Periodontal ligament removal and surface treatment agents: an in vitro comparative study

Abstract

Periodontal ligament (PDL) healing following tooth avulsion is the primary feature that determines tooth survival. The prognosis is considered poor following avulsion injury. More than a quarter of avulsed teeth exhibit external inflammatory (infection) related tooth resorption. Replacement resorption is seen in around 50% of reimplanted teeth after avulsion. PDL survival determines prognosis. Interventions which eliminate the risk of inflammatory root resorption and reduce the rate of replacement resorption should be attempted. Slowing the rate of replacement resorption can be achieved using root surface treatment agents. Treatment measures should be controlled to slow down tooth loss by reducing the rate of replacement resorption, thereby preserving alveolar bone. In order to achieve this goal, complete removal of the PDL without damaging cementum should be done, along with the use of surface treatment agents. Evidence is lacking regarding the correct method of PDL removal and cementum surface treatment.