Novel acemannan-integrated bioceramic for enhancing human dental pulp stem cell viability and transforming growth factor beta-1 release in pulp regeneration

Context: Vital pulp therapy (VPT) preserves pulpal vitality by utilising bioactive materials that promote cell survival and regeneration. Calcium phosphate cement (CPC) and calcium sulfate hemihydrate (CSH) are biocompatible and osteoinductive, while acemannan, a polysaccharide from Aloe vera, exhibits immunomodulatory and regenerative properties. Their combination may synergistically enhance pulpal healing. Aims: This study evaluates the effects of a novel acemannan-integrated CPC-CSH (CPC-CSH-Ace) bioceramic on pH, human dental pulp stem cells (hDPSCs) viability, and transforming growth factor beta-1 (TGF-β1) release. Settings and Design: An in vitro experimental study conducted at ProSTEM (Prodia StemCell) Indonesia. Subjects and Methods: CPC and CSH were combined with 3%, 5%, and 10% acemannan to form test group with NeoPutty and EndoCem Mineral Trioxide Aggregate as controls. pH was measured at 3, 24, and 72 h. hDPSCs viability (%) was assessed using MTT assays at 24 and 72 h, and TGF-β1 levels (pg/mL) quantified by Enzyme-Linked Immunosorbent Assay after 7 days. Data were analysed using one-way analysis of variance followed by Tukey's post hoc test (P < 0.05). Results: The CPC-CSH-Ace 3% group showed the highest cell viability at both 24 and 72 h (P < 0.05) and significantly increased TGF-β1 release (P < 0.05). This upregulation of TGF-β1 represents a key biological signal that promotes odontoblast proliferation and reparative odontogenesis - essential processes for successful pulp capping. All CPC-CSH-Ace groups displayed a slightly alkaline pH conducive to proliferation. Conclusions: The CPC-CSH-Ace 3% formulation showed superior bioactivity, indicating its potential as a novel material for VPT.