping PDL cells alive. Further studies are required to evaluate the efficacy of more commonly found storage media besides milk.

Effect of propolis on preserving human periodontal ligament cells and regulating pro-inflammatory cytokines.

Propolis has been suggested as a storage medium for avulsed teeth. The aim of this study was to compare the effectiveness of Brazilian propolis with Hank's balanced salt solution and milk in maintaining the viability of human periodontal ligament cells, their osteogenic differentiation potential, and pro-inflammatory cytokine expression. Cell Counting Kit 8 assays were performed to test human periodontal ligament cell viability in different storage media. The preservative effect on osteogenic differentiation was evaluated using alkaline phosphatase staining and activity assays, Alizarin Red S staining, and western blotting. Quantification of pro-inflammatory cytokines was performed using real-time PCR and enzyme-linked immunosorbent assays. Brazilian propolis at 10 μg/ml was not cytotoxic toward human periodontal ligament cells. The milk group showed the highest cell viability. Brazilian propolis and Hank's balanced salt solution groups showed similar cell viabilities. Alkaline phosphatase staining and activity were similar in all groups. Calcium deposition and mineralization nodule formation were similar in the Brazilian propolis and Hank's balanced salt solution groups, but were higher in the milk group. Osteogenic marker gene and protein levels were similar in all groups. The genes and protein expression levels of IL1β, IL6, and IL8 decreased significantly after treatment with Brazilian propolis. TNFα mRNA expression showed no significant difference among the experimental groups. Pro-inflammatory cytokine levels in the milk group were higher than in the Brazilian propolis and Hank's balanced salt solution groups. Brazilian propolis, Hank's balanced salt solution, and milk maintained the viability of human periodontal ligament cells and preserved their osteogenic differentiation ability similarly. However, Brazilian propolis showed a better anti-inflammatory effect. This article is protected by copyright. All rights reserved.

New Application of Psoralen and Angelicin on Periodontitis With Anti-bacterial, Anti-inflammatory, and Osteogenesis Effects

Psoralen and angelicin are two effective compounds isolated from psoraleae, a traditional Chinese medicine. They have a wide range of applications for bone disease treatment and immune modulation. In this study, we explored their new applications for the treatment of periodontal diseases. This study aimed to investigate the effects of psoralen and angelicin on Porphyromonas gingivalis growth and P. gingivalis-derived lipopolysaccharide (Pg-LPS)-induced inflammation, and further to evaluate their effects on osteogenesis. Finally, the effects of angelicin on a mouse model of periodontitis were also investigated. The results showed that psoralen and angelicin had beneficial dose-dependent effects regarding the inhibition of planktonic P. gingivalis and biofilms of P. gingivalis. There were no significant differences in the viability of monocyte-like THP-1 cells and human periodontal ligament cells (hPDLCs) treated with either psoralen or angelicin compared to the untreated control cells. Psoralen and angelicin also markedly decreased the mRNA expression and release of inflammatory cytokines (interleukin [IL]-1β and IL-8) by THP-1 cells in a dose-dependent manner. They significantly enhanced the alkaline phosphatase (ALP) activity of hPDLCs and up-regulated the expression of osteogenic proteins (runt-related transcription factor 2 [RUNX2], distal-less homeobox 5 [DLX5], and osteopontin [OPN]). Angelicin significantly attenuated alveolar bone loss and inflammation response in the mice with periodontitis. In conclusion, our data demonstrated that psoralen and angelicin could inhibit the growth of planktonic P. gingivalis and P. gingivalis biofilm. It is also the first report on the anti-inflammatory effect of psoralen and angelicin against Pg-LPS. They also had an osteogenesis-potentiating effect on hPDLCs. The in vivo study also indicated the effect of angelicin regarding protection against periodontitis. Our study highlighted the potential ability of psoralen and angelicin to act as novel natural agents to prevent and treat periodontitis.

Inhibitory effect of Thai propolis on human osteoclastogenesis.

