الفهرس 
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Abstract
”Background: Periodontitis is a polyfactorial disease assaulting both soft and hard constituents of periodontium. The pathogenesis of periodontitis is based mainly upon complex interactions between the microbial dysbiosis and host immune response releasing wide range of destructive cytokines. The control upon the destructive periodontal status by the local administration of anti-inflammatory drug as aspirin along with osteo-inducting agent such as erythropoietin could represent a suitable treatment modality adjunctive to SRP. GCF IL-1ꞵ and osteocalcin biomarkers could provide precise monitoring of the disease activity and response to treatment.Aim: The aim of this study was to evaluate the clinical effect of using aspirin and erythropoietin injectable hydrogels as adjuncts to SRP in treatment of stage II periodontitis patients, and assessment of the level of interleukin-1β (IL-1β), and osteocalcin in GCF of those patients.Patients and methods: This study was carried out on eighty apparently systemic healthy patients who were