Storage Media for Avulsed Teeth: Current Evidence, Biological Principles, and Future Perspectives

Tooth avulsion is among the most severe traumatic dental injuries, and successful replantation depends on preserving periodontal ligament (PDL) cell viability during extra-alveolar time. When immediate replantation is not feasible, the avulsed tooth should be placed in an appropriate storage medium to maintain cellular viability and prevent root surface desiccation. Thus, selecting an appropriate storage medium is critical to preventing PDL breakdown, ankylosis, and root resorption. This review provides an updated overview of storage media for avulsed teeth, outlining physiological requirements, mechanisms of action, and comparative performance of conventional and experimental solutions. Advances in cell culture methods, biomarker profiling, and genomic analyses have clarified cellular responses under storage conditions, supporting the development of biomimetic and nanotechnology-based media. This review underscores the need for timely intervention, proper handling, and evidence-based medium selection for successful replantation. Future research should prioritize clinical trials, protocol standardization, and next-generation biologically active and patient-specific media to improve long-term outcomes.