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Abstract Mahmoud Ahmed Abdo Saeed; A Comparative Study for positive predictive healing potentiality of Cryopreserved Human Treated Dentin Matrix Scaffold versus Tri-Calcium Silicate Based Cement on Direct Pulp Capping in Mongrel Dogs.(An Animal Study) Under supervision of Mona Mohamed Abo El Fotoh, Rabab Tawfik Mubarak and Mohammed El Awdy Grawish Aim: The aim of the study was to compare the in vivo positive predictive healing potentiality of cryopreserved human treated dentin matrix (ChTDM) scaffold and tri-calcium silicate based cement on direct pulp capping in mongrel dogs. Methodology: Fourty sound and fully erupted premolars scheduled to be extracted for orthodontic treatment were involved for the ChTDM scaffolds preparation. The validity of the ChTDM scaffold as a DPC material was investigated in vitro and in vivo. In the animal study, mechanical pulp exposures were performed in the upper and lower anterior teeth of eight mongrel dogs. The dogs were randomly divided according to the follow-up periods into two equal groups; group I after 3days and group II after 3months. The involved teeth were examined histologically for investigating the acute inflammatory response after 3days, while the chronic one and dentin-pulp complex regeneration were investigated after 3months. The in vitro analysis of the ChTDM scaffold surface was carried out by studying the surface topography, the surface roughness, and surface wettability. However, the chemical characterization was performed through studying the elemental analysis, alkalinity test, and immunohistochemical analysis using IL-6, PDGF, and TGF-β antibodies. The biological characterization was investigated through studying its antibacterial test, Trans-well migration test, and cellular biocompatibility test. vii Results: The results of the animal study; the histological examination of MTA group after three days revealed score 1 (mild) and score 2 (moderate) acute inflammatory response. However, the ChTDM group revealed score 0 (none) inflammatory response. Regarding the chronic pulp inflammatory response after three months, MTA group showed score 1 (mild) inflammatory response. However, ChTDM group scaffolds score 0 (none) inflammatory response. According dentin-pulp complex regeneration, the MTA group was occurred by forming a calcific bridge without any distinct structures towards the pulp chamber. However, the ChTDM group showed the healing at the exposure site by formation of new pulp tissue along the ChTDM scaffold towards the exposure site with a distinct odontoblastic layer. The results of in vitro characterization; the surface characterization of the ChTDM scaffolds revealed a nano-tubular pattern with high surface wettability. However, chemical characterization revealed optimum partial demineralization and alkalinity of ChTDM scaffolds. Moreover, the biological characterization of ChTDM scaffold reported its antibacterial activity, cellular biocompatibility, and migration potentiality. Conclusion: ChTDM scaffold is a novel promising substitution for the tri-calcium silicate based cement as a DPC material. The surface, chemical, and in vitro characterization of ChTDM scaffold exhibited that it is an excellent nano-environment for DPSCs migration, attachment, proliferation, and odontogenic differentiation. The ability of ChTDM scaffold to optimize the mineralization process at the physiologic level makes it a reasonable natural substitute for the tri-calcium silicate based cement. Besides, its superiority in directing the healing process towards the exposure site rather than the residual pulp tissue avoiding pulp chamber obliteration. The in vivo investigation of the ChTDM scaffold revealed its higher positive predictive healing potentiality in iatrogenic pulp exposure as compared to MTA. ChTDM scaffold provides optimum pH favorable for odontogenesis process as compared to MTA. Clinically, ChTDM scaffold solved the problem of time-consuming direct pulp procedures. Superior antibacterial activity of ChTDM scaffold as compared to MTA. from the present work we recommend further clinical investigations have to be carried out since this work was done under optimal circumstances where all viii teeth used were intact as well as the capped pulps were healthy when exposed. For a precise understanding of the healing mechanism by ChTDM scaffold, further researches are recommended at different intervals. Conducting further researches to determine the expiry date of ChTDM scaffold efficiency. Further studies are recommended for acquiring the ChTDM scaffold a bactericidal effect without decreasing its cellular biocompatibility. |