Abstract
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 > 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p < 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.
Highlights
Dental caries is a major oral health problem, especially in developing countries
The aim of this study was to verify the effectiveness of acemannan by comparing its impact to that of mineral trioxide aggregate (MTA) on partial pulpotomy in immature permanent teeth using a three-dimensional (3D) approach with cone beam computed tomogramphy (CBCT)
There was no significant difference between the overall success rates of the acemannan and MTA groups at 12-months post-treatment (p > 0.05) (Figure 2)
Summary
When the pulp is exposed due to caries, trauma, or mechanical excavation, the appropriate treatment, i.e., vital pulp therapy or root canal treatment, has to be determined. A vital pulp therapy treatment, is generally regarded as the treatment of choice for immature teeth with exposed pulp tissue [2]. Mineral trioxide aggregate (MTA) is widely used as the material of choice for pulp capping [2]. This material has several disadvantages, such as difficult handling, long setting time [3], and high cost for developing countries [4]. Due to direct contact with vital tissue, capping biomaterials must be biocompatible, implantable, and demonstrate a regenerative effect in vitro and in vivo; especially in a clinical trial compared with a suitable control material as the definitive study
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