Avulsed teeth should be immediately replanted into the socket or otherwise kept in a physiologic storage medium to maintain periodontal ligament cell viability. A previous study has demonstrated that Thai propolis extract can maintain viability of human periodontal ligament cells. However, root resorption by osteoclasts often occurs when the avulsed teeth are replanted. The aim of this study was to determine the inhibitory effect of Thai propolis extract on human osteoclastogenesis in vitro. Human peripheral blood mononuclear cells were isolated for osteoclast precursors and cultured in the presence or absence of various non-toxic concentrations of propolis extract, as determined by the alamarBlue® assay, during in vitro induction of osteoclastogenesis. Osteoclast formation was examined by tartrate-resistant acid phosphatase staining, actin ring formation, and real-time polymerase chain reaction. The resorption pit assay was performed to determine osteoclast function. Non-toxic concentrations of propolis extract suppressed osteoclast formation by significantly decreasing the percentages of tartrate-resistant acid phosphatase-positive multinuclear cells and the ratios of cells with F-actin ring formation (P<.01) in a dose-dependent fashion. Expression of several osteoclast-specific genes was significantly downregulated by propolis in a dose-dependent manner (P<.05). The percentages of resorption areas on dentin slices were significantly decreased by propolis (P<.05). Thai propolis can inhibit human osteoclast formation and function, which may be beneficial for prevention of root resorption following replantation of avulsed teeth.

Human periodontal fibroblasts viability stored in Custodiol® , coconut water, and propolis. An ex vivo study.

Successful replantation of an avulsed tooth depends on the regeneration of periodontal ligament (PDL) attachment which is affected by the transport medium, dry time, and storage time. Various storage media have been studied but the search for the optimum storage medium is still needed to determine the ideal material and storage time to maintain PDL cells. The aim of this study was to determine the ability of Custodiol® , coconut water (CW) from different stages of maturity, and propolis as storage media for avulsed teeth by evaluating the viability of PDL cells for different time intervals. PDL cultures were subjected to Cutodiol® , immature, half mature, and mature coconut water, and different concentrations of propolis in Dulbecco's Modified Eagles Medium (DMEM). Culture plates with the tested media were incubated for 1, 2, 6, 24, 48, 72, and 168hour. PDL fibroblast cell viability was assessed by MTT assay. CW showed significantly higher viability of cells than other groups at 6hour with half mature CW being superior. Propolis at 6.25mg/mL in DMEM resulted in 138% viable PDL and it was able to preserve PDL cells for up to 168hour. Half mature and mature CW are superior storage media if replantation of avulsed teeth is within 6hour. Propolis in DMEM could be a potential storage media for prolonged storage intervals up to 48hour.

Assessment of cell viability in four novel endodontic sealers.

Objective:The aim of this study was to evaluate the viability of human periodontal ligament (PDL) cells on MTA-Fillapex, GuttaFlow 2, TotalFill Sealer, and BioRoot™ RCS in comparison to conventional epoxy resin-based (AH Plus) and zinc oxide-eugenol-based (Roth's 801) sealers.Materials and Methods:Sealers were divided into two groups, and five coverslips for each material per group were prepared. In the first group, PDLs were added immediately after the preparation of sealers (Fresh Group), and in the second, PDLs were added after 24 h. PDLs were cultured for 72 h and afterward, counted using standard hematocytometry. A Mann–Whitney U-test and Kruskal–Wallis test were used for the statistical analysis. The level of significance was set at 5%. Furthermore, cell morphology was assessed by confocal microscopy.Results:The number of viable cells for the 24 h-set groups was higher than the freshly mixed in all sealers except Roth's 801. In both groups, GuttaFlow 2 presented the highest number of viable cells. In a descending order of cells' survival, TotalFill, BioRoot, and MTA-Fillapex are following and the conventional sealers, AH Plus and Roth's 801, seem not to exhibit the biological properties of the others. Cells grown on GuttaFlow 2, TotalFill, and BioRoot were observed to be well-formed. In contrast, MTA-Fillapex exhibited untypical morphology. No cells were detected on the surfaces of AH Plus, as well as Roth's 801.Conclusions:All novel sealers presented increased cell viability in comparison to conventional sealers. GuttaFlow 2 exhibited the highest cell viability.

