Viability of human periodontal ligament fibroblasts in milk, Hank’s balanced salt solution and coconut water as storage media

Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringers Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth

Background and objective

The viability of the periodontal ligament (PDL) cells on the root surface of the avulsed tooth determines the prognosis of the replanted tooth, which in turn is determined by a suitable transport medium in which the tooth was stored. The aim of the present study is to evaluate and compare the effectiveness of Ringer's lactate (RL) as a storage medium for an avulsed tooth in maintaining the PDL cell viability with dextrose normal saline (DNS), oral rehydration salt (ORS), egg white (EW), and infant milk formula (IMF).

Materials and methods

A total of 85 freshly extracted human teeth were divided into five experimental groups and two control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of five experimental media (RL, DNS, ORS, EW, and IMF) for 45 minutes. The teeth were then treated with collagenase type III and trypsin for 10 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed.

Results

Statistical analysis showed that IMF, RL, and EW had no statistically significant differences among them in maintaining the viability of the PDL cells but were significantly better than DNS. No statistically significant difference between RL, EW, and ORS in the number of viable PDL cells.

Conclusion

Infant milk formula (IMF), RL, and EW showed similar results within the parameters of the study; they can be used as alternative storage media for avulsed teeth. DNS showed poor results, and ORS could serve as short-term storage media if the other solutions are not readily available.

Clinical significance

The search for an appropriate storage media with favorable pH and osmolality along with easy availability is the basic thought behind this study.

How to cite this article

Kumar P, Kotumachagi SS, Fabi AJ, et al. Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringer's Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth. Int J Clin Pediatr Dent 2023;16(3):453-458.

An in vitro evaluation of efficacy of ViaSpan, aloe vera, gatorade solution, and propolis storage media for maintaining the periodontal ligament cell viability

Background

Replantation is a commonly performed method for avulsed tooth. A vital periodontal membrane (periodontal ligament [PDL]) is significant for the successful healing of replanted teeth. Hence, various storage media are used to preserve the viability of periodontal cells before replantation.

Objectives

The present study was conducted to evaluate the efficacy of ViaSpan, Aloe vera, Gatorade solution, and propolis storage media for maintaining the PDL cell viability.

Materials and Methods

The present study was conducted on 40 recently extracted teeth which were randomly divided into four study storage groups: Group I: ViaSpan, Group II: Aloe vera, Group III: Gatorade solution, and Group IV: Propolis. Later they were subjected to centrifugation, and the cells from supernatant were colored with 0.4% trypan blue for determination of viability. The obtained data were statistically evaluated with SPSS package (21.0 version, Inc.; Chicago, IL, USA) using analysis of variance, Mann-Whitney test, and Post hoc tests.

Results

The mean viable periodontal cell in Group I was 30.2 cumm, in Group II was 24.6 cumm, Group III was 14.5 cumm, and Group IV in 31.4. The difference was significant (P < 0.01). Post hoc test between different groups revealed a significant difference in mean viable periodontal cells (P < 0.001). Propolis, ViaSpan, and Aloe vera had higher pH and osmolality values.

Conclusion

This study found that propolis had higher periodontal cell viability followed by ViaSpan solution and Aloe vera and least in Gatorade solution. Propolis, ViaSpan, and Aloe vera media can be used as a storage media.

R. R, Purayil TP. Survival of human periodontal ligament fibroblast cells in Cornisol and HBSS for transportation of avulsed teeth: a comparative ex vivo study

OBJECTIVE

Viability of periodontal ligament fibroblast cells (PDFC) is one of the key factors in determining the success of replantation of avulsed teeth. Extra-oral time and transport media are closely related to the same. The present study aims to evaluate and compare the efficiency of Cornisol, Hank's balanced salt solution (HBSS) and normal saline in preserving the viability of PDFC.

MATERIALS AND METHODS

The human PDFC were isolated from primary culture from freshly extracted human premolars. Effect of Cornisol, HBSS and normal saline on viability of isolated PDFC was assessed using standard MTT assay. The cells were exposed to the experimental solutions (Cornisol/HBSS/normal saline) for varying time points (30 min, 1 h, 24 h, 48 h and 96 h) and viability was determined by colorimetric MTT method by quantifying the amount of formazan crystal formed (optical density). Experiment was performed in triplicates and the data were subjected to statistical analysis.

