ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In-Vitro Evidence Shows That Milk May Be A Better Medium Than Coconut Water for Storage of Avulsed Teeth When Immediate Re-implantation Is Not An Option
Clinical Question Is the storage of avulsed teeth in coconut water a better alternative to milk in terms of a better prognosis for re-implantation, measured by the amount of viable periodontal ligament cells after soaking time?
Clinical Bottom Line The in-vitro study indicates that milk should be chosen over coconut water as a storage medium for an avulsed tooth until a dentist can be seen for further treatment, however this level of evidence is not strong enough to support clinical use.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21083571Souza/201196-well culture plates seeded with PDL fibroblasts, one plate per experimental groupIn vitro research
Key resultsPeriodontal ligament fibroblasts were placed in 96-well culture plates. One plate was used per medium being studied, with 8 x 103 PDL fibroblasts per well. Plates were stored at 5 oC and checked for cell viability at intervals of 3, 6, 24, 48, 96 and 120 hours. A spectrophotometer measured optical density in order to determine cell viability. Mean absorbance values were higher for milk than coconut water. Skimmed and whole milk performed significantly better than natural coconut water (P<0.05) from 24 to 120 hours. Industrialized coconut water performed worse than natural coconut water.
Evidence Search ("Tooth Avulsion"[Mesh]) AND "Cocos"[Mesh]
Comments on
The Evidence
The study was performed in-vitro. All samples of PDL fibroblasts were similar at start and present at completion of the trial. All plates of PDL fibroblasts were stored at 5 degrees Celsius. No competing interests were present, and biases were unlikely. A clinical study should be done to support this in-vitro research.
Applicability This in-vitro trial is applicable to patients with tooth avulsion, desiring to re-implant the tooth into its socket. Milk is recommended, as it is more effective at preserving PDL cell viability and is more widely accessible as a storage medium than coconut water.
Specialty/Discipline (Endodontics) (General Dentistry) (Pediatric Dentistry)
Keywords Tooth avulsion, avulsed teeth, milk, coconut
ID# 2389
Date of submission: 03/07/2013spacer
E-mail farooque@livemail.uthscsa.edu
Author Sheela Farooque
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Robert Kaminski, DDS, MS
Faculty mentor/Co-author e-mail kaminskir@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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