Root surface treatment for delayed replantation of avulsed teeth in animal models: a systematic review

The aim of this study was to perform a systematic review of the in vivo effectiveness of different types of root surface treatment materials used in delayed replanted teeth following tooth avulsion in animal models. A systematic review was conducted according to the PRISMA statement. Two reviewers performed a database search for studies published between January 1966 and April 2019 which were indexed in the PubMed, Scopus, and Bireme databases. Studies performed in vivo, in animal models with an avulsion/delayed replantation design ([≥] 20 min of extra oral dry time) that evaluated the use of different materials for root surface treatment were included. The assessment for risk of bias was performed following recommendations included in Cochrane handbook for systematic reviews of interventions. We found 21 types of materials used for root surface treatment alone and 29 materials used with associations. Stannous fluoride, sodium fluoride, citric acid, doxycycline, Emdogain, alendronate, minocycline, Odanacatib, MFR buffer, recombinant human bone morphogenetic protein, gallium nitrate, acidulated phosphate fluoride, vitamin C, propolis, zoledronic acid, diode laser, indomethacin, fibrin sealant, adipose-tissue derived stem cells treatment and basic fibroblast growth gel. After Grading of Recommendations Assessment, Development, and Evaluation, four studies were scored as low quality of evidence, fifteen studies with moderate quality and six with high quality of evidence. Meta-analysis was not performed due to heterogeneity among studies and materials used for root surface treatment and therefore it was not possible to ascertain which material or protocol present better efficacy when used as root surface treatment material.