Delayed Tooth Replantation after Root Surface Treatment with Papain and Sodium Fluoride in Rats: A Histological and Histomorphometrical Evaluation
Iranian Endodontic Journal,
Vol. 15 No. 3 (2020),
1 July 2020
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.
- Avulsion; Papain; Sodium Fluoride, Tooth Replantation
How to Cite
Alani A, Austin R, Djemal S. Contemporary management of tooth replacement in the traumatized dentition. Dent Traumatol. 2012;28(3):183-92.
Rouhani A, Movahhed T, Ghoddusi J, Mohiti Y, Banihashemi E, Akbari M. Anterior traumatic dental injuries in East Iranian school children: prevalence and risk factors. Iran Endod J. 2015;10(1):35-8.
Heydari A, Tahmasbi S, Badiee M, Izadi S, Mashhadi Abbas F, Mokhtari S. The effect of root coating with titanium on prevention of root resorption in avulsed teeth: an animal study. Iran Endod J. 2016;11(4):309-14.
Panzarini SR, Gulinelli JL, Poi WR, Sonoda CK, Pedrini D, Brandini DA. Treatment of root surface in delayed tooth replantation: a review of literature. Dent Traumatol. 2008;24(3):277-82.
Sottovia AD, Sonoda CK, Poi WR, Panzarini SR, Lauris JR. Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats. J Appl Oral Sci. 2006;14(2):93-9.
dos Santos CL, Sonoda CK, Poi WR, Panzarini SR, Sundefeld ML, Negri MR. Delayed replantation of rat teeth after use of reconstituted powdered milk as a storage medium. Dent Traumatol. 2009;25(1):51-7.
Mohammadi Z, C Cehreli Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Management of root resorption using chemical agents: a review. Iran Endod J. 2016;11(1):1-7.
Andreasen JO. Analysis of pathogenesis and topography of replacement root resorption (ankylosis) after replantation of mature permanent incisors in monkeys. Swed Dent J. 1980;4(6):231-40.
Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, Kenny DJ, Sigurdsson A, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Tsukiboshi M. Guidelines for the management of traumatic dental injuries: 2. avulsion of permanent teeth. Pediatr Dent. 2016;38(6):369-76.
Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part I: Timing of pulp extirpation. Dent Traumatol. 2009;25(1):32-42.
Gomes WD, Silva CA, Melo ME, Silva VF, Almeida MM, Pedrini D, Poi WR, Sonoda CK, Panzarini SR. Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline. Dent Traumatol. 2015;31(6):448-56.
Poi WR, Carvalho RM, Panzarini SR, Sonoda CK, Manfrin TM, Rodrigues Tda S. Influence of enamel matrix derivative (Emdogain) and sodium fluoride on the healing process in delayed tooth replantation: histologic and histometric analysis in rats. Dent Traumatol. 2007;23(1):35-41.
Lindskog S, Pierce AM, Blomlof L, Hammarstrom L. The role of the necrotic periodontal membrane in cementum resorption and ankylosis. Endod Dent Traumatol. 1985;1(3):96-101.
Esper HR, Panzarini SR, Poi WR, Sonoda CK, Casatti CA. Mechanical removal of necrotic periodontal ligament by either Robinson bristle brush with pumice or scalpel blade. Histomorphometric analysis and scanning electron microscopy. Dent Traumatol. 2007;23(6):333-9.
Nayak SB, Pinto Pereira L, Maharaj D. Wound healing activity of Carica papaya L. in experimentally induced diabetic rats. Indian J Exp Biol. 2007;45(8):739-43.
da Silva CR, Oliveira MB, Motta ES, de Almeida GS, Varanda LL, de Padula M, Leitao AC, Caldeira-de-Araujo A. Genotoxic and cytotoxic safety evaluation of papain (Carica papaya L.) using In vitro assays. J Biomed Biotechnol. 2010;2010:197898.
Silveira S, Guimarães TD. Papain associated with urea in the debridement of necrotic wounds. J Phlebol Lymphol. 2010;3(1):6-7.
Couto De Oliveira G, Ferraz CS, Andrade Junior CV, Pithon MM. Chlorhexidine gel associated with papain in pulp tissue dissolution. Restor Dent Endod. 2013;38(4):210-4.
Bussadori SK, Guedes CC, Bachiega JC, Santis TO, Motta LJ. Clinical and radiographic study of chemical-mechanical removal of caries using Papacarie: 24-month follow up. J Clin Pediatr Dent. 2011;35(3):251-4.
Montero JC, Mori GG. Assessment of ion diffusion from a calcium hydroxide-propolis paste through dentin. Braz Oral Res. 2012;26(4):318-22.
Andreasen JO, Kristerson L. Repair processes in the cervical region of replanted and transplanted teeth in monkeys. Int J Oral Surg. 1981;10(2):128-36.
Andreasen JO. Analysis of topography of surface- and inflammatory root resorption after replantation of mature permanent incisors in monkeys. Swed Dent J. 1980;4(4):135-44.
Hulsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J. 2003;36(12):810-30.
Panzarini SR, Perri de Carvalho AC, Poi WR, Sonoda CK. Use of vitamin C in delayed tooth replantation. Braz Dent J. 2005;16(1):17-22.
Mori GG, de Moraes IG, Garcia RB, Borro LC, Purificacao BR. Microscopic investigation of the use of gallium nitrate for root surface treatment in rat teeth submitted to delayed replantation. Braz Dent J. 2007;18(3):198-201.
Merzel J, Novaes PD. Development of functional dentin incisors after a partial resection of the odontogenic organ of rat incisors. Arch Oral Biol. 2006;51(10):825-35.
Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endod Dent Traumatol. 1995;11(2):76-89.
Lam K, Sae-Lim V. The effect of Emdogain gel on periodontal healing in replanted monkeys' teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):100-7.
Adl A, Motamedifar M, Shams MS, Mirzaie A. Clinical investigation of the effect of calcium hydroxide intracanal dressing on bacterial lipopolysaccharide reduction from infected root canals. Aust Endod J. 2015;41(1):12-6.
Lin S, Ashkenazi M, Karawan M, Teich ST, Gutmacher Z. Management of ankylotic root resorption following dental trauma: a short review and proposal of a treatment protocol. Oral Health Prev Dent. 2017;15(5):467-74.
Schwartz O, Andreasen FM, Andreasen JO. Effects of temperature, storage time and media on periodontal and pulpal healing after replantation of incisors in monkeys. Dent Traumatol. 2002;18(4):190-5.
Lopes MC, Mascarini RC, da Silva BM, Florio FM, Basting RT. Effect of a papain-based gel for chemomechanical caries removal on dentin shear bond strength. J Dent Child (Chic). 2007;74(2):93-7.
Dawkins G, Hewitt H, Wint Y, Obiefuna PC, Wint B. Antibacterial effects of Carica papaya fruit on common wound organisms. West Indian Med J. 2003;52(4):290-2.
- Abstract Viewed: 89 times
- PDF Downloaded: 71 times