It is crucial to choose suitable storage conditions before tooth replantation to maintain the viability of periodontal ligament cells before replantation. A systematic review published in Dent Traumatol aims to identify the best available evidence for the effectiveness of any technique available to laypeople with teeth stored in milk or saliva.
Researchers searched the following databases (September 2019). Cochrane Libraries, MEDLINE, and Embase. Two reviewers independently considered trial eligibility, then extracted and analyzed data, and assessed risk of bias. The certainty of the body of evidence was assessed according to the GRADE methodology.
RESULTS, Across 4118 references, 33 studies were included and 23 comparisons were reported, 10 of which were synthesized in a meta-analysis. There was limited evidence that, compared with storage in milk, lost teeth were stored in Hank’s balanced salt solution (pooled SMD 2.47, 95% CI [1.59;3.34], P < .00001), propolis solution (pooled SMD 1.73 , 95% CI [1.12; 2.33], P < .00001), oral rehydration salts (pooled SMD 4.16, 95% CI [2.10; 6.23], P < .0001), rice water, and plastic wrap were better. Teeth stored in saline (pooled SMD -4.35, 95% CI [-7.55; -1.14], P = .008), tap water, buttermilk, castor oil, GC toothpaste, and turmeric extract showed significant cell viability Below the teeth stored in milk. There is insufficient evidence to compare the temporary storage of lost teeth in saliva and other conditions. The certainty of the evidence was considered to be low to very low due to limitations in study design, indirectness of study populations and outcome measures, and imprecision.
Taken together, this result shows that while milk was shown to prolong the survival of periodontal ligament cells before replantation compared to normal saline or tap water, the following medium was also shown to preserve cell survival: Hank’s Balanced Salt Solution, propolis, oral rehydration salts, rice washing water and plastic wrap.
Original source:
Niels De Brier， et al.， Storage of an avulsed tooth prior to replantation： A systematic review and meta-analysis. Dent Traumatol. 2020 Oct;36(5)：453-476. doi： 10.1111/edt.12564.
