Transport media for avulsed teeth: A review

Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long-term prognosis and survival of these teeth. The use of an inappropriate transport or storage medium potentially increases the risk of PDL cell necrosis, which can result in ankylosis and replacement resorption of the tooth root. Considering the critical role of these media, an informed choice of a suitable medium is essential for a favourable outcome. The literature regarding transport media for avulsed teeth was reviewed using PubMed/MEDLINE up to February 2010. This review outlines the common storage media that are available and highlights their specific features or problems. Although HBSS, ViaSpan and Eagle's medium have great potential to maintain the PDL cells in a viable state after avulsion, the practicalities of using these solutions, the costs and the lack of ready availability to the general public make them less than ideal. Milk remains the most convenient, cheapest and readily available solution in most situations while also being capable of keeping PDL cells alive. Hence, milk remains the storage medium of choice for avulsed teeth that cannot be replanted immediately or very soon after the avulsion.