Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation

Abstract

<jats:p>Direct pulp-capping, a vital pulp therapy, is used to protect and preserve pulp vitality by applying a biomaterial on the pulp exposure site. Acemannan, a polysaccharide extracted from Aloe vera, induces osteodentin-bridge formation to cover the exposure site in vivo. We evaluated the effect of acemannan sponges on partial pulpotomized permanent teeth with caries or accident-induced pulp exposure (n = 50). After removing infected dentin and inflamed pulp tissue, the teeth were randomly divided into acemannan or control (mineral trioxide aggregate (MTA) groups (n = 25). The teeth were examined immediately after treatment (baseline) and at 6- and 12-month follow-ups for clinical and cone beam computed tomography (CBCT) examination. The three-dimensional tooth length and root apex area were simulated to determine treatment success. We found that the overall success rate in the acemannan and MTA groups from baseline to 12-month follow-up was 90.91% and 95.65%, respectively, with no significant difference between the two groups (p &gt; 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p &lt; 0.05), indicating continued root formation. Our results suggest that acemannan is a promising low-cost biomaterial for partial pulpotomy treatment for immature permanent teeth requiring vital pulp therapy.</jats:p>

Effectiveness of Three Agents in Pulpotomy Treatment of Permanent Molars with Incomplete Root Development: A Randomized Controlled Trial

“…Immature permanent teeth present a fragile root with open apices. The primary aim of vital pulp treatment of these teeth is to ensure the complete root apex formation and reinforcing the root walls [ 45 , 49 ]. Pulpotomy, a type of VPT, is considered the suitable procedure for an immature permanent tooth with exposed pulp due to a deep caries or trauma [ 8 , 9 , 10 , 11 , 36 ].…”

Pulse Oximetry and Three-Dimensional Analysis in Evaluating Immature Permanent Teeth Apexogenesis: Two Case Reports

“…In animal and clinical studies, acemannan induced osteo-dentin bridge formation with vital pulp tissue beneath it [10,11]. Therefore, acemannan would be an alternative implantable biomaterial to promote pulp healing for vital pulp therapy similar to MTA and Biodentin [12].…”

Calcium silicate and calcium aluminate cements for dentistry reviewed

“…Calcium hydroxide (Ca(OH) 2 ) has been considered the "gold standard" of direct pulp capping materials in permanent teeth, against which new materials should be tested although a wide variety of materials have been used for direct pulp capping. 68,253,254 Pulp-capping clinical studies have shown equal 255 or more successful results for the calcium silicate cements compared to calcium hydroxide dressings. 102,104,[256][257][258][259][260] Calcium hydroxide itself does not set, unlike the calcium silicate cement products.…”