Acemannan-induced tooth socket healing: A 12-month randomized controlled trial.

BACKGROUND/PURPOSE: Natural compounds have become alternatives for bone regeneration. Acemannan, the main polysaccharide extracted from Aloe vera, has been demonstrated as a promising osteoinductive material in vitro and in vivo. This clinical study investigated the effect of acemannan on tooth socket healing. MATERIALS AND METHODS: Thirty-five otherwise healthy patients, 18-25 years old and diagnosed with horizontal or vertical partial impaction of the lower third molars, were enrolled in this randomized controlled trial. After removing the teeth, the sockets randomly received one of the following treatments: spontaneous blood-clotting (control), 20 mg acemannan sponge, or 50 mg acemannan sponge. Cone-beam computed tomography of the mandible was performed immediately (baseline), and at 3-, 6-, and 12-months postoperatively; the data were analyzed using the OsiriX MD program. Bone healing in the socket was determined measuring the socket volume. One-way ANOVA was used to analyze the differences within each group and between groups. RESULTS: Thirty-five patients with 43 partially impacted lower third molars participated in this study. No patients exhibited alveolar osteitis or secondary infection. Compared with baseline, all groups showed significant reduction in socket volume at all observation time-points (p < 0.05). The 50 mg acemannan group had a significantly greater reduction in socket volume compared with the control at all postoperative time-points (p < 0.05). The 20 mg group had a significantly greater reduction in socket volume compared with the control at 3-months postoperatively (p < 0.05). CONCLUSION: We conclude that acemannan increases bone healing at 3-, 6-, and 12-months after removal of partially impacted mandibular third molars.

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

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.

Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus.

BACKGROUND: The aim of the present study is to determine the relationship between dental findings and mucosal abnormalities of the maxillary sinus among dental patients, using cone-beam computed tomography (CBCT). METHODS: Two hundred fifty CBCT scans of dental patients were studied. Dental findings of the upper posterior teeth, including periodontal bone loss, periapical lesions, and root canal fillings, were assessed. The presence of mucosal thickening and mucosal cysts of the maxillary sinus was recorded. Logistic regression analysis was used to determine the influence of periodontal bone loss, periapical lesions, and root canal fillings on these sinus mucosal abnormalities. RESULTS: Mucosal thickening was present in 42% of patients and in 29.2% of sinuses studied. Mucosal cysts were observed in 16.4% of patients and in 10% of sinuses studied. Both abnormalities were present more frequently among males than females. Severe periodontal bone loss was significantly associated with mucosal thickening (odds ratio: 3.02, P <0.001), whereas periapical lesions and root canal fillings were not. There was no association between dental findings and mucosal cysts. CONCLUSIONS: Severe periodontal bone loss was significantly associated with mucosal thickening of the maxillary sinus. Sinuses with severe periodontal bone loss were three times more likely to have mucosal thickening. Mucosal cysts were not associated with any dental findings.