An In vitro comparison of coconut water, milk, and saline in maintaining periodontal ligament cell viability

D'Costa, Vivian Flourish; Bangera, Madhu Keshava; Kini, Shravan; Kutty, Shakkira Moosa; Ragher, Mallikarjuna

doi:10.4103/jpbs.jpbs_117_17

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…Storage techniques showing less benefit compared with milk on the preservation of tooth or cell viability are summarized in Table 3. Firstly, a meta‐analysis of six comparisons from three RCTs and two non‐RCTs involving 104 extracted teeth showed that the cell viability rate was significantly lower in extracted teeth stored in saline solutions for 30 to 120 minutes compared with those stored in milk (pooled SMD −4.35, 95% CI [−7.55;−1.14], P = .008) (Figure 2, comparison 1.1.4) 43,45–48 . The heterogeneity across the trials was substantial (non‐overlapping CIs, I 2 = 94%, and Chi 2 test P < .0001), and one study, Sunil et al, 47 showed that the teeth stored in saline solution had significantly higher cell viability rates compared with teeth stored in milk (SMD 3.81, 95% CI [2.00;5.62], P < .0001), in contrast to all other studies.…”

Section: Resultsmentioning

confidence: 99%

“…The effect of coconut water for storing extracted teeth also suffers from conflicting evidence originating from four RCTs including 96 extracted teeth. Three RCTs showed improved cell viability rates after storing extracted teeth for 45 minutes in coconut water compared with milk, 45,47,53 while the fourth RCT showed lower cell viability rates following storage in coconut water for 45 minutes 50 …”

Section: Resultsmentioning

confidence: 99%

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Storage of an avulsed tooth prior to replantation: A systematic review and meta‐analysis

Brier

Dorien

Borra³

et al. 2020

Dental Traumatology

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Background/Aim It is crucial to store an avulsed tooth appropriately to preserve the viability of the periodontal ligament cells prior to replantation. The aim of this systematic review was to identify the best available evidence for the effectiveness of any technique available to laypeople for storing an avulsed tooth compared with storage in milk or saliva. Methods The following databases were searched (September 2019): Cochrane Library, MEDLINE, and Embase. Two reviewers independently considered trial eligibility, then extracted and analyzed data, and assessed the risk of bias. The certainty of the body of evidence was appraised according to the GRADE methodology. Results Out of 4118 references, 33 studies were included and reported 23 comparisons of which 10 were synthesized in a meta‐analysis. The limited evidence available favors storing an avulsed tooth in Hank's balanced salt solution (pooled SMD 2.47, 95% CI [1.59;3.34], P < .00001), propolis solution (pooled SMD 1.73, 95% CI [1.12;2.33], P < .00001), oral rehydration salts (pooled SMD 4.16, 95% CI [2.10;6.23], P < .0001), rice water, and cling film compared with storage in milk. The cell viability rate was significantly lower in teeth stored in saline solutions (pooled SMD −4.35, 95% CI [−7.55;−1.14], P = .008), tap water, buttermilk, castor oil, GC Tooth Mousse, and turmeric extract than those stored in milk. There is insufficient evidence to recommend for or against temporary storage of an avulsed tooth in saliva compared with alternative solutions. The certainty of evidence was considered low to very low due to limitations in study design, indirect study populations and outcome measures, and imprecision. Conclusion Although milk was shown to extend the periodontal ligament cell viability before replantation compared with saline or tap water, the following media have also demonstrated efficacy at preserving the cell viability: Hank's balanced salt solution, propolis, oral rehydration salts, rice water, and cling film.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Storage of an avulsed tooth prior to replantation: A systematic review and meta‐analysis

Brier

Dorien

Borra³

et al. 2020

Dental Traumatology

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“…For the critical outcome of viability, as measured by the number or percentage of viable PDL cells, we identified very low-certainty evidence (downgraded for risk of bias, indirectness, and imprecision) from 3 RCTs demonstrating harm from immersion in buttermilk, 263 castor oil, 255 and turmeric extract. 264 (downgraded for risk of bias, inconsistency between trials, indirectness, and imprecision) from 6 RCTs 243,247,253,259,263,265,271 showing inconsistent evidence of benefit of coconut water and aloe vera when compared with milk. Furthermore, very low-certainty evidence (downgraded for risk of bias, indirectness, and imprecision) from 6 RCTs that did not demonstrate a benefit for viability from immersion in egg white, 244,248,259,271 epigallocatechin-3-gallate, 245 or neem extract (an evergreen tree extract) 264 compared with milk.…”

