الفهرس 
Chronic PeriodontitisOnly 14 pages are availabe for public view
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Abstract
Background: chronic periodontitis is a bacterially induced inflammatory disease. The immune response plays a major role in alveolar bone destruction observed in such disease entity. Handling of the immune response to suppress unwanted reaction is desirable in conditions such as autoimmunity and allergy so strategies to achieve modulation of host response were developed. Host modulation therapy was proposed as a treatment for periodontal disease. Resveratrol which is a natural polyphenol, has several biologic effects such as antioxidant, anticancer, anti-inflammatory, immunomodulatory and bone protective effect, so it may have a role in treating of periodontitis. The aim of this randomized controlled study is to evaluate and compare the clinical immunemodulatory effect of systemic versus local delivery controlled release application of resveratrol as an adjunct to conventional periodontal treatment of moderate to severe chronic periodontitis .and to Test the systemic effect of resveratrol experimentally on an induced periodontitis for albino rats. Materials and Method:1- Human Part: Thirty subjects with moderate to severe chronic periodontitis were divided randomly into 3 groups. group I: received local resveratrol + scaling and root planing (SRP), group II: received systemic resveratrol + SRP and group III (control): received SRP only. Assessment of the following parameters were done: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), radiographic bone density (BD) and gingival crevicular fluid interleukin 17 level (IL-17) by enzyme-linked immunosorbant assay (ELISA) at 1month, 3months & 6months. 2Experimental part: The experimental study was applied on induced periodontitis in rats. Animals were randomly divided into 3 groups. GPI: Negative control (normal), GPII: Positive control (with induced periodontitis), GP III: In which periodontitis was induced& systemic resveratrol was administrated (10mg/kg for 30 days). All groups were evaluated by light microscope by histomorphometric analysis & scanning electron microscope (SEM) comparison between normal (-ve control group), periodontitis (+ve control group) and systemic resveratrol group Results: Regarding the mean differences of PI there were no statistical significant (St.sig) differences between GPI&GPII and between GPII&GPIII after 1,3 and 6months.While there were St.sig differences between GPI&GPIII after 1 and 3 months at P≤0.05.Regarding the percentage of change of PI St.sig differences were found between GPI &GPII after 3months and between GPI &GPIII after 1,3 and 6months.While no St.sig differences between GPII&GPIII after 1,3 and 6months and between GPI&GPII after 1and 6months. Regarding the mean differences and percentage of change of GI there were St.sig differences between GPI&GPII after 1 and 3months while no St.sig differences between them at 6 months. Additionally, St.sig differences were found between GPI&GPIII after 1,3 and 6months at P≤0.05. While there were no St.sig differences between GPII&GPIII after 1,3 and 6 months at P=0.05. Regarding the mean differences of PD there were St.sig differences between GPI&GPII after 1and 3months and between GPI&GPIII after 1,3 and 6months.Moreover, St.sig differences were found between GPII&GPIII after 1and 6months. While no St.sig differences were found between GPII&GPIII after 3 months and between GPI&GPII after 6months at P=0.05. Regarding the percentage of change of PD St.sig differences were found
between GPI &GPIII after 1,3 and 6months, between GPI &GPII after 6months and between GPII&GPIII at 1 and 6months.While no St.sig differences were found between GPI&GPII after 1 and 3months and between GPII&GPIII after 3months. Concerning the mean differences of CAL there were St.sig differences between GPI&GPIII and between GPII&GPIII after 1,3months and 6months.Moreover, there were St.sig differences between GPI&GPII after 1 and 3 months at P≤0.05 while no St.sig differences between GPI&GPII after 6 months. Regarding the percentage of change of CAL St.sig differences were found between GPI &GPII, between GPI &GPIII and between GPII& GPIII after 1,3 and 6months at P≤ 0.05. Quantitative image analysis results showed bone density improvement in all treatment modalities from baseline to 6 months with statistically significant difference at P≤ 0.05 .Regarding the mean differences and percentage of changes of BD a St.sig difference was found between all groups after 1 and 6 months in the favor of GP I (local resveratrol group+ SRP) .Regarding the mean of IL 17, results showed no St.sig difference between GPI &GPII and between GPII&GPIII at 1,3 and 6 months. While a St.sig was found between GPI&GPIII at 1,3 and 6months.Regarding the mean differences and the percentage of change of IL 17 there were St.sig differences between GPI&GPIII and between GPII&GPIII after 1,3months and 6months.Moreover, there were St.sig differences between GPI&GPII after 1month at P≤0.05 while no St.sig differences between GPI&GPII after 3and 6 months. Experimental Results: showed that systemic resveratrol group significantly increase number of osteoblasts and non significantly decrease number of osteoclasts. Moreover, Resveratrol decrease the alveolar bone loss highly significantly proved by measuring the distance from CE-J to the alveolar crest as compared to normal group (negative control) and periodontitis group (positive control) Conclusion: from the results we may conclude that resveratrol has a benefit in the treatment of moderate to severe chronic periodontitis patients as an adjunctive therapy to scaling &root planing. Resveratrol has an immune-modulatory effect through inhibition of gingival crevicular fluid IL-17& has a role in decreased bone loss in chronic periodontitis patients. Newly developed formulation of local delivery of resveratrol microbeads overcome the low bioavailability of systemic resveratrol