Acemannan induces rapid early osseous defect healing after apical surgery: A 12-month follow-up of a randomized controlled trial

Abstract

Background/purpose Acemannan is an osteoinductive material. This study's objective was to compare the outcomes of bone defect healing using 3-dimensional images after apical surgery with or without adding acemannan sponges. Materials and methods Twenty-two anterior teeth from 9 males and 13 females requiring apical surgery were included in this randomized controlled trial. Post-surgery, the bone defects were randomly divided into three groups: blood clot control, 5-, or 10-mg acemannan sponge groups. CBCT scans were taken immediately (baseline), 3-, 6-, and 12-month post-surgery. Sagittal serial sections (1 mm thick slices parallel to the long axis of the tooth) of the defect image were created. The defect boundary was located and the total bone defect volume (BDV) was calculated from the sum of the volume of the serial defect sections. The bone healing was assessed by the percentage of total bone defect volume reduction (%ΔBDV). The paired t-test and one-way ANOVA were used to analyze the differences within each group and between groups, respectively. Results The baseline mean BDV of the control, 5-, and 10-mg acemannan groups were not significantly different ( p > 0.05). After treatment, the mean BDV for each group was reduced in a time-dependent manner. Compared with the control group, the 5- and 10-mg acemannan groups had a significantly greater %ΔBDV (approximately 2- and 1.89-fold) at 3-months post-surgery, respectively ( p < 0.05). However, at the 6- and 12- month follow-up, the %ΔBDV was not significantly different between the groups. Conclusion These data suggest acemannan enhanced early bone healing after apical surgery.

Synthetic Calcium–Phosphate Materials for Bone Grafting

“…Furthermore, two randomized controlled trials with 3- and 12-month follow-ups evaluated the effects of acemannan gel treatment on bone regeneration after tooth extraction and apical surgery, respectively. X-ray studies revealed that the administration of acemannan gel significantly improved the rate of bone wound healing without any reported side effects [ 383 , 384 , 385 ]. These findings highlight the potential of acemannan as a beneficial agent in promoting bone healing and regeneration in dental applications.…”

A New Biomaterial Derived from Aloe vera—Acemannan from Basic Studies to Clinical Application

“…In addition, Le Van et al applied AC in the study of bone healing during apical surgery. It was found that, at 3 months after surgery, the osteogenesis rate in the AC group had a faster osteogenic rate in the surgical area, and the percentage of total bone defect volume reduction (%ΔBDV) was significantly increased ( Figure 10 C) [ 102 ]. Moreover, in clinical practice, AC in the form of SaliCept patches has been found to reduce the incidence of common complications such as alveolar osteitis in tooth extraction and was more effective than clindamycin-soaked gelatin sponges [ 103 ].…”

Potential Combination of Acemannan Sponge and Calcium Phosphate Cement-Calcium Sulfate Hemihydrate (CPC-CSH) as Direct Pulp Capping Alternative Materials for Reparative Dentin Formation

“…25 Acemannan is a polymannose acetate molecule B-(1-4) produced from aloe vera gel extract. 26 The main components of the acemannan molecule are mannose (57-77%), glucose (15-22%), and galactose (5-7%), forming a chain of repeating tetrasaccharide units o-(acetyl mannose)-o-(acetyl mannose)-o -(glucose)-o-(acetyl mannose) of four mannose residues in single-branched galactose on the second or fourth. 25 Acemannan material has been widely used for pharmacology from biology to medicine and industry, such as for the treatment of oral, metabolic, cardiovascular, and tumor diseases.…”