الفهرس 
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Abstract
The current study was performed to assess and compare in vivo the effect of triclosan gel, chitosan gel and triclosan loaded chitosan gel clinically, microbiologically and immunologically as an adjunctive treatment in patients with moderate chronic periodontitis. Medically free twenty one patients with age ranged between 35-50 years old suffering from moderate chronic periodontitis were selected from the Periodontology clinic, Faculty of Dentistry, Tanta University to participate in this study. For each patient the deepest periodontal pockets were selected to receive treatment. All patients received initial therapy of full mouth SRP with oral hygiene instructions. Re-evaluation was carried out at the end of the initial therapy (one month), then the patients were randomly divided into three groups as the following: 1) GroupІ: 7 sites received triclosan gel + SRP & 7 sites treated with SRP only. 2) GroupІІ: 7 sites received chitosan gel + SRP & 7 sites treated with SRP only. 3) GroupІІІ: 7 sites received triclosan loaded chitosan gel + SRP &7 sites treated with SRP only. The comparison and evaluation of the three groups on the outcome of chronic periodontitis treatment were performed by: І) The clinical parameters of periodontal therapy: plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). Summary and Conclusions 148 ІІ) Bacteriological study: The bacterial effect of triclosan gel, chitosan gel and triclosan loaded chitosan gel on the putative periodontopathogens, Porphyromonas gingivalis, Tanerella forsythensis and Tannerella forsythia using (BANA) test. ІІІ) Immunological study: The quantitative measurement of prostaglandin E2 (PGE2) concentration in gingival crevicular fluid by using Enzyme- Linked Immuno-Sorbent Assay (ELISA) test. Clinical results: Sites treated with SRP combined with local application of either triclosan gel, chitosan gel or triclosan loaded chitosan gel showed gradual comparable significant improvement in all tested clinical parameters (PI, GI, PPD, and CAL). This improvement seemed to be continued up to the end of the study. Additionally, sites treated with SRP+triclosan gel showed better clinical PI and GI scores than those treated with SRP+chitosan gel as compared to their control sites till the end of the study and this could be explained by the distinctive antigingivitis as well as plaque-inhibitory effects of triclosan. While tested sites in group ІІ (SRP+chitosan gel) showed better reductions for PPD and CAL than tested sites in group І (SRP+triclosan gel) at 3 and 6 months evaluation periods as compared to their control sites and this was shown by having greater differences. This could be explained by the bioadhesiveness properties of chitosan, which favor the proliferation and organization of the cells with subsequent enhanced capability of reconstructing a histological architecture of the gingiva on the root surfacess. However the difference was too small to give statistical significant differences.