RESULTS

Statistical analysis was performed using the Kruskal-Wallis ANOVA with post hoc Bonferroni's test with a significance level of p value ≤.05. Cornisol ≥ HBSS > saline.

CONCLUSION

Cornisol can be used as a storage media for avulsed teeth and is significantly more effective than HBSS in maintaining the periodontal ligament cell viability at tested time intervals.

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.

Assessment of platelet-rich fibrin in the maintenance and recovery of cell viability of the periodontal ligament

This study analyzed the efficacy of autologous platelet-rich fibrin (PRF) in maintaining and recovering cell viability of the periodontal ligament (PDL). The PDL cells were isolated from 45 extracted teeth randomly distributed among 6 groups: 5 min, 1 h, 2 h, PRF 30 min, PRF 1 h and PRF 2 h. In the groups 5 min, 1 h and 2 h (n = 5), the teeth were kept dry in extra-alveolar times of 5 min, 1 h and 2 h respectively. The teeth of the groups PRF 30 min, PRF 1 h and PRF 2 h (n = 10) were kept dry at extra-alveolar times of 30 min, 1 and 2 h followed by immersion in PRF for 45 min. PDL cells were isolated by enzymatic digestion with type II collagenase and dispase, counted and analyzed for viability with Trypan blue vital dye in Neubauer chamber. The variables total number of cells and cell viability demonstrated that in the 5 min, 1 h and 2 h groups there was a decrease after the extra-alveolar dry times of 1 and 2 h. In comparison with the total number of cells, group 1 h, considered immediate reimplantation, did not present statistical difference when compared to the groups PRF 30 min, PRF 1 h and 2 h, a result that demonstrates that PRF assists in cell maintenance and recovery. PRF provided increased cell viability in relation to the different dry extra-alveolar times analyzed (p < 0.001). Autologous PRF presented effectiveness in maintaining and recovering PDL cells from extracted teeth and kept dry for up to 2 h.

Comparative evaluation of periodontal ligament fibroblasts stored in different types of milk: effects on viability and biosynthesis of collagen

Milk remains one of the most frequently recommended solutions for storage of avulsed teeth because it can maintain cell viability and is easily accessible. However, some negative effects of milk on avulsed teeth have been reported, just as the effects of milk on the long-term functions of cells are not clear. This study aimed to evaluate the effects of different types of milk on the viability, proliferation, and functions of periodontal ligament fibroblasts (PDLF)s in vitro. Human PDLFs were culture-medium depleted for 5 min and stored in Hanks' balanced salt solution (HBSS), whole cow's milk, low-fat cow's milk, or almond milk for 1 h at 25°C. Cell viability and proliferation were assessed using MTT assays. Expression of the genes encoding type I collagen and its modifying enzymes were analyzed using real-time PCR. Collagen matrix production was evaluated using Picrosirius red polarization. Our results showed the overall efficiency of low-fat cow's milk in maintaining the viability and proliferation of PDLFs, and in enhancing the process of collagen production. Almond milk storage resulted in the highest rate of PDLF proliferation, and comparable collagen biosynthesis ability to the control. Therefore, besides low-fat cow's milk, almond milk may potentially be an alternative tooth-storage medium for PDLF preservation and PDL tissue regeneration.

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 systematic review and meta-analysis (MA) aimed to verify the capacity of different storage media to preserve viability of periodontal ligament cells in comparison to Hank’s Balanced Salt Solution. The searches, selection process, data extraction and Risk of Bias control were conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five MA were conducted to compare the cell viability between milk versus Hank's balanced salt solution (HBSS) in a dichotomous (1) or continuous (2) data model; tap water versus HBSS (3); medicinal herbals versus HBSS (4); and saline solution versus HBSS (5). 693 potentially studies were identified, with 18 studies included in the qualitative and 8 studies included in the quantitative analysis. Most of the articles presented a low risk of bias. HBSS medium showed a superior ratio of cell viability compared to tap water (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%) and saline solution (RR 0.76; 95% CI [0.69, 0.84]; p < 0.0001; I2 = 99%). Herbal medicines showed a similar ratio of cell viability when compared to HBSS (RR 0.97; 95% CI [0.94, 1.00]; p = 0.08; I² = 50%). Mixed results were observed between milk and HBSS: a superior ratio of HBSS was observed in an overall evaluation (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I² = 96%), and a similar ratio was achieved when periodontal ligament (PDL) cells were removed prior to immersion in the solution (RR 0.94; 95% CI [0.87, 1.01]; p = 0.10; I2 = 0%) or rinsed in tap water or maintained in open air prior to immersion (RR 0.63; 95% CI [0.35, 1.12]; p = 0.11; I2 = not applicable). This systematic review and MA suggests that milk and herbal medicines could represent an alternative to HBSS. However, more studies are necessary to obtain a reliable conclusion.

