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

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.