الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The current study was carried out to evaluate and compare clinically, radiographically, and biochemically the effect of IngeniOs β-TCP alone versus 1% metformin gel loaded synthetic bone graft (IngeniOs β-TCP) in the treatment of angular intrabony defects in patients with generalized aggressive periodontitis (GAP). Thirty angular intra-bony defects in seven patients diagnosed with GAP were selected. Their ages ranged between 18 to 42 years old. All subjects received initial therapy including scaling & root planing as well as comprehensive oral hygiene instructions. Re-evaluation was conducted after one month to evaluate the tissue response and insure the need for surgery. The defects were randomly allocated into two groups (15 defect in each group) as follows: group I: treated by open flap debridement conjugated with guided bone regenerative surgery using synthetic bone graft (IngeniOs β-TCP) and collagen membrane. group II: treated by open flap debridement conjugated with guided bone regenerative surgery using synthetic bone graft (IngeniOs β-TCP) loaded with 1% metformin gel and collagen membrane. Comparison between the two groups was assessed by the following parameters 1) Clinical parameters: probing pocket depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) at baseline, 3, 6 and 9 months study periods. 2) Radiographic assessment: Standardized periapical radiographs were taken at baseline and at 9 month postoperative study period. Then, quantitative digital subtraction radiography (QDSR) was done to assess bone gain expressed as surface area (height X width) and bone mineral density. 3) Biochemical assessment: from all sites, GCF samples were taken at baseline, and 9 months follow-up period. GCF samples were analysed using ELIZA kit and RANKL/OPG ratio was calculated. Clinical Results The two groups showed significant improvement in all clinical parameters (PD, BOP and CAL) values after 3, 6 and 9 months post-operatively when they were compared to baseline measurements. In addition, intergroup comparison for PD, CAL and BOP showed that, there was no statistically significant difference in clinical parameters values (PD, CAL and BOP) in group I when they were compared to their similar values in group II at all the study intervals. Radiographic Results The intragroup results of bone gain and bone mineral density for the two tested graft materials were favorable throughout the study period. Comparison between the two studied groups showed that, there was more bone gain and bone mineral density in the two groups at 9 months postoperative when compared with baseline measurements. While, intergroup comparison of the two studied groups revealed that the amount of bone gain at 9 month post-operative study period was statistically non-significant. At the same time intergroup comparison of the value of increased bone density at 9 months post-operative study period was statistically significant. Biochemical Results The results showed decreased RANKL level in GCF at 9 months study interval when compared to baseline in the two studied groups. At the same time it is found that OPG level in GCF was increased at 9 month post-operative study interval. Also, there was an increase in RANKL/OPG ratio in the two groups at 9 month post-operatively.