Replanted teeth stored in a newly developed powdered coconut water formula

A newly developed powdered coconut water formulae (ACP-404) has been proposed to preserve periodontal ligament cell viability. The aim of this study was to investigate the periodontal healing of dog teeth replanted after storage in ACP-404 with 2 different osmolalities. Sixty teeth of 10 adult beagle dogs were extracted and randomly subjected to the following protocols: immediate replantation after extraction (positive control); dry conditions (negative control); and storage in ACP-404 I (G1), ACP-404 II (G2), in coconut water long shelf life (G3) or in pH-neutralized coconut water long shelf life (G4) for 50minutes before replantation. The animals were euthanized 28days post-operatively and processed for histomorphometric analysis using an optical microscope. The groups were subjected to histomorphometric analysis compared with immediate replantation and dry conditions. The data were statistically analysed using the Kruskal-Wallis test with post-analysis using Dunnett's test. The normal periodontal area was significantly higher for the G1 than for the G2 and G3 groups (P<.001). The positive control group presented similar normal periodontal areas compared to the experimental groups, except for the G3 and negative control groups (P<.001). G1 presented the lowest level of external root replacement resorption compared to the other groups (P<.05). All storage solutions had similar periodontal conditions for repaired resorption areas, inflammatory root resorption, ankylosis and replacement resorption (P>.05). ACP-404 I (G1) was better overall and was able to preserve the normal periodontium and had less external root replacement resorption.

Which is the most recommended medium for the storage and transport of avulsed teeth? A systematic review.

A wide variety of materials has been researched for their use as potential storage media for avulsed teeth, but it is essential to recognize the medium most recommended for improvement of the prognosis of avulsed teeth. The aim of this systematic review was to identify the most recommended medium to store and transport avulsed teeth based on the survival of periodontal ligament (PDL) cells as determined by in vitro studies. Only laboratory-based experimental studies on PDL cells found on adult permanent teeth were included. Data were collected using PubMed, CINAHL plus (EBSCO host), and the Cochrane Library, along with Google Scholar and a hand search. The key terms employed were permutations of [avulsed permanent teeth* OR dental avulsion* OR knocked out teeth*] AND [storage media* OR transport media* OR biological transport* OR PDL cell viability* OR PDL cell survival*]. A customized data extraction pro forma was used to extract the data and to evaluate the quality and risk of bias. The initial search yielded 978 articles, but only 67 were selected. Milk was the most recommended individual medium followed by Hank's balanced salt solution. Among natural products other than milk, propolis and coconut water were most frequently recommended. Recommendations were based on maintenance of PDL cell viability followed by ease of availability, low cost, and long shelf life. Natural products are more effective in maintaining the PDL cell viability compared to synthetic products. Some storage media recommendations were also based upon practical aspects. Although natural products other than milk have more recommendations as a group, milk is the most recommended storage medium individually, based not only on PDL cell viability, but also practical considerations.

Viability and Reproducibility of Periodontal Ligament Cells on Avulsed Teeth Stored in Ham's F-10 Solution.

The purpose of the present study was to evaluate the efficacy of Ham's F-10 in maintaining the viability and reproducibility of PDL cells on avulsed teeth. Sixty mature, healthy extracted premolars were used. The experimental media used were Ham's F-10, Hank's balanced salt solution (HBSS), skim milk, and tap water (n = 15 specimens each). Cell viability was tested after 1, 3, 6, and 24 h storage in medium. Cell reproducibility was assessed by methyl-thiazol-tetrazolium (MTT) assay after1, 3, and 6 h storage in Ham's F-10, HBSS, and tap water. The viability of PDL cells stored in Ham's F-10 and HBSS was significantly greater than that of samples stored in milk and tap water at all-time points (P<0.001). A significant difference in cell viability between samples stored in Ham's F-10 and HBSS (favoring the former) was observed only at 6h (P=0.04). MTT assay results were significantly better for samples stored in Ham's F-10 and HBSS than for those stored in tap water (P<0.001), with a significant difference between Ham's F-10 and HBSS observed only at 3h (P<0.001). Ham's F-10 is capable of preserving PDL cells viable and reproducible better than milk and tap water and similar to HBSS.

