{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T23:27:28Z","timestamp":1782689248258,"version":"3.54.5"},"reference-count":43,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","award":["CU_GR_63_08_32"],"award-info":[{"award-number":["CU_GR_63_08_32"]}],"id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"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>","DOI":"10.3390\/pharmaceutics12070644","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T09:45:31Z","timestamp":1594374331000},"page":"644","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation"],"prefix":"10.3390","volume":"12","author":[{"given":"Tien Thuy","family":"Vu","sequence":"first","affiliation":[{"name":"Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Truong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Odonto-Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polkit","family":"Sangvanich","sequence":"additional","affiliation":[{"name":"Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0941-7318","authenticated-orcid":false,"given":"Quang Ngoc","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Communications and Computer Engineering, Faculty of Science and Engineering, Waseda University, Tokyo 169-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasutha","family":"Thunyakitpisal","sequence":"additional","affiliation":[{"name":"Research Unit of Herbal Medicine, Biomaterial and Material for Dental Treatment, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"ref_1","unstructured":"(2016). Guideline on pulp therapy for primary and immature permanent teeth. Pediatr. Dent., 38, 280\u2013288."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1016\/j.joen.2008.02.030","article-title":"Vital pulp therapy with new materials: New directions and treatment perspectives\u2014Permanent teeth","volume":"34","author":"Witherspoon","year":"2008","journal-title":"J. Endod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.joen.2005.08.006","article-title":"The effects of various additives on setting properties of MTA","volume":"32","author":"Kogan","year":"2006","journal-title":"J. Endod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.joen.2017.10.012","article-title":"Outcomes of direct pulp capping by using either proroot mineral trioxide aggregate or biodentine in permanent teeth with carious pulp exposure in 6- to 18-year-old patients: A randomized controlled trial","volume":"44","author":"Parinyaprom","year":"2018","journal-title":"J. Endod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0192-0561(97)00010-6","article-title":"Upregulation of phagocytosis and candidicidal activity of macrophages exposed to the immunostimulant acemannan","volume":"19","author":"Stuart","year":"1997","journal-title":"Int. Immunopharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.jdermsci.2015.03.016","article-title":"Acemannan accelerates cell proliferation and skin wound healing through AKT\/mTOR signaling pathway","volume":"79","author":"Xing","year":"2015","journal-title":"J. Dermatol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jobcr.2020.01.005","article-title":"Evaluation of hydrophilic gel made from Acemannan and Moringa oleifera in enhancing osseointegration of dental implants. A preliminary study in rabbits","volume":"10","author":"Pachimalla","year":"2020","journal-title":"J. Oral Biol. Craniofac. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Liu, C., Cui, Y., Pi, F., Cheng, Y., Guo, Y., and Qian, H. (2019). Extraction, purification, structural characteristics, biological activities and pharmacological applications of acemannan, a polysaccharide from aloe vera: A review. Molecules, 24.","DOI":"10.3390\/molecules24081554"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.joen.2017.01.037","article-title":"Stimulation of dentin regeneration by using acemannan in teeth with lipopolysaccharide-induced pulp inflammation","volume":"43","author":"Songsiripradubboon","year":"2017","journal-title":"J. Endod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s10266-015-0215-4","article-title":"Clinical, radiographic, and histologic analysis of the effects of acemannan used in direct pulp capping of human primary teeth: Short-term outcomes","volume":"104","author":"Songsiripradubboon","year":"2016","journal-title":"Odontology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/jre.12090","article-title":"Acemannan sponges stimulate alveolar bone, cementum and periodontal ligament regeneration in a canine class II furcation defect model","volume":"49","author":"Chantarawaratit","year":"2014","journal-title":"J. Periodontal Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1007\/s10266-012-0101-2","article-title":"Effect of acemannan, an extracted polysaccharide from Aloe vera, on BMSCs proliferation, differentiation, extracellular matrix synthesis, mineralization, and bone formation in a tooth extraction model","volume":"102","author":"Boonyagul","year":"2014","journal-title":"Odontology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1089\/ten.tea.2009.0593","article-title":"Acemannan, an extracted product from Aloe vera, stimulates dental pulp cell proliferation, differentiation, mineralization, and dentin formation","volume":"16","author":"Jittapiromsak","year":"2010","journal-title":"Tissue Eng. Part A"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.carbpol.2016.12.034","article-title":"Acemannan increases NF-kappaB\/DNA binding and IL-6\/-8 expression by selectively binding Toll-like receptor-5 in human gingival fibroblasts","volume":"161","author":"Thunyakitpisal","year":"2017","journal-title":"Carbohydr. Polym."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bouman, A.C., ten Cate-Hoek, A.J., Ramaekers, B.L., and Joore, M.A. (2015). Sample size estimation for non-inferiority trials: Frequentist approach versus decision theory approach. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0130531"},{"key":"ref_16","first-page":"364","article-title":"Partial pulpotomy in immature permanent molars after carious exposures using different hemorrhage control and capping materials","volume":"39","author":"Ozgur","year":"2017","journal-title":"Pediatr. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.oooo.2015.07.033","article-title":"AAE and AAOMR joint position statement: Use of cone beam computed tomography in endodontics 2015 update","volume":"120","author":"Fayad","year":"2015","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1111\/iej.13187","article-title":"European society of endodontology position statement: Cone beam computed tomography","volume":"52","author":"Patel","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_19","first-page":"358","article-title":"Guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth","volume":"38","author":"DiAngelis","year":"2016","journal-title":"Pediatr. