A Comparative Evaluation of the Periodontal Ligament Cell Viability Using Placentrex, Propolis, and Hanks' Balanced Salt Solution: An In-Vitro Study

BACKGROUND AND OBJECTIVES

Most of the dento-alveolar trauma that occurs frequently in childhood is often linked to avulsion injuries. Two considerable elements influencing the prognosis of tooth avulsion after replantation are extraoral dry duration and the characteristics of the storage media to support the viability of cells. The study aimed to compare and assess the effectiveness of Hanks' balanced salt solution (HBSS) (HiMedia Laboratories, Thane, India) and Placentrex (Albert David Limited, Kolkata, India) against propolis (5% and 10%) as storage media in preserving the vitality of periodontal ligament (PDL) cells.

MATERIALS AND METHODS

Four groups with 15 samples each were selected for the study. Sixty recently extracted premolars were left to incubate for 30 minutes in 15-ml falcon tubes containing 2.5 ml of collagenase 0.2 mg/ml in phosphate-buffered saline and 2.4 mg/ml of dispase in HBSS, Placentex, propolis 5%, and propolis 10%. After the addition of bovine serum, it was centrifuged for 4 minutes. Trypan blue 0.4% was utilized to recognize the cells, and a hemocytometer was employed for counting the live PDL cells under a light microscope.

RESULTS

Propolis 5% and 10%, HBSS, and Placentrex all showed statistically significant differences in PDL cell viability; however, HBSS was significantly outperformed by Placentrex and propolis.

CONCLUSION

Placentrex is a superior substitute storage medium in cases of tooth avulsion as opposed to alternatives such as propolis 5% and 10%.

Comparative assessment of the efficacy of an intralesional injection of placentrex, hyaluronidase and dexamethasone in the management of oral submucous fibrosis: A randomized controlled trial

The prevalent symptoms of oral submucous fibrosis (OSMF) are a burning sensation and trismus. The aim of the present study was to compare the efficacy of placentrex, hyaluronidase and dexamethasone, and their combination in the treatment of OSMF. For this purpose, 160 patients with OSMF were divided into four groups (each with 40 patients at a 1:1:1:1 allocation ratio). The patients in group 1 (control) received only oral supplements, along with regular mouth-opening exercises; patients in group 2 received an injection of placental extract; patients in group 3 were injected with hyaluronidase and dexamethasone; and patients in group 4 received a combination of injections from groups 2 and 3. The injections were administered once weekly for 12 weeks and patients were followed-up for 12 months. The data of the patients (mouth opening ability and a burning sensation) were analyzed using ANOVA and the Kruskal-Wallis test. The maximum increase in mouth opening (7.30±0.80 mm) was noted in group 4, and the lease increase was observed in the control group (0.37±0.16 mm), from baseline levels to the end of the 12th week. The maximum relapse in mouth opening of 1.62±0.45 mm was noted in group 2, and a minimum relapse of 0.20±0.08 mm was noted in group 4. On the whole, the present study demonstrates that the intralesional injection of a combination of the three drugs (placentrex, hyaluronidase and dexamethasone) in addition to the use of oral supplements and mouth opening exercises has a high level of efficacy in improving trismus and burning sensation in patients with OSMF.

Comparison of Intralesional Placentrex Versus Hyaluronidase and Dexamethasone Injection in the Symptomatic Management of Stage II Oral Submucous Fibrosis - a Prospective Study

AIM

The present study aimed to compare the effectiveness of intralesional placentrex versus hyaluronidase + dexamethasone injection in the symptomatic management of stage II OSMF.

MATERIALS AND METHODS

This was a non-randomized prospective study conducted over a period of 14 months at a tertiary referral center. Patients with clinical stage II OSMF were randomly grouped into A(n = 18) and B(n = 17). These patients were treated with weekly intralesional injection of placentrex and hyaluronidase + dexamethasone respectively, over a period of six weeks. Variables such as mouth opening, burning sensation and colour of mucosa were evaluated at baseline(T0), second week(T1), fourth week(T3), sixth week(T4) of follow up. A p-value < 0.05 was considered statistically significant.

RESULTS

A total of 15 patients completed the study in each group with regular follow up. The mean improvement in mouth opening was 4.3 ± 0.57 mms in group A(p-value < 0.001) and 7.2 ± 0.76 mms in group B(p-value < 0.001) which were significant at the end of six weeks. Mean change in burning sensation at the end of six weeks in group A was 1.2 ± 0.73(p-value < 0.001), and 3.6 ± 0.63(p-value < 0.001) in group B. Mean change in colour of mucosa at the end of six weeks was 1.4 in group A(p-value > 0.05) and 2 in group B(p-value > 0.05). On comparison between both groups, patients in group B exhibited better mouth opening and reduction of burning sensation than patients in group A(p-value < 0.001).

CONCLUSION

Both intralesional placentrex and hyaluronidase + dexamethasone injection are effective in alleviating the symptoms of stage II OSMF. However, hyaluronidase + dexamethasone injection showed slightly better improvement in mouth opening and burning sensation after six weeks.

