Efficacy of photobiomodulation in the treatment of avulsed teeth: A systematic review of animal studies.

The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (i.e., "PRISMA") statement 2020 and was registered in the International Prospective Register of Systematic Reviews (i.e., PROSPERO) with number CRD42022362198. The participants, intervention, comparison, outcomes, and study design (i.e., PICOS) for the present study considered the following question: "Does the use of laser PBM in the treatment of teeth with avulsion influence tissue repair performance?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest databases until January 2023. The SYRCLE's RoB tool (Systematic Review Center for Laboratory Animal Experimentation) for animal studies were used for quality assessment. A total of 7 in vivo studies published between 2011 and 2018 were included in this systematic review for qualitative analysis. All studies used Wistar rats, totaling 368 specimens that simulated tooth avulsion trauma. The effect of photodynamic therapy in the treatment of avulsed teeth was positive in 5 studies (significant increase in tissue repair) and negative in 2 studies, in which both studies with negative results kept teeth in saline solution before reimplantation and showed the longest time and power of laser application. PBM appears to be effective for tissue repair in the treatment of avulsed teeth, depending on the means of conservation of the avulsed tooth and the laser application protocol.

Delayed Tooth Replantation after Root Surface Treatment with Papain and Sodium Fluoride in Rats: A Histological and Histomorphometrical Evaluation.

Introduction: The aim of this study was to examine the histological effect of papain and sodium fluoride in delayed replantation of rat incisor teeth on the repair process. Methods and Materials: Forty upper incisors of Wistar rats were randomly assigned to four groups (n=10). In group I, the dental papilla and the pulp tissue of extracted teeth were removed before immediate replantation in their sockets. In the other groups, the extracted teeth were maintained in dry storage for 60 min and subjected to different root surface treatments. In group II, the teeth were immersed in 10% papain for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group III, the teeth were immersed in saline for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group IV, root surface treatment was not applied. The root canals were treated and filled with a calcium hydroxide paste and the teeth were replanted. The animals were euthanized after 60 days and anatomic specimens containing the teeth were subjected to routine histochemical processing and staining with hematoxylin and eosin. The Kruskal-Wallis test was used, followed by the Dunn's test for multiple comparisons. Results: Groups I and II had less inflammatory root resorption and total area of root resorption (P<0.05) than groups III and IV respectively. Conclusions: Based on this animal study, root surface treatment with papain and sodium fluoride in delayed tooth replantation showed greater efficacy in controlling inflammatory root resorption and may be a viable option for clinical application.

Surgical and Orthodontic Treatment of Severely Intruded Permanent Incisors: A Case Report.

Traumatic dental intrusion is a serious injury and results in significant damage to the periodontal ligament, dentin-pulp complex, and alveolar bone. This article presents a case of severe intrusion of the two upper permanent central incisors where the treatment option was the combination of the surgical and orthodontic technique. The difficulty of accessing the crowns of these teeth to bond the brackets was solved by lifting a full thickness flap. To disengage the teeth from the alveolus, a careful dislocation motion was performed. After suturing the flap, a removable orthodontic appliance was installed and an extrusive force was applied for 8 weeks. After 10 weeks, the endodontic treatment was performed and the crowns were restored. The 10-year clinical control showed normal mobility. Radiographically, minor losses of the cervical alveolar cortical bone and integrity of the periodontal ligament were observed.

Surface free energy of enamel treated with sodium hexametaphosphate, calcium and phosphate.

OBJECTIVE: This study evaluated the capacity of sodium hexametaphosphate (HMP) at different concentrations to alter the surface properties of dental enamel in order to increase calcium and phosphate adsorption. DESIGN: Bovine enamel blocks (4 mm × 4 mm, n = 144, 12/group) were divided: 0%; 0.25%; 0.5%; and 1% HMP, followed or not by application of solutions containing Ca or Ca-PO4, totaling 12 groups. The treatments were performed for 2 min, and the surface free energy (mN/m) was calculated by measuring the contact angles of three probing liquids (deionized water, diiodomethane and ethylene glycol), which was used to determine the polar and nonpolar components of the enamel surface. Calcium (Ca), phosphate (PO4) and HMP in the solutions treatment solutions were analyzed before and after treatment. The data presented normal and homogeneous distribution and then were subjected to ANOVA, followed by Student-Newman Keuls' test (p < 0.05). RESULTS: The higher the% of HMP in the solutions, the greater HMP adsorption and more electron-donor sites on enamel surface were achieved (p < 0.05). Also, Ca adsorption was higher with increasing% HMP in the solutions (p < 0.05), which in turn reduced electron-donor sites on enamel surface. Increased Ca and PO4 adsorption occurred at 0.5% and 1% HMP after treatment with Ca-PO4 solution, resulting in a less electron-donor sites on surface when compared to the other treatments (P < 0.05). CONCLUSIONS: HMP leads to a more electron-donor sites on enamel surface, what promotes greater adsorption of Ca and PO4 ions.

