الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
Abstract
SUMMARY
Periodontitis is an inflammatory disease of the supporting tissues of the teeth, caused by a group of specific microorganisms; Periodontitis can result in bone resorption creating bony defects, which may cause tooth loss. Several treatment procedures have been studied to achieve periodontal regeneration.
A critical step in periodontal regenerative therapy is to alter the periodontitis affected root surface to make it a hospitable substrate, to support and encourage migration, attachment, proliferation and proper phenotypic expression of periodontal connective tissue progenitor cells. So the concept of EDTA root modification or alteration of the root surface has emerged as a potential therapeutic approach to the reconstruction of the periodontal unit.
Nanocrystalline hydroxyapatite is an alloplastic material chemically similar to the inorganic component of bone matrix and is known for its osteoinductive and osteoconductive properties in alveolar bone regeneration, NHA paste is a stimulator of cell proliferation, possibly contributing to the main processes of periodontal tissue regeneration. NHA improves alveolar socket healing, increasing angiogenesis and osteogenesis through increasing the synthesis of proosteogenic factors as bone morphogenetics protein BMP-2, BMP-4.
Enamel matrix derivative (EMD) is a commercially available protein extract, mainly comprising amelogenins. A number of other polypeptides have been identified in EMD, mostly growth factors, which promote cementogenesis and osteogenesis during the regeneration processes through the regulation of cell proliferation, differentiation and activity; however, not all of their functions are clear. Enamel extracts have been proposed to have numerous activities such as bone morphogenetic protein.
This study was performed to compare the clinical effectiveness of minimally invasive surgical technique combined with Enamel matrix derivatives versus Nano crystalline hydroxyapatite paste in the management of intrabony defects in chronic periodontitis patients, and to investigate concentrations of gingival cervicular fluid (GCF) bone morphogenic protein-2 (BMP-2) level during the early stages of healing for sites treated.
Eighteen patients with chronic periodontal disease, were randomly treated with a combination of either (EMD and β-TCP ) or (NHA and β-TCP ) or with only (β –TCP) after EDTA application on root surface. Clinical evaluation was performed at baseline and 3, 6 months following therapy.
Clinical findings of present study revealed improvement in clinical and radiographic parameter in all groups after three and six months. The difference between baseline and three months, and between three and six months were significant regarding (PD, CAL) in each group, comparison between groups at three months and at six months revealed significant differences in all groups regarding PD & CAL.
The results of the study showed the highest BMP-2 levels in samples of day 1 and 7 respectively followed by decreased levels in day 14 and 21 samples for group III, while in group I continue to increase to day 21, with no statistical significant differences between times interval regarding BMP-2 among group I, II, III in day 14 and day 21. This sustained level of BMP-2 reported with EMD treated group could be attributed to the EMD carrier amelogenins who allowed for more EMD substantivity.