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

BACKGROUND/AIMS

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.

MATERIALS AND METHODS

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 168 hour. PDL fibroblast cell viability was assessed by MTT assay.

RESULTS

CW showed significantly higher viability of cells than other groups at 6 hour with half mature CW being superior. Propolis at 6.25 mg/mL in DMEM resulted in 138% viable PDL and it was able to preserve PDL cells for up to 168 hour.

CONCLUSIONS

Half mature and mature CW are superior storage media if replantation of avulsed teeth is within 6 hour. Propolis in DMEM could be a potential storage media for prolonged storage intervals up to 48 hour.

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

BACKGROUND/AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Histomorphometric analysis of the healing process after the replantation of rat teeth maintained in bovine milk whey and whole milk

BACKGROUND/AIM

In cases of tooth avulsion, a minimal extra-alveolar dry storage period or the use of a suitable storage medium is crucial to maintaining the vitality of the periodontal ligament. Whey has similar properties to milk and has therefore been investigated as a storage medium for avulsed teeth. The aim of this study was to evaluate the repair process after replantation of rat teeth kept in whey and whole milk.

MATERIALS AND METHODS

Thirty-six male rats were divided into four groups of nine animals. The upper right incisor was extracted under general anesthesia. In Group I, the teeth were immediately replanted without treatment (positive control). In Group II, the teeth were stored in 50 mL of sweet whey. In Group III, the teeth were kept in 50 mL of long-shelf-life whole milk (UHT, Parmalat^® ). In Group IV, the teeth were kept dry (negative control). After 60 minutes, the teeth in Groups II, III, and IV were replanted into their sockets. The animals were subjected to euthanasia 60 days after replantation. The specimens were stained with hematoxylin and eosin for histomorphometric analysis.

RESULTS

The organization of the periodontal ligament in Group II (whey) was similar to that in Groups I (immediate replantation) and III (whole milk) (P > .05). However, some specimens in this group exhibited periodontal fibers inserted into the bone and cementum throughout the entire length of the periodontal ligament. This occurred in the group submitted to immediate replantation, whereas this histological aspect was not seen in whole milk group. Group IV (late replantation) had a higher rate of root resorption. Regarding the root repair process, it was expected that Group I (immediate) would demonstrate more favorable repair than the other groups. However, Group III (whole milk) had better results when compared to Groups II (whey) and IV (late) (P < .05).

CONCLUSION

Whey and whole milk achieved similar results and were adequate storage media for avulsed teeth.

Effect of Milk Renewal on Cell Viability In Vitro at Different Time Frames

Abstract The purpose of this study was to evaluate if the renewal of milk as a storage medium, every 12, 24 and 48 h, is able to increase its ability to maintain human periodontal ligament fibroblasts (PDLF) viability over time. PDLF were soaked in Minimum Essential Medium at 37 °C (MEM-37) (positive control), tap water (Water) (negative control) and in skimmed milk (44 wells) at 5 °C and 20 °C. The skimmed milk was renewed every 12 h (Milk-12), 24 h (Milk-24) and 48 h (Milk-48) in 11 wells of each plate, and the milk in the remaining 11 wells of each plate was maintained in situ (not renewed milk) (NRM). After 24, 48, 72, 96 and 120 h, cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by Kruskal-Wallis, Scheffé and Mann-Whitney tests (a=5%). At 5 °C, only Milk-48 was significantly better than NRM. At 20 °C, NRM was more effective than Milk-12 and Milk-24 in all time periods. In relation to the temperature (5 °C or 20 °C), renewal of milk at 5 °C was better in maintaining cell viability than the renewal at 20 °C. In conclusion, the renewal of milk was able to increase its ability to maintain cell viability only when performed every 48 h in milk maintained at 5 °C.

