Storage Media for Periodontal Ligament Cell Preservation

Preservation of periodontal ligament (PDL) cells following tooth avulsion is critical for successful replantation and long-term periodontal health. An ideal storage medium must maintain cell membrane integrity, support metabolic activity and minimise inflammatory responses throughout the extra-alveolar period. Key parameters include physiologically balanced osmolarity and pH, provision of essential nutrients (glucose, amino acids) and the presence of bioactive compounds with antioxidant or anti-inflammatory properties. Historically, cell-culture solutions such as Hank’s Balanced Salt Solution (HBSS) and Minimum Essential Medium have served as gold-standards in laboratory settings. Readily accessible alternatives—pasteurised milk, saline and natural fluids such as coconut water—have been widely adopted in emergency scenarios, while emerging botanical extracts, novel peptides and synthetic formulations are under investigation. Recent work seeks to combine optimal physicochemical properties with global availability, enabling immediate use at the site of trauma and improving the prognosis of avulsed teeth in diverse healthcare settings.

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Storage Media for Periodontal Ligament Cell Preservation publication trend

The graph below shows the total number of articles in storage media for periodontal ligament cell preservation across all publications each year (not limited to Nature Index journals).

Technical terms

Periodic ligament (PDL) cells: Connective tissue cells that attach the tooth root to alveolar bone and whose viability determines replantation success.

Hank’s Balanced Salt Solution (HBSS): A buffered saline solution designed to maintain physiological osmolarity and pH, commonly used to preserve cells ex vivo.

Viability assay: Laboratory technique (e.g., MTT, trypan blue exclusion) used to quantify live versus dead cells after treatment.

Extra-alveolar time: Duration for which an avulsed tooth remains outside its socket; longer periods increase the risk of PDL cell death.

Network meta-analysis: Statistical method that compares multiple interventions across different studies to establish a relative ranking of effectiveness.

References

1. Storage Media For Avulsed Teeth: A Literature Review. Brazilian Dental Journal (2013).
2. Evaluation of delphinidin as a storage medium for avulsed teeth. BMC Oral Health (2023).
3. 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. Cureus (2023).
4. Network Meta-Analysis of 10 Storage Mediums for Preserving Avulsed Teeth. Frontiers in Medicine (2021).