Layug M L, Barrett E J, Kenny D J
Hospital for Sick Children, Toronto, Ont.
J Can Dent Assoc. 1998 May;64(5):357-63, 365-9.
This literature review examines the effects of extra-alveolar duration and storage conditions on the healing of the periodontal ligament (PL) of avulsed teeth following replantation. A critical assessment of the so-called "reconstitution theory" for PL cells is also presented. The ideal treatment for an avulsed tooth is immediate replantation (i.e. less than five minutes). Unfortunately, immediate replantation is not the norm, and most avulsed teeth experience delayed replantation. The greatest risk to the vitality of the PL cells attached to the root of an avulsed tooth is desiccation. Not surprisingly, storage media affect PL healing. Storing avulsed teeth in an isotonic liquid is superior to dry storage. Numerous studies support the use of Modified Eagle's Medium, Hank's Balanced Salt Solution (HBSS), ViaSpan, saline, milk, and saliva as storage media. A recent study has suggested that chicken egg white may also prove to be a suitable storage medium for avulsed teeth. Of these media, only saliva is always present at the scene of an accident, however. Milk can usually be obtained on short notice, but even 10 minutes of desiccation can affect the outcome of replantation. From a practical standpoint, milk packed in ice seems to be the best alternative for the temporary storage of avulsed teeth, due to its wide availability and the minimal detrimental effects it has on PL cells. There is no evidence to support the suggestion that HBSS or any other media will "reconstitute" the PL cells when the extra-alveolar duration of avulsed teeth is greater than 30 minutes.
这篇文献综述探讨了牙槽外持续时间和储存条件对再植后脱位牙牙周膜（PL）愈合的影响。同时还对所谓的PL细胞“重建理论”进行了批判性评估。脱位牙的理想治疗方法是立即再植（即少于5分钟）。不幸的是，立即再植并非常态，大多数脱位牙经历延迟再植。附着在脱位牙根上的PL细胞活力面临的最大风险是干燥。毫不奇怪，储存介质会影响PL愈合。将脱位牙储存在等渗液体中优于干储存。大量研究支持使用改良 Eagle 培养基、汉克平衡盐溶液（HBSS）、ViaSpan、盐水、牛奶和唾液作为储存介质。最近一项研究表明，鸡蛋白也可能被证明是脱位牙的合适储存介质。然而，在这些介质中，只有唾液总是在事故现场出现。通常可以在短时间内获得牛奶，但即使干燥10分钟也会影响再植结果。从实际角度来看，冰袋包装的牛奶似乎是脱位牙临时储存的最佳选择，因为其易于获得且对PL细胞的有害影响最小。没有证据支持当脱位牙的牙槽外持续时间大于30分钟时，HBSS或任何其他介质会“重建”PL细胞这一说法。