Fibroblast Viability after Storage at 20 °C in Milk, Hank's Balanced Salt Solution and Coconut Water

The objective of this study was to evaluate the effectiveness of various storage media at 20 °C in maintaining the viability of human periodontal ligament fibroblasts (HPLF) over time. HPLF were maintained at 20 °C in skim milk (SM), whole milk (WM), freshly prepared Hank's balanced salt solution (HBSS), Save-A-Tooth(r), natural coconut water (NCW), coconut water industrialized (ICW) and tap water (negative control) for 3, 6, 24, 48, 72, 96 and 120 h. Cells maintained in Minimal Essential Medium (MEM-37) at 37 °C served as a positive control. Cell viability was determined by MTT assay. Statistical analysis was performed by Kruskal-Wallis test and Scheffe test (α = 5%). From 24 h, NCW was significantly better in maintaining cell viability than all other tested storage media (p<0.05). SM and WM were significantly better than HBSS for up to 72 h. Save-A-Tooth(r) and ICW were the worst conservation storage media. In conclusion, the effectiveness of the tested storage media to maintain the viability of the periodontal ligament cells was as follows, in a descending order: NCW > MEM-37> SM and IM> HBSS> ICW > Save-A-Tooth(r)> tap water.

Evaluation of coconut water neutralized by different agents on the viability of human fibroblasts: an in vitro study

Abstract Objective This study evaluated four types of pH adjustment of the coconut water (CW) on viability of human fibroblasts (HFF). Material and method Natural and industrialized CW were adjusted to pH 7.0 using: (1) Sodium Hidroxide (NaOH), (2) Sodium bicarbonate (NaHCO3), (3) Triethanolamine (C6H15NO3), (4) 2-Amino-2-Methil-1-Propanol (C4H11NO). Fibroblasts were plated at 2×104/ well in 96 well plates and maintained in the CW solutions for 2 h and 4 h. Positive control was represented by HFF maintained in DMEM and the negative control by tap water. Cell viability was analyzed by MTT formazan method. Data were analyzed by 3-way ANOVA followed by Tukey’s and Dunnet’s test. Result There are no significant effect on the cell viability regarding type of CW, period of evaluation, and the interactions between CW and period of evaluation, CW and pH adjustment method, pH adjustment method and period of evaluation (p>0.05). Conclusion The product used for CW pH adjustment did not influenced HFF viability, thought there are a tendency of better performance in natural CW.

Effect of laser photobiomodulation on the periodontal repair process of replanted teeth

BACKGROUND/AIM

Tooth replantation is the optimal treatment in cases of avulsion. However, its success is limited due to the occurrence of external root resorption. The aim of this study was to assess the effect of laser photobiomodulation (LPBM) at λ808 nm and λ660 nm and of storage media on the periodontal repair process of replanted teeth in rats.

MATERIAL AND METHODS

Sixty maxillary right incisors were extracted from sixty Wistar rats and randomly assigned to six groups (n = 10). Groups consisted of 10 teeth stored in paper napkins (PN), whole milk (WM), and soy milk (SM), for 45 min; and PNL, WML and SML, in which teeth were stored in the same storage media, but the root surface and the alveolus were treated with LPBM at λ808 nm before replantation, and the buccal and palatal mucosa of the alveolus were treated with LPBM at λ660 nm after replantation. Five rats from each group were euthanized after 15 or 30 days. The right hemimaxilla including the replanted incisor was removed and processed for histomorphometric analysis to assess root resorption areas, replacement root resorption, perimeter with ankylosis and periodontal repair, and areas of type I and III collagen deposition, using the ImageJ 1.50b software. Data were analyzed statistically by anova followed by Tukey's multiple comparison test (α = 5%).

RESULTS

WM and SM showed smaller root resorption areas and higher collagen deposition in both experimental periods, and SM showed the largest perimeter of periodontal repair. LPBM reduced the occurrence of root resorption only in the PNL group, both at 15 and 30 days, and increased the perimeter of periodontal repair in all groups at 30 days. There was higher collagen deposition in the irradiated groups regardless of the experimental period.

CONCLUSIONS

The LPBM protocol at λ808 nm and λ660 nm as well as whole milk and soy milk favored the periodontal repair process of replanted teeth in rats.

Powdered coconut water as a storage medium to preserve the viability of periodontal ligament cells: a laboratory study

AIM

To investigate the ability of newly developed powdered coconut water formulas (ACP) with different osmolarities to maintain the viability of periodontal ligament (PDL) cells over time compared with other solutions.

