CASE REPORT


Clinical and Radiographic Evaluation of Combined Acemannan and Periodontal Surgery Induced-Periodontal Regeneration: 5-Year Follow-up Case Report



Rutchanoo Chansamart1, Polkit Sangvanich2, Pasutha Thunyakitpisal3, 4, *
1 Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand
2 Department of Chemistry, Faculty of Sciences, Chulalongkorn University, Bangkok 10330, Thailand
3 Department of Anatomy, Research Unit of Herbal Medicine, Biomaterial and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
4 Institution of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand


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Creative Commons License
© 2023 Chansamart et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Research Unit of Herbal Medicine, Biomaterial and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand. Tel. +662-2188899, Fax. +662-2188899, Current address: Institution of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand; Tel: +6681-713-3311; Fax: +664-4224070, Emails: pthunyak@yahoo.com, Pasutha@sut.ac.th


Abstract

Background and Objective:

Acemannan, a polysaccharide extracted from aloe vera gel, accelerates oral wound healing, reparative dentin formation, and bone formation in extraction sockets. In this report, we evaluated the efficacy of combined acemannan and periodontal surgery on periodontal regeneration in severe periodontitis cases requiring periodontal surgery.

Case Presentation and Discussion:

Three chronic periodontitis patients with probing pocket depths of at least 6 mm and two- or three-walled vertical bone defects after initial periodontal therapy were included. The patients underwent minimally invasive periodontal surgery with acemannan sponges placed in the defect. Maintenance recall was scheduled every 6 months for 5 years. Clinical and radiographic evaluations were performed to assess the effects of the combined acemannan and periodontal surgery on periodontal regeneration. The patients demonstrated improved clinical parameters and increased radiographic bone fill at the 5-year follow-ups. The percentage bone fill in the three-walled defect, combined two- and three-walled defect, and two-walled defect cases were 70%, 60%, and 20%, respectively. The underlying mechanism of action of acemannan in periodontal regeneration was also discussed.

Conclusion:

Acemannan sponges can be used as an adjunct to periodontal surgery for periodontal regeneration.

Keywords: Acemannan sponge, Infrabony pocket, Bone formation, Periodontal regeneration, Radiograph, Case report.