الفهرس 
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Abstract
Objective: The aim of the study is to evaluate the effect of hyaluronic acid (HA) in combination with Beta-tri-calcium phosphate (𝛽TCP) in treatment of vertical bone loss in periodontitis patients clinically and radiographically. Methods: A total of forty patients with age range from 24-55 years old were diagnosed as stage III & grade B periodontitis and showed radiographic bone loss ≥5mm with vertical infrabony defects. The patients were divided into four groups. group I was treated with combination of hyaluronic acid (HA) and Beta-tri-calcium phosphate (𝛽TCP). group II was treated with HA alone, group III was treated with 𝛽TCP alone and group IV was treated by open flap debridement using minimally invasive surgical technique. Clinical periodontal parameters (plaque index PI, gingival index GI, clinical probing depth PD, clinical attachment level CAL) were also taken from each patients at baseline, 3 months and 6 months after treatment. Periapical radiograph was also taken for each patient to evaluate the radiographic bone level change before and after treatment. The radiographs were taken with the same timing interval as the clinical parameters. Result: the mean value of plaque index (PI) at the baseline before surgery was 1.34±0.32, after 3 months after surgery it was 0.43±0.22 while after 6 months it was 0.39±0.19. The mean value of gingival index (GI) at the baseline before surgery was 1.47±0.25, after 3 months after surgery it was 0.53±0.23 while after 6 months it was 0.516±0.22. The mean value of clinical probing depth (PD) at the baseline was 7.50±1.58, after 3 months after surgery it was 5.20±1.39 while after 6 months it was 2.60±1.51. The mean value of clinical attachment level (CAL) at the baseline before surgery was 8.0±1.76, after 3 months after surgery it was 5.0±1.7 while after 6 months it was 3.45±0.71. The mean value of bone level 7.5±1.8 at base line, after 3 months after surgery it was 4.10±1.52 while after 6 months it was 4.20±1.14. Conclusions: Combination of Hyaluronic acid and 𝛽TCP gave good results in the treatment outcomes as regard bone level and periodontal clinical parameters. Hyaluronic acid in combination with 𝛽TCP showed a synergistic effect on regeneration of vertical bony defects. The application of Hyaluronic acid gel alone as a regenerative material in vertical bony defect gave a promising predictable outcome regarding bone level gain and periodontal clinical parameters improvements. Although 𝛽TCP showed good results as regard improving bone level and periodontal clinical parameters, but it was not as effective as when it was combined with Hyaluronic acid.