METHODOLOGY

Dogs teeth were extracted and stored for two periods, 3 h or 24 h, in the following media: long-shelf life CW (CW), pH-adjusted long-shelf life CW (pH-CW) and powdered CW that was pH and osmolality adjusted (ACP-404-I, 250 mOsm kg^-1 H₂ O; pH 7.0; ACP-404-II, 372 mOsm kg^-1 H₂ O; pH 7.0; ACP-404-III, 300 mOsm kg^-1 H₂ O; pH 7.4). The positive control group (Pc) corresponded to immediate measurement after tooth extraction, and two negative controls (Nc) corresponded to 3 h and 24 h of dry time. PDL cells were extracted, and cell viability analysed by Trypan blue exclusion. Data were analysed statistically using two-way anova followed by the Tukey test and one-way anova followed by the Dunnett test (P < 0.05).

RESULTS

At 3 h and 24 h, ACP-404-I had a performance similar to those of ACP-404-II and pH-CW, with significantly higher (P = 0.004) percentages of viable cells than ACP-404-III and CW. The positive control group had a significantly higher (P = 0.002) percentage of viable cells than the negative control groups, CW and ACP-404-III, irrespective of the period evaluated.

CONCLUSION

Powdered coconut water formulas, ACP-404-I and ACP-404-II, preserved viability for up to 24 h.

Storage media for avulsed teeth: a literature review

Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a wide array of types of wet storage media have been evaluated in laboratory studies and clinical reports, including cell and tissue culture solutions like Hank's Balanced Salt Solution (HBSS); medical/hospital products developed specifically for organ storage purposes, such as Viaspan® and Euro-Collins®; culture media, like Minimum Essential Medium (MEM); saline; natural products like water, saliva, bovine milk and its variations, propolis, green tea, Morus rubra (red mulberry), egg white and coconut water; rehydrating solutions, like Gatorade® and Ricetral, and even contact lens solutions. Based on the literature, it could be stated that, so far, apart from Based on the literature, it could be stated that, so far, apart from solutions designed specifically for storage and culture purposes, regular pasteurized whole milk is the most frequently recommended and with the best prognosis among other solutions that are likely to be available at the scene of an accident, such as water, saline or saliva. Its advantages include its high availability, ready accessibility, physiologically compatible pH and osmolality (fluid pressure) with the root-surface adhered PDL cells, presence of nutrients and growth factors. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on.

Phytodentistry: use of medicinal plants

Finding healing powers in plants is an ancient idea. Herbs have been used as a traditional form of medicine since time immemorial. The natural products derived from medicinal plants have proven to be an abundant source of biologically active compounds, many of which have been the basis for the development of new chemicals for pharmaceuticals. Phytodentistry implies the use of plants and their products in the process of treating disease directly or indirectly. A crucial role is played by phytotherapy in the treatment of stomatological problems. It started with the use of miswak (chewing stick), and it is still relevant today as herbal toothpaste in many parts of the country. India is the largest producer of medicinal herbs and is appropriately called the botanical garden of the world. The use of this readily available, natural and safe resource as a part of dental practice has great potential for a more "Natural and Green Dental Practice". Plant products have long been used in dentistry as part of various dental materials right from impression materials to eugenol, which forms an integral part of the dental clinic. The use of herbs in dental practice is not limited to only material sciences. A single herb shows a variety of effects like anti-inflammatory, antibacterial, antifungal activity and many more. Hence the incorporation of these herbs in dental practice will prove to be a valuable adjunct in dental treatment. This review is aimed at exploring the perspectives of this holistic treatment approach in dentistry and its benefits as an adjunctive therapy.

Histologic and micro-computed tomographic analyses of replanted teeth stored in different kind of media

INTRODUCTION

Coconut water (CW) and soy milk (SM) have been proposed as storage media for avulsed teeth because of their nutrients that preserve cell viability. The present study investigated the periodontal healing process of dog teeth replanted after storage in CW, SM, and whole milk (WM) using micro-computed tomographic (μCT) and histologic analyses compared with immediate tooth replantation.

