Evaluation of the periodontal and pulpal healing of replanted rat molars with doxycycline root conditioning

Abstract

Purpose This study aimed to evaluate periodontal and pulpal healing in replanted rat teeth, preserved under different storage conditions, with or without root conditioning using doxycycline. Methods A total of 40 maxillary first molars extracted from 20 Sprague-Dawley rats were stored for different durations under different conditions (5 minutes in dry storage and 60 minutes in Hank's balanced salt solution [HBSS]) and subsequently replanted. The rats were divided into 2 groups based on the use of root surface treatment: the doxycycline group (root surface treated with doxycycline) and the control group (no doxycycline treatment). Eight weeks after replantation, the animals were sacrificed, and the teeth were evaluated using micro-computed tomography (micro-CT) and histomorphometric analysis. Results In the micro-CT analysis, the doxycycline group showed the same rate of occurrence of periapical radiolucency as was observed in the control group, but a lower degree of root resorption in teeth replanted after 60 minutes of storage in HBSS ( P <0.05). In the histomorphometric analysis, the doxycycline group exhibited no improvement in either pulpal or periodontal healing of the replanted tooth after 5 minutes of dry storage, but showed a lower grade of surface root resorption (1.37±0.77) and inflammatory resorption in the teeth stored for 60 minutes in HBSS (1.33±0.71). Conclusions In conclusion, doxycycline improved the periodontal healing of replanted teeth stored for 60 minutes in HBSS, whereas doxycycline did not improve periodontal healing of replanted tooth after 5 minutes of dry storage. Within the limits of this study, doxycycline showed more favorable periodontal healing despite delayed replantation.

Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies

“…All articles that met our inclusion criteria were animal studies. There were ten studies evaluating the effect of topical application of tetracyclines on pulp and periodontal healing [ 21 , 24 , 27 – 29 , 34 – 36 , 50 , 51 ]. Five studies focused on the influence of systemic tetracyclines after tooth replantation [ 23 , 25 , 26 , 32 , 33 ].…”

“…Five articles received a moderate risk of bias [ 21 , 23 , 28 , 29 , 34 ]. Ten articles showed a high risk of bias [ 24 – 27 , 32 , 33 , 35 , 36 , 50 , 51 ]. Risk of bias assessment according to the Cochrane Handbook for Systematic Reviews of Interventions for each study is presented in Table 2 .…”

“… + _ + + + Selvig et al [ 35 ] _ ? + _ + + + Liu et al [ 50 ] _ _ _ _ + + + Nam et al [ 51 ] _ ? + _ + + + + , low risk of bias; _, high risk of bias; ?, unclear risk of bias …”

Pulp healing in immature replanted permanent teeth: A competing risk analysis

“…The healing process starts immediately after replantation and aims to establish end‐to‐end anastomosis in the pulp‐periodontium interface to guarantee blood flow to the ischemic pulp tissue 4 . However, such anastomosis can only take place if replantation is accomplished soon after avulsion, before the pulp becomes infected during this ischemic state as the presence of bacteria would definitely arrest pulp revascularization and lead to pulp necrosis 5–8 . Once the initial anastomosis occurs, immune‐inflammatory and stem cells, together with newly formed blood vessels and nerves, may gradually replace the affected pulp tissue 3,9–13 .…”

“…4 However, such anastomosis can only take place if replantation is accomplished soon after avulsion, before the pulp becomes infected during this ischemic state as the presence of bacteria would definitely arrest pulp revascularization and lead to pulp necrosis. [5][6][7][8] Once the initial anastomosis occurs, immune-inflammatory and stem cells, together with newly formed blood vessels and nerves, may gradually replace the affected pulp tissue. 3,[9][10][11][12][13] Experimental studies using animal models have reported two types of repaired pulp tissue: reparative dentin and bone-like tissue, which have been described in isolation, or a mixture of both tissues.…”