In vitroevaluation of plants as storage media for avulsed teeth: A systematic review

Abstract

Background/AimsDental 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.MethodsThis 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.ResultsIn 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.ConclusionThe methodological limitations persist, and the evaluation of the pharmacological potential of plants on dental tissues still requires more research.

Evidence mapping and quality assessment of systematic reviews in dental traumatology

“…Forty‐four SRs had been published in last six years (2015‐2020) 18‐78 . Twenty‐eight of the SRs had been published in Dental Traumatology, 16,17,20‐27,29,30,36,39‐41,44,45,59,60,67,69,71,74,75,77,78 and five were from the Cochrane database 38,46,50,53,70 . The remaining SRs were spread across journals in general dentistry, sports medicine, orthodontics, special care dentistry, endodontics, maxillofacial radiology, oral and maxillofacial surgery, pediatric dentistry, oral sciences, periodontology, community dentistry, epidemiology, dental hygiene, education sciences, and restorative dentistry (Table 3).…”

Storage of an avulsed tooth prior to replantation: A systematic review and meta‐analysis

“…The use of a suitable temporary storage solution or technique for an avulsed tooth should not delay efforts at replantation, but it may aid in the survival of the tooth before receiving professional help. While recent systematic reviews attempted to identify the most recommended media for storing an avulsed tooth based on descriptive analysis of (cultured) PDL cell viability, 10,21,22 this systematic review is the first to quantitatively report on the comparisons between various storage media and techniques available to laypeople and the currently recommended transport solutions: milk and saliva.…”

“…Recent systematic reviews have focused mainly on the viability of cultured PDL cells and found that of the media which are available to laypeople, HBSS, 21–23 milk, 21,22 propolis, 10,21,22 coconut water, 10,21,22 and aloe vera gel, 10,21 were most effective in preserving the cell viability. In this systematic review, the limited evidence available favors storing an avulsed tooth in HBSS or propolis compared with milk prior to replantation but there was conflicting evidence regarding the potential of coconut water and aloe vera gel.…”

“…Treating trauma to permanent teeth is costly, 6 and missing an anterior tooth may lead to functional, psychological, and esthetic problems 7,8 . Tooth avulsion is defined as the complete displacement of a tooth from the alveolar socket as a result of trauma, 9 and it is characterized by compromised neurovascular supply, pulp necrosis, and loss of periodontal ligament (PDL) cells 10–13 . The PDL is a layer of dense fibrous connective tissue which surrounds the root and attaches the tooth to its alveolar socket 14 .…”

“…However, the evidence provided by the use of cultured cell lines is too indirect to guide first aid care. Other systematic reviews were limited to the use of storage media derived from plant material or HBSS solely as potential interventions 10,23 . Furthermore, past systematic reviews solely focused on the effectiveness of different solutions for storing an avulsed tooth but alternative storage techniques such as plastic bags, cling film, wraps, and containers have thus far not been described in treatment guidelines for avulsed teeth.…”