Estudo do processo de reparo do reimplante de dentes de ratos mantidos em albumina / Study of the reimplant repair process of teeth mainted on albumin

Quando o reimplante imediato não é possível, os meios de conservação têm papel fundamental para a manutenção da integridade do ligamento periodontal do dente avulsionado, para que um tratamento adequado seja alcançado. A clara do ovo apresentou resultados favoráveis para esse fim e a albumina constitui seu principal componente. Assim o propósito desse estudo foi analisar se a albumina pasteurizada em pó possui o mesmo potencial que a sua forma natural, como meio de conservação. Para isso foram utilizados 40 ratos divididos em 4 grupos de 10 animais. Após a extração do incisivo superior direito, os dentes do grupo IM foram reimplantados em seus respectivos alvéolos após 5 minutos (controle positivo grupo AP os dentes serão imersos em 40 ml de clara de ); No ovo pasteurizada em pó, reconstituída em água (10 gramas de pó em 30ml de água); No grupo CO dentes foram imersos em 40 ml de clara de ovo in natura; No grupo SE - os dentes serão mantidos em meio seco (controle negativo ). Com exceção do grupo IM, os demais dentes foram mantidos em seus respectivos meios por 60 minutos em temperatura ambiente para serem então reimplantados em seus respectivos alvéolos. Os animais receberam em dose única, antibiótico e analgésico. Na análise histológica da inserção epitelial e ligamento periodontal, foram consideradas a ocorrência de inflamação e a localização. Na superfície radicular foi analisada a ocorrência de reabsorção inflamatória, reabsorção por substituição, total de reabsorção, áreas reparadas por ligamento periodontal, anquilose. Os dados foram submetidos à análise estatística a um nível de significância de 5%. Os resultados demonstraram que a intensidade da inflamação aguda no tecido conjuntivo da inserção epitelial, foi maior no grupo SE em relação ao grupo IM. O grupo SE foi o mais comprometido que os demais grupos em relação à reabsorção total, reabsorção inflamatória e reabsorção por substituição. O grupo SE apresentou a menor extensão de ligamento periodontal que os demais grupos. Para o ligamento periodontal reinserido, o grupo SE apresentou menor extensão do que os grupo IM e AP. Pode-se concluir que a albumina em pó apresentou resultado histológico semelhante ao da clara de ovo in natura e do reimplante imediato, constituindo uma opção como meio de conservação de dentes avulsionados(AU)

When immediate replantation is not possible, preservatives play a fundamental role in maintaining the integrity of the periodontal ligament of the avulsed tooth so that proper treatment is achieved. Egg white showed favorable results for this purpose and a lbumin is its main component. Thus the purpose of this study was to analyze whether pasteurized albumin powder has the same potential as its natural form as a preservative medium. Forty rats were divided into 4 groups of 10 animals. After extraction of the right upper incisor, the teeth of the IM group were reimplanted in their respective alveoli after 5 minutes ( group AP positive control); In the teeth will be immersed in 40 ml of pasteurized egg white powder, reconstituted in water (10 grams of powder i n 30ml of water); In group CO were immersed in 40 ml of fresh egg white; In the SE group -- the teeth the teeth will be kept in a dry environment ( negative control). With the exception of the IM group, the remaining teeth were kept in their respective mea ns for 60 minutes at room temperature and then reimplanted in their respective alveoli. The animals received a single dose, antibiotic and analgesic. Histological analysis of epithelial insertion and periodontal ligament considered the occurrence of inflam mation and location. The root surface was analyzed for inflammatory resorption, replacement resorption, total resorption, areas repaired by periodontal ligament, ankylosis. Data were subjected to statistical analysis at a significance level of 5%. The resu lts showed that the intensity of acute inflammation in the connective tissue of the epithelial insertion was higher in the SE group than in the IM group. The SE group was the most compromised than the other groups in terms of total resorption, inflammatory resorption and replacement resorption. The SE group had the smallest periodontal ligament extension than the other groups. For the reinserted periodontal ligament, the SE group presented smaller extension than the IM and AP groups. It can be concluded tha t albumin powder presented histological results similar to that of fresh egg white and immediate replantation, constituting an option as a means of preserving avulsed teeth(AU)