الفهرس 
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Abstract
The aim of this study was to evaluate the effect of chitosan based 1.2% simvastatin in treatment of periodontitis, and to evaluate the role of Netrin-1 as novel biomarker in periodontal health and disease. Methods : This study was conducted on 55 volunteers, 45 of whom were diagnosed with stage II grade A or B periodontitis, while 10 were apparently systemically and periodontally healthy individuals, and grouped as following: group 1 was a study group with 15 patients received SRP and chitosan based 1.2% simvastatin gel. group 2 was a study group with 15 patients received SRP and 1.2% simvastatin gel. group 3 was the positive control group with 15 patients received SRP only. group 4 was the negative control group with 10 apparently systemically and periodontally healthy individuals. Clinical periodontal parameters (PI, GI, PD, and CAL) were recorded for all groups at baseline, and for the study and positive control groups only 6 weeks after treatment. Netrin-1 level was evaluated by taking GCF samples from the pockets subjected to the study at baseline and 6 weeks after treatment, while GCF samples were taken only once from the negative control group. GCF samples were evaluated for Netrin1 level using Human Netrin-1 ELISA kit. Results : Regarding inter-group comparison of baseline mean values of the clinical parameters, no statistically significant difference was observed Abstract VI between periodontitis groups, while there was a statistically significant difference between periodontitis groups and the negative control group. Considering post treatment mean values of the clinical parameters, no statistically significant difference was observed between periodontitis groups in regards of PI, while GI, PD, and CAL showed a statistically significant differences between groups 1&3 and groups 2&3. Regarding intra-group comparison, all periodontal parameters revealed a statistically significant difference after 6 weeks of treatment among periodontitis groups compared to baseline. Regarding Netrin-1 level in GCF at baseline, there was a statistically significant difference between periodontitis groups compared to the negative control group, as it was much lower in periodontitis groups. After 6 weeks treatment period, a statistically significant increase in Netrin-1 level was noticed in periodontitis groups compared to baseline measurements, however, a statistically significant difference between periodontitis groups and the negative control group regarding post treatment Netrin-1 GCF level was noticed. Conclusion : Local application of Chitosan based 1.2% simvastatin gel as adjunct to SRP offers a promising therapeutic approach in the management of chronic periodontitis. Moreover, Netrin-1 GCF level could be considered as a novel anti-inflammatory biomarker in periodontal disease.