Evaluating the effectiveness of rehydrating solutions in preserving periodontal ligament cells vitality: An in vitro study

Background and Purpose of the Study: Two of the most critical factors affecting the prognosis of an avulsed tooth after replantation are extraoral dry time and the storage medium in which the tooth was placed before treatment could be rendered. The ability of a storage medium to support cell viability of the periodontal ligament (PDL) can be an important factor in the prognosis, and thus, the aim of this study was to evaluate the efficacy of commonly available storage media. Materials and Methods: Cultured PDL cells of sixty freshly extracted human teeth were randomly divided into four groups of 15 each, Group I: Electral solution, Group II: Ringer's lactate, Group III: Oral rehydration salt liquid (ORS-L), and Group IV: Coconut water. Samples in each group were further divided into three subgroups depending on the time duration they were placed in the storage medium, i.e., 1, 4, and 8 h. Further these samples were subjected to Collagenase assay, the cells were stained with trypan blue and viable PDL cells were counted under light microscope. Results: Statistical analysis showed that Group II demonstrated significantly (P Conclusion: Ringer's lactate maintained highest PDL cell viability followed by coconut water, electoral solution, and ORS-L at various time intervals. More studies with large samples are required to prove the efficacy of Ringer's lactate as viable storage media.

Efficiency of different storage media for avulsed teeth in animal models: a systematic review.

Tooth avulsion consists of the complete displacement of a tooth from the alveolar socket. When immediate replantation is not possible, the avulsed tooth should be kept in a storage medium capable of maintaining the viability of periodontal ligament (PDL) cells on the root surface. However, there is no consensus on the best storage medium able to prevent sequels such as ankylosis and tooth resorption. The aim of this study was to perform a systematic review to evaluate the in vivo effectiveness of different storage media for avulsed teeth. Two reviewers performed a database search for studies published between January 1950 and December 2015 which were indexed in the PubMed, Scopus, Web of Science, and Bireme databases. An additional manual search was performed. Studies with animal models that evaluated tooth avulsion, storage media, and replantation were included. After full-text analysis of the potentially relevant studies, the selected studies were included in the systematic review. The database search found 157 distinct studies evaluating avulsed teeth storage media. However, only six studies met the selection criteria and were included in the review. There was a high variability in the study estimates for the parameters analyzed. When assessing the quality and level of evidence of each study, one study was rated as having a very low level of evidence, four studies had low levels of evidence, and one had a moderate level of evidence. As a result of data heterogeneity and limitations of the studies, there was insufficient evidence to determine the most effective storage medium for avulsed teeth.

PLATELET-RICH FIBRIN AS A POSSIBLE AUTOGENOUS TRANSPORT MEDIUM FOR AVULSED TEETH: AN IN VITRO STUDY

Objectives: Replantation of avulsed tooth depends on the viability of periodontal ligament cells. The aim of this study was to evaluate the survival of periodontal ligament cells (PDL) when placed in platelet-rich fibrin (PRF) transport media after an extra-oral dry time of 40 minutes. Method: Forty human mandibular first premolar teeth with healthy periodontium and closed apices, previously planned for orthodontic extraction, were selected. The teeth were randomly divided into study group, PRF and control group, Hank‘s balanced salt solution (HBSS) as a reference medium. In both groups, the teeth were stored dry for 40 minutes, followed by 30 minutes immersion in the study and control media. Results: There is a statistically significant increase in the number of viable PDL cells in PRF group as compared to reference medium group. Conclusion: PRF demonstrated higher number of viable PDL cells and hence could be a suitable transport medium for avulsed teeth.