Effect of low-level laser therapy on the healing process after tooth replantation: a histomorphometrical and immunohistochemical analysis

Abstract

Success of tooth replantation is limited because part of the replanted tooth is lost because of progressive root resorption. This study used histomorphometry and immunohistochemistry to evaluate the effect of low-level laser therapy (LLLT) on the healing process of rat teeth replanted after different extra-oral periods, simulating immediate and delayed replantation. Sixty Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and randomly assigned to six groups (n = 10): C4, C30 and C45, in which the teeth were replanted 4 min (immediate), 30 min (delayed) and 45 min (delayed) after extraction, respectively, and L4, L30 and L45, in which the teeth were replanted after the same extra-alveolar times, but the root surfaces and the alveolar wounds were irradiated with a gallium-aluminum-arsenate (GaAlAs) diode laser before replantation. The animals were sacrificed after 60 days. The anatomic pieces containing the replanted teeth were obtained and processed for either histomorphometrical analysis under optical microscopy or immunohistochemical expression of receptor activator of nuclear factor Kappa-B (RANK), and its ligand (RANKL), osteoprotegerin (OPG) and tartrate-resistant acid phosphatase (TRAP) proteins. Areas of external replacement and inflammatory root resorption were observed in all groups, without statistically significant differences (P > 0.05). Ankylosis was more frequent in L30 than in C30 (P < 0.05). RANKL immunostaining predominated over RANK and OPG immunostaining in both groups with immediate tooth replantation (P < 0.05). For the 45-min extra-alveolar time, however, there was greater evidence of RANK immunostaining compared to RANKL for both control and laser-treated groups (P < 0.05). Positive TRAP immunostaining predominated in L4 and L30 (P < 0.05). In conclusion, under the tested conditions, the treatment of the root surface and the alveolar wound with LLLT did not improve the healing process after immediate and delayed tooth replantation in rats.

Replantation of Immature Avulsed Teeth with Prolonged Extraoral Dry Storage: A Case Report

“…zoledronate, etidronate, alendronate), 13 dexamethasone, 14 topical application of propolis 15 may decrease or prevent inflammatory root resorption and replacement root resorption and facilitates the regeneration of periodontal tissues after replantation. Recently a low-level laser therapy 16 is also advocated to promote favorable healing in cases of delayed replantation. However, the use of these agents in replantation is still experimental and more data to support clinical effectiveness are required.…”

Evaluation of two formulations containing mineral trioxide aggregate on delayed tooth replantation: relevance of RANKL/RANK/OPG system

“…This could explain data obtained in our study, showing that MTA Fillapex and WMTA groups displayed more ankylosis areas than other groups. Of note, OPG staining was found increased in WMTA and calcium hydroxide groups, what might well be associated with a better outcome concerning the healing process and mineralization status [43]. Alternatively, a marked immunopositivity for RANKL was observed for the MTA Fillapex group, when compared to calcium hydroxide or WMTA groups at 60 days.…”

Tooth replantation with adipose tissue stem cells and fibrin sealant: microscopic analysis of rat’s teeth

“…Choosing a rodent model (Lustosa-Pereira et al 2006; dos Santos et al 2009; Poi et al 2007) over a dog, sheep or pig model to test our hypothesis was because of availability and budgetary reasons. To ensure maximum recapitulation of clinical cases, we removed the apical papilla of the teeth which is responsible for continuous growth of incisors teeth in rats as previously described in a number of studies (Saito et al 2011; Sottovia et al 2006; Lustosa-Pereira et al 2006). After treatment, we selected to examine the middle root in all samples considering cervical and apical thirds might be affected during the surgical and endodontic procedures.…”

“…The use of substances such as enamel matrix derivative (Emdogain) and Vitamin C for root surface treatment applied before replantation reduced the root resorption not ensuring PDL regeneration (Barrett et al 2005; Panzarini et al 2008). Emdogain and low level laser therapies were found to be insufficient to secure an improved PDL regeneration after replantation of tooth (Barrett et al 2005; Saito et al 2011). Therefore, there is a need of new therapeutic strategies to enhance PDL regeneration in avulsion cases.…”