الفهرس 
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Abstract
Background: Periodontal disease is a chronic inflammatory condition and is initiated by accumulation of bacterial plaque, which induces an inflammatory response. Destruction of the protective components of the periodontium by bacterial virulence mechanisms results in the exposure of cells and underlying tissues to bacterial agents and initiation of a number of destructive processes.(1) .Visfatin known as pre–B-cell colony-enhancing factor, is a pleiotropic adipokine that plays roles in many processes, including insulin mechanisms, apoptosis, and inflammation regulation.(2). Visfatin, which is thought be involved in the pathogenesis of systemic diseases such as diabetes,(3) cardiovascular diseases,(4)[ and rheumatoid arthritis,(5) induces proinflammatory cytokines such as tumor necrosis factor-a, interleukin (IL)-1b, and IL-8 (6). Boric acid are considered as quinoline esters which are a recent detected class of new antibacterial compounds which contains boron(7). It was found that the periodontal clinical parameters are significantly reduced by the use of boric acid (0.75%) subgingival irrigation as an adjunct to mechanichal therapy (8). Objective: The aim of this study was to evaluate the level of visfatin in GCF in chronic moderate periodontitis patients before and after application of boric acid gel as an adjunct to non-surgical periodontal treatment . Subjects and Methods: A total of forty The aim of this study was to evaluate the level of visfatin in GCF in chronic moderate periodontitis patients before and after application of boric acid gel as an adjunct to non-surgical periodontal treatment. subjects were selected and grouped as follow; group I, included fifteen moderate chronic periodontitis patients as study group who received SRP and topical application of boric acid gel, group II included fifteen chronic periodontitis patients as positive control group who received SRP and topical application of placebo gel and group III included ten systemically and clinical periodontal healthy subjects. During treatment, patients were instructed to establish good oral hygiene by daily tooth brushing and flossing. Clinical periodontal parameters (plaque index, gingival index, periodontal pocket depth and clinical attachment level) were recorded at baseline for all groups and eight weeks after nonsurgical periodontal therapy for the study and positive control groups. Visfatin concentration was measured in gingival crevicular fluid samples which were collected from the study and positive control groups at baseline and eight weeks after SRP while were collected from the healthy group only once at baseline. The GCF samples were analyzed using ELISA method to evaluate visfatin concentration. Results: Analysis of visfatin in gingival crevicular fluid at base line showed significantly higher levels in chronic periodontitis patients as compared to the clinical healthy group. In addition, these levels declined significantly eight weeks after periodontal treatment in both periodontitis groups (study and control) with higher improvement in the periodontal status of the study group as judged by the clinical parameters. The levels of GCF visfatin were significantly higher in chronic periodontitis patients than clinical healthy group, and decreased significantly after treatment. Conclusions: GCF Visfatin is considered as a potential biomarker for assessment of periodontal disease treatment, Boric acid gel has significant decreasing effects on periodontal inflammation, so boric acid could be considered to be effective local delivery drug for management of chronic periodontitis with minimal side effects.