الفهرس 
Introduction and review of literatureOnly 14 pages are availabe for public view
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Abstract
Chronic periodontitis was defined as an infectious disease resulting in inflammation within the structures that support the teeth , progressive attachment loss , and bone loss . It is the most prevalent form of periodontitis .Altought the periodontal disease is a multifactorial infectous disease but the microbial plaque is established as the primary etiologic factor to intitiate and progress the disease .
One of the most benfical surgical approaches in treatment of moderate to advanced chronic periodontitis was modified minimally invasive surgical technique (M-MIST) which improves wound stability, maintain space for regeneration , preserve the papillary tissue and also the least postoperative pain .
In this study 15 patients diagnosed to have bilateral clinical attachment loss (CAL) ≥ 4mm and pocket probing depth (PD) ≥ 5mm . Split mouth design was done to compare the effect of nano hydroxyapatite bone graft and nano-microsized composite hydroxyapatite bone graft and by using modified minimally invasive surgical technique (M-MIST) in both groups to maintain maximum clot and graft stabilization .
The patients were diagnosed having mild to moderate chronic periodontitis . Both males and females were included in the study age between 35 years – 55 years old . The selected patients were assigned in a split mouth design , one side is treated by modified minimally invasive surgical technique (M-MIST) with nano hydroxyapatite and the other side is treated with modified minimally invasive surgical technique (M-MIST) with nano-microsized hydroxyapatite. Also the patients were selected to be systemically free to exclude all variable confounders that may affect wound healing. The clinical parameters included plaque index, gingival index, probing depth and clinical attachment loss were recorded at baseline and 3 months after surgery. BMP-2 level was measured in the gingival crevicular fluid at day zero, 3 days , 7 days , 14 days , 30 days after surgery in both groups .
The results of this study revealed an insignificant statistical difference of PD , PI , GI and CAL between nano hydroxyapatite bone graft and nano-microsized composite hydroxyapatite . Also the level of BMP-2 showed insignificant statistical difference between nano hydroxyapatite and nano-microsized composite hydroxyapatite in treating moderate to advanced chronic periodontitis .