Section: Media Demonstrating Benefit Compared With Milkmentioning

confidence: 99%

2020 International Consensus on First Aid Science With Treatment Recommendations

Singletary¹,

Zideman²,

Bendall³

et al. 2020

Resuscitation

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This is the summary publication of the International Liaison Committee on Resuscitation's 2020 International Consensus on First Aid Science WithTreatment Recommendations. It addresses the most recent published evidence reviewed by the First Aid Task Force science experts. This summary addresses the topics of first aid methods of glucose administration for hypoglycemia; techniques for cooling of exertional hyperthermia and heatstroke; recognition of acute stroke; the use of supplementary oxygen in acute stroke; early or first aid use of aspirin for chest pain; control of life-threatening bleeding through the use of tourniquets, hemostatic dressings, direct pressure, or pressure devices; the use of a compression wrap for closed extremity joint injuries; and temporary storage of an avulsed tooth. Additional summaries of scoping reviews are presented for the use of a recovery position, recognition of a concussion, and 6 other first aid topics. The First Aid Task Force has assessed, discussed, and debated the certainty of evidence on the basis of Grading of Recommendations, Assessment, Development, and Evaluation criteria and present their consensus treatment recommendations with evidence-to-decision highlights and identified priority knowledge gaps for future research.The 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations (CoSTR) is the fourth in a series of annual summary publications from the International Liaison Committee on Resuscitation (ILCOR). This 2020 CoSTR for first aid includes new topics addressed by systematic reviews performed within the past 12 months. It also includes updates of the first aid treatment recommendations published from 2010 through 2019 that are based on additional evidence evaluations and updates.As a result, this 2020 CoSTR for first aid represents the most comprehensive update since 2010.

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“…We obtained 31 full texts to further verify their eligibility. After evaluating the full texts, 11 studies were excluded due to six reasons: ineligible topic (n = 5), no full text available (n = 1), duplicate records (n = 2), ineligible media (n = 1), ineligible outcome (n = 1), and inadequate data (n = 1), and then 20 eligible studies (6,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) including 31 reports were considered to be eligible for our inclusion criteria. The identification and selection of studies were Figure 1.…”

Section: Identification and Selection Of Studiesmentioning

confidence: 99%

“…Among the 20 included studies, only three studies (31,38,39) definitively reported the methods of generating random sequence, none of the studies (6,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) reported the details of performing allocation concealment, and all studies were rated as low risk of bias in incomplete data, selective reporting, and other bias domains. Overall, the level of risk of bias among all studies was considered to be moderate.…”

Section: Risk Of Biasmentioning

confidence: 99%

Network Meta-Analysis of 10 Storage Mediums for Preserving Avulsed Teeth

Zhang

Cheng

et al. 2021

Front. Med.

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Many storage mediums are available for the storage of avulsed teeth to preserve the viability of periodontal ligament (PDL) cells before replantation; however, it is unclear which medium is the optimal option. We performed this network meta-analysis to answer this question. A comprehensive search was conducted in PubMed, EMBASE, and the Cochrane library to capture eligible studies investigating the comparative efficacy of Hank's balanced salt solution (HBSS), aloe vera gel (AVG), oral rehydration solution (ORS), coconut water, egg white, green tea, propolis, saline, milk, and water. Statistical analysis was conducted using Review Manager v5.3 and ADDIS v1.16.8. In total, 20 RCTs involving 31 reports were included finally. Direct meta-analysis suggested that HBSS was superior to ORS, milk, saline, and water, ORS was superior to milk but inferior to coconut water and propolis, egg white was superior to milk but inferior to AVG and propolis, propolis was superior to AVG, milk, and saline, and coconut water and water was inferior to saline and milk, respectively. Network meta-analysis suggested that AVG was inferior to the other nine mediums, and propolis was superior to HBSS (SMD, −5260.24; 95% CrI, −10447.39 to −70.37) and milk (SMD, −5461.11; 95% CrI, −10574.99 to −328.51). Moreover, ranking probabilities indicated the highest probability for propolis, followed by saline, ORS, HBSS, milk, egg white, water, green tea, and AVG successively. Propolis may be the optimal media for storing avulsed teeth before replantation. However, given the availability of propolis and HBSS and the hypotonic properties of saline, ORS or milk should also be preferentially selected.

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An In vitro comparison of coconut water, milk, and saline in maintaining periodontal ligament cell viability

Cited by 9 publications

References 23 publications

Storage of an avulsed tooth prior to replantation: A systematic review and meta‐analysis

Storage of an avulsed tooth prior to replantation: A systematic review and meta‐analysis

2020 International Consensus on First Aid Science With Treatment Recommendations

Network Meta-Analysis of 10 Storage Mediums for Preserving Avulsed Teeth

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