الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
The marginal periosteal pedicle graft has been suggested to provide complete coverage and protection of the intrabony defect maintaining the periodontal defect space for repopulation by regenerating periodontal tissues. It was thought to provide adequate blood supply rich in growth factors and osteoprogenitor cells, which might differentiate into cementoblasts upon contact with the root surface or increase the number of fibroblast in the connective tissue filling the defect. The aim of this study was to evaluate the healing potential of the marginal periosteal pedicle (MPP) graft versus collagen membrane through estimation of TGF-β1 in GCF in management of intrabony defects. Materials and Methods: Twenty-five patients participated in this study (both males and females), 10 healthy volunteers (group C) and 15 patients with severe chronic periodontitis were selected with at least two sites with (PPD) ≥ 6 mm and CAL≥ 5 mm, with 2- or 3-wall intrabony defect depth ranging from 3 to 6 mm. The facial surface of teeth adjacent to the interproximal defect were free of extensive recession and marginal bone loss, with at least a 4 to 5 mm band of keratinized gingiva to allow for periosteal manipulation.In a split mouth design, patients with residual pockets ≥ 5mm were divided into 2 groups, group (A) and (B).Group (A) was treated by OFD with marginal periosteal pedicle graft defect coverage used as an autogenous membrane for guided tissue regeneration Group (B) was treated by OFD and a collagen membrane was adapted on the intrabony defect to act as a guided tissue membrane.GI, PI, PPD and CAL were measured at baseline then 3 months postoperatively in both groups.In groups A and B the GCF samples were collected immediately before surgery (baseline)and at 1, 2 weeks and 3 months post-surgery. Results: Comparing the percentage reduction in PPD and percentage gain in CAL in the two treated sites, there was no statistically significant difference between the two treatment modalities after three months (P=0.501) and (P =0.704) respectively. There was no statistically significant difference in GCF-TGF-β1 levels at 1 week between group A and group B as well as control group with no statistically significant difference in GCF TGF-β1 levels between group A at 2 weeks as well as 3 months when compared to control values. However, at 2 weeks and 3 months group B showed statistically significant higher GCF-TGF-β1 levels than corresponding values in group A and control group (P< 0.001).Conclusion : GCF TGF-β1 level changed after GTR with fluctuating levels. However, at what stages of periodontal healing TGF-β1 exerted pro- or anti- inflammatory role remains to be elucidated.