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"63","DOI":"10.5624\/isd.2013.43.2.63","article-title":"Patient radiation dose and protection from cone-beam computed tomography","volume":"43","author":"Li","year":"2013","journal-title":"Imaging Sci. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/iej.12225","article-title":"Randomized control trial comparing calcium hydroxide and mineral trioxide aggregate for partial pulpotomies in cariously exposed pulps of permanent molars","volume":"47","author":"Chailertvanitkul","year":"2014","journal-title":"Int. Endod. J."},{"key":"ref_22","first-page":"29","article-title":"Partial pulpotomy for immature permanent teeth, its present and future","volume":"24","author":"Fong","year":"2002","journal-title":"Pediatr. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.joen.2012.10.007","article-title":"Treatment outcome of mineral trioxide aggregate in open apex teeth","volume":"39","author":"Mente","year":"2013","journal-title":"J. Endod."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.dental.2007.04.007","article-title":"Mineral trioxide aggregate material use in endodontic treatment: A review of the literature","volume":"24","author":"Roberts","year":"2008","journal-title":"Dent. Mater."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"464280","DOI":"10.1155\/2009\/464280","article-title":"Reparative dentinogenesis induced by mineral trioxide aggregate: A review from the biological and physicochemical points of view","volume":"2009","author":"Okiji","year":"2009","journal-title":"Int. J. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1046\/j.1365-2591.2002.00471.x","article-title":"The dentinogenic effect of mineral trioxide aggregate (MTA) in short-term capping experiments","volume":"35","author":"Tziafas","year":"2002","journal-title":"Int. Endod. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jdent.2016.07.015","article-title":"randomized controlled trial of various MTA materials for partial pulpotomy in permanent teeth","volume":"60","author":"Kang","year":"2017","journal-title":"J. Dent."},{"key":"ref_28","first-page":"399","article-title":"Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis)","volume":"28","author":"Avery","year":"2006","journal-title":"Pediatr. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"305","DOI":"10.14219\/jada.archive.2008.0160","article-title":"Direct pulp capping with mineral trioxide aggregate: An observational study","volume":"139","author":"Bogen","year":"2008","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/j.carres.2005.02.016","article-title":"Chemical characterization of the immunomodulating polysaccharide of Aloe vera L.","volume":"340","author":"Williamson","year":"2005","journal-title":"Carbohydr. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.carbpol.2015.07.039","article-title":"Deacetylation affects the physical properties and bioactivity of acemannan, an extracted polysaccharide from Aloe vera","volume":"133","author":"Chokboribal","year":"2015","journal-title":"Carbohydr. Polym."},{"key":"ref_32","first-page":"149","article-title":"Effect of acemannan on BMP-2 expression in primary pulpal fibroblasts and periodontal fibroblasts, in vitro study","volume":"4","author":"Jittapiromsak","year":"2007","journal-title":"J. Oral Tissue Eng."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1365-263X.2008.00955.x","article-title":"Assessment of pulp vitality: A review","volume":"19","author":"Gopikrishna","year":"2009","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"365785","DOI":"10.1155\/2009\/365785","article-title":"Dental pulp testing: A review","volume":"2009","author":"Chen","year":"2009","journal-title":"Int. J. Dent."},{"key":"ref_35","first-page":"1","article-title":"Diagnostic aids in pediatric dentistry","volume":"4","author":"Gopakumar","year":"2011","journal-title":"Int. J. Clin. Pediatr. Dent."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.joen.2008.02.022","article-title":"Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery","volume":"34","author":"Low","year":"2008","journal-title":"J. Endod."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/aej.12217","article-title":"Clinical and histological responses of human dental pulp to MTA and combined MTA\/treated dentin matrix in partial pulpotomy","volume":"44","author":"Mehrvarzfar","year":"2018","journal-title":"Aust. Endod. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/iej.12270","article-title":"Cone beam computed tomography in Endodontics\u2014A review","volume":"48","author":"Patel","year":"2015","journal-title":"Int. Endod. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1016\/j.joen.2018.06.015","article-title":"A retrospective case series in regenerative endodontics: Trend analysis based on clinical evaluation and 2- and 3-dimensional radiology","volume":"44","author":"Meschi","year":"2018","journal-title":"J. Endod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.joen.2005.12.008","article-title":"A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth","volume":"32","author":"Qudeimat","year":"2006","journal-title":"J. Endod."},{"key":"ref_41","unstructured":"Berman, L.H., and Hargeaves, K.M. (2015). Pediatric endodontics: Endodontic treatment for the primary and yong permanent dentition. Cohen\u2019s Pathways of the Pulp Expert Consult\u2014E-Book, Elsevier. [11th ed.]."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.joen.2015.03.017","article-title":"Tomographic evaluation of reparative dentin formation after direct pulp capping with Ca(OH)2, MTA, Biodentine, and Dentin bonding system in human teeth","volume":"41","author":"Nowicka","year":"2015","journal-title":"J. Endod."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s00784-012-0794-1","article-title":"Color stability of white mineral trioxide aggregate","volume":"17","author":"Valles","year":"2013","journal-title":"Clin. Oral Investig."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/12\/7\/644\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:49:01Z","timestamp":1760176141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/12\/7\/644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,8]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["pharmaceutics12070644"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics12070644","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,8]]}}}