الفهرس 
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)
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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.
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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
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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.