The Comparative Analysis of the Effectiveness of Four Different Storage Media (Placentrex, Propolis 10%, Pomegranate Juice 5%, and Hank's Balanced Salt Solution) in Preserving the Viability of Periodontal Ligament Cells: An In Vitro Study

BACKGROUND

Out of all traumas, dentoalveolar trauma occurs quite frequently and is commonly linked to avulsion injuries. Of all severe lesions to the permanent dentition, tooth avulsion accounts for 1%-16% of cases. The extraoral dry time and the storage medium in which the tooth is stored and its capacity to promote cell viability are two important variables influencing the prognosis of an avulsed tooth following replantation.

AIM

The aim of this paper is to assess and contrast the effectiveness of placentrex, propolis 10%, pomegranate juice 5%, and Hank's balanced salt solution (HBSS) as a storage medium in preserving the periodontal ligament (PDL) cells' viability.

METHODS

Sixty freshly extracted premolars were put in four various media for 45 minutes each, including HBSS, placentrex, propolis 10%, and pomegranate juice 5%, and placed in an incubator for 30 minutes in 15 mL falcon tubes with 2.5 mL solutions of collagenase 0.2 mg/mL and dispase 2.4 mg/mL in phosphate-buffered saline. Bovine serum was added after incubation, and the mixture was centrifuged for four minutes. Trypan blue 0.4% was used to identify the cells. Under a light microscope, a hemocytometer was utilized to quantify the number of periodontal ligament cells that were still alive.

RESULTS

Propolis, pomegranate, and placentrex are all significantly inferior to HBSS in the context of the sustainability of the cells. It was discovered that HBSS with placentrex and pomegranate juice 5% was statistically insignificant. The difference in periodontal ligament cell viability between propolis 10%, HBSS, placentrex, and pomegranate juice 5% was shown to be statistically significant.

CONCLUSION

When compared to other media such as propolis 10% and pomegranate juice 5%, placentrex is a better alternative storage medium for avulsed teeth.

The study of placentrex and hydrocortisone as an adjunct treatment in oral submucous fibrosis

BACKGROUND

Submucous fibrosis with a high incidence rate in the Indian subcontinent is a devastating disease affecting the oral cavity and oropharynx.

AIMS AND OBJECTIVE

To evaluate the efficacy of injection placentrex and injection hydrocortisone in oral submucous fibrosis patients in increasing mouth opening, burning sensation, and improve the mucosal lining.

MATERIALS AND METHODS

We recruited 60 patients with Stage II and Stage III of the ailment, who were randomly divided into Group A and Group B. They were administered submucosal injections of hydrocortisone and placentrex along with physiotherapy and oral iron, nutrients, and B-carotene supplements over a period of 2 months.

INTERPRETATIONS AND RESULTS

The pinnacle rate of the incidence was found in the age group of 30 to 40 years among both the genders. Statistically significant difference (P = 0.0001), that is, 5.19 ± 1.33 in Group A and 11.69 ± 1.26 mm in Group B was noted in the mean mouth opening values. Statistically significant difference in burning sensation was noted to be better in Group A than in Group B.

DISCUSSION AND CONCLUSION

Overall hydrocortisone seems to be a better regimen for improving the mucosal health and increasing the mouth opening as compared to placentrix regimen. Although Placentrex is better than hydrocortisone in reducing burning sensation.

Therapeutic Benefit of Placentrex in the Management of Acute Chemo Radiation Induced Mucositis in Oral Cancer Patients

Background:

A troublesome and usually unavoidable consequence of Head and Neck chemo radiation is oral mucositis which decreases patients’ compliance and negatively influences the outcome of therapy by increasing overall treatment time. Currently, no single effective recommended treatment exists for this problem and a variety of supportive care measures have been practiced with limited benefits. This study was done to evaluate the therapeutic benefit of Placentrex in the management of oral mucositis seen in oral cancer patients undergoing treatment with concurrent chemoradiation.

Methodology:

This study was carried out, as a retrospective analysis, on oral cancer patients undergoing concurrent chemoradiation with weekly Cisplatin regimen treated between Oct 2015 and July 2017. All the patients received 2ml of Inj Placentrex, once daily administered intramuscularly for 4 weeks, NSAIDs, topical analgesics, and mouth wash as treatment for oral mucositis. The results were compared with a historical control group of 40 oral cancer patients who had received treatment prior to the study period without receiving Inj Placentrex as a part of oral mucositis management.

Results:

Over 60% of the patients in both groups were older than 60 years of age. Buccal mucosa was the predominant sub site of the investigated cancer type. The addition of placentrex resulted in delay in the progression of mucositis, reduction of treatment breaks, regression of pain, and improvement of dysphagia while leading to no adverse effects (p<0.05).

Conclusion:

Placentrex appears to be a beneficial therapeutic option for the management of concurrent chemo-radiation induced acute oral mucositis in oral cancer patients.