The Effects of Different Regenerative Treatments after Tooth Avulsion

Purpose of Review Traumatic injury to the teeth can cause dental avulsion. There is little time to return the tooth to its socket. Also, after tooth avulsion, the regeneration process might fail. Using appropriate techniques to save the tooth and the surrounding tissue immediately is one of the main goals of dental traumatology. In this study, we intend to discuss about interventions that have an effect on regenerative mechanism in avulsed teeth. Recent Findings Research has shown that PDL regeneration, pulp revascularization therapy for avulsed teeth using growth factors, and keeping teeth in cell-compatible storage medium after tooth avulsion could be effective in regeneration process after dental avulsion. PDL regeneration may be accomplished using a variety of techniques and materials, which are Periodontal ligament cell sheets, Enamel matrix derivative (EMD), Tissue engineering, Cell homing, Titanium Coating, Near-infrared LED therapy are the most. Despite the acceptable results of other techniques, LED therapy and tissue engineering with BMMCs/PRP/Ca did not have an effect on tooth regeneration after replantation. Covering the root surfaces of avulsed teeth with titanium seems to have the potential to inhibit replacement root resorption, but did not have an effect on PDL regeneration. In some studies growth factors were added to the culture media. The results demonstrated that supplementation of storage media without growth factors is not preferred in short periods. Summary Using different methods for tooth regeneration after dental avulsion mainly lead to decrease in inflammation, ankylosis, root resorption, and inflammatory infiltration. On the other hand revascularization, PDL regeneration, microvessel density, bone integration with replanted tooth and increased cell survival was achieved. Most of the studies, used in vitro approach in teeth avulsed from animals, which makes the results different. However, more clinical studies on human are necessary for further investigations.