الفهرس 
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Abstract
Summary
This study is performed to evaluate Pulpine Mineral and Pulpine NE materials in immature permanent teeth after pulpotomy, regarding: Histopathological response (Hard tissue formation,Inflammatory cell count), Immunohistochemical reaction with Osteopontin marker and their physical properties.
Materials and Methods:
I-In vivo study: A total of 6 mongrel dogs (12 teeth/dog) were selected for the study, randomly divided into 3 equal study groups, according to the post treatment evaluation period; GP1 10, 30 and 90 days, each main group was subdivided according to the materials used; 2 experimental groups (PMIN, n=8 and PNE, n=8) and one control group (MTA, n=8).
Pulpotomy technique was accomplished. Capping materials were mixed according to manufacturer’s instructions, then finally stored with resin reinforced glass ionomer (RIVA)
Methods of evaluation classified to quantitative evaluation (inflammatory cell count, dentin bridge formation) using Image J analysis software and qualitative evaluation (inflammatory cell infiltration, calcific barrier continuity) using scoring systems.
For immunohistochemical interpretation, after 90 days the specimens were incubated with the primary antibody goat anti-OPN, the most homogenous areas of the reaction were chosen for the automated measuring of area percent of the positive reaction using Leica software.
II-In vitro study:
1-Solubility was recorded by the percentage of material mass loss over time, by using Split Teflon ring molds containing tested materials for 24hrs and one week.
2-pH was recorded after each evaluation period using pH meter.
3-Radiopacity: The specimens with molds were digitally radiographed on a size 2 sensor plate along with an aluminum step wedge ranging from 1 to 5 mm thickness. Then images obtained were analyzed by the ImageJ software.
4-Discoloration: sound single-rooted maxillary or mandibular premolars human teeth were chosen, Color values were measured using the VITA Easy Shade spectrophotometer, using the Commission Internationale de l’eclairage (CIE) L* a* b* equation.
I-Histopathological results:
1-Quantitative evaluations
For inflammatory cell count:
at 10 days; there was no statistically significant difference between all groups P=0.056, at 30 and 90 days; There was no statistically significant difference between MTA and PMIN, but high significant difference (P<0.000) was found between PNE and other groups.
For newly formed dentin bridge:
At 10 and 30 days follow up: there was no statistically significant difference among all groups but there was a statistically significant difference was found between PNE and 2 other groups at 90 days follow up.
2- qualitative evaluations:
For inflammatory cell infiltration:
There was no statistical significant difference between MTA, PMIN and PNE at 10 days (P=0.583), but significant difference was found between PNE and the other groups at 30 and 90 days (P=0.018 in 30 days and P=0.006 in 90 days).
For calcific barrier continuity:
there was no statistical significant difference between MTA and PMIN, but a high statistically significant difference was found between PNE and other groups at each time interval.
II-Immunohistochemical results:
MTA group showed the highest mean value of osteopontin+ve fraction area (4.660), followed by pulpine mineral (PMIN) group (4.130), the least mean value was recorded to pulpine NE (PNE) group (0.5333), with a statistically significant difference between PNE and both MTA, PMIN.
III-Physical test results:
1- For Solubility test, at 24hrs and one week the greatest mean percentage loss was recorded in PMIN group, followed by PNE group, and the least mean percentage was recorded for MTA group with no statistically significant difference between PMIN and PNE but a statistically significant difference was found between MTA and the other groups.
2- For pH: at 24hrs and one week, the greatest pH value was recorded to PMIN, followed by MTA, while the least value was recorded to PNE, with no statistically significant difference between MTA and PMIN, but a statistically significant difference was found between PNE and the other groups.
3-For Radiopacity test: the greatest mean value was recorded in the MTA group (165.17) which is equivalent to 5 aluminum step-wedge, followed by PNE (124.6) which is equivalent to 3 aluminum step-wedge which is the minimum radiopacity recommended by the American National Specification number 57, the least value was recorded by PMIN (38.47), which is equivalent to less than number one aluminum step-wedge.
4- For Discoloration test: the control group showed the least change in discoloration (ΔE= 3.9) followed by PMIN (ΔE =7.66) and MTA (ΔE =17.71), the highest value was recorded to PNE (22.14), with no statistically significant difference between MTA and PNE and also no significant difference between PMIN and control group.
Conclusion:
1-PMIN showed comparable results to that of MTA, regarding hard tissue formation and low pulpal inflammation.
2- PNE showed high pulpal inflammation and decreased hard tissue formation.
3-IHC test using Osteopontin marker revealed from moderate to high immunoreaction in MTA, followed by PMIN, while PNE showed very faint reaction.
3- PMIN showed the highest solubility value compared to that of MTA and PNE.
4- PMIN showed high pH value compared to PNE.
5-PMIN exhibited low radiopacity value below ISO 6876/2012, while PNE exhibited the least accepted value.
6- PMIN revealed the best discoloration value compared to MTA and PNE.
Recommendations:
we had some minor limitations, as we used sound teeth without signs of inflammation, although this increases the reliability of the study, it didn’t give information about the effects of these novel vital pulp therapy medicaments on carious teeth with different levels of inflammation.
Therefore we need to:
1- Establish the pulpotomy technique on inflammed pulp rather than sound pulp.
2-Perform the study on human rather than dog model.
3-Adding radiopacifier agent to PMIN to be clinically distinguishable