METHODS

Forty roots of 10 adult beagle dogs were extracted and subjected to the following protocols: immediate replantation after extraction (control), stored in CW with an adjusted pH, and SM and WM for 50 minutes before replantation. The animals were euthanized 28 days postoperatively, and the obtained specimens were scanned using a μCT scanner and subjected to routine processing for histometric analyses under an optical microscope.

RESULTS

CW and SM performed similarly to WM; however, SM showed significantly higher ankylosis than the control group.

CONCLUSIONS

Additionally, this study showed that the combined use of histologic analysis and μCT is a promising method to better identify tooth resorption and the repair process and to evaluate the total extension of the periodontium. CW as a storage medium is a promising transport media for avulsed teeth.

Use of soymilk as a storage medium for avulsed teeth

OBJECTIVE

Tooth avulsion is one of the most severe forms of dental trauma. In these cases, immediate reimplantation is ideal; however, it almost never happens. The purpose of this study was to evaluate the viability of cells stored in soymilk and compare with other several storage media.

MATERIALS AND METHODS

The media tested were: long-shelf-life coconut water, long-shelf-life whole milk, long-shelf-life soymilk, Gatorade, egg white, and Hank's Balanced Salt Solution. Cells cultured in DMEM and distilled water served as positive and negative controls, respectively. Plates containing confluent 3T3 fibroblast were soaked in the various media for 2, 12 and 24 h. After incubation at 37°C, viability of the cells was determined using the MTS assay. Data were analyzed by using one-way ANOVA and complemented by Tukey test with a significance level of 5%.

RESULTS

Statistical analysis showed that DMEM, whole milk, HBSS and soymilk were the most effective media for maintaining cell viability at all tested times (p < 0.05), followed by coconut water, egg white and Gatorade. The least amount of viable cells was observed in the distilled water group.

CONCLUSIONS

The present study shows that the efficacy of soymilk in maintaining the viability of 3T3 fibroblasts is similar to that of HBSS and milk. Therefore, it can be concluded that soymilk could be a suitable alternative storage medium for avulsed teeth.

Effect of skimmed pasteurized milk and Hank's balanced salt solution on viability and osteogenic differentiation of human periodontal ligament stem cells

BACKGROUND/AIM

The purpose of this study was to compare the effect of skimmed pasteurized milk and Hank's balanced salt solution on the viability and osteogenic differentiation potential of the human periodontal ligament stem cells at room temperature in vitro.

MATERIAL AND METHODS

Human periodontal ligament stem cells were obtained from extracted healthy third molars and conserved in skimmed pasteurized milk and Hank's balanced salt solution for 1, 2, and 4 h at room temperature to detect the viability of the cells and their osteogenic differentiation potential.

RESULTS

The efficacy of skimmed pasteurized milk on cell viability at 4 h was significantly higher than that of HBSS (P < 0.05), and cells stored in skimmed pasteurized milk showed significantly higher levels of mineralization than those in HBSS at 2 and 4 h (P < 0.05).

CONCLUSIONS

Skimmed pasteurized milk was more effective than Hank's balanced salt solution in maintaining the viability and osteogenic differentiation potential of PDLSCs at room temperature in vitro.

Soy milk as a storage medium to preserve human fibroblast cell viability: an in vitro study

Soy milk (SM) is widely consumed worldwide as a substitute for cow milk. It is a source of vitamins, carbohydrates and sugars, but its capacity to preserve cell viability has not been evaluated. The purpose of the present study was to investigate the efficacy of SM to maintain the viability of human fibroblasts at short periods compared with different cow milks. Human mouth fibroblasts were cultured and stored in the following media at room temperature: 10% Dulbecco's Modified Eagle Medium (DMEM) (positive control group); long shelf-life ultra-high temperature whole cow milk (WM); long shelf-life ultra-high temperature skim cow milk (SKM); powdered cow milk (PM); and soy milk (SM). After 5, 15, 30 and 45 min, cell viability was analyzed using the MTT assay. Data were analyzed statistically by the Kruskal-Wallis test with post-analysis using the Dunn's method (α=0.05). SKM showed the lowest capacity to maintain cell viability in all analyzed times (p<0.05). At 30 and 45 min, the absorbance levels in control group (DMEM) and SM were significantly higher than in SKM (p<0.05). Cell viability decreased along the time (5-45 min). The results indicate that SM can be used as a more adequate storage medium for avulsed teeth. SKM was not as effective in preserving cell viability as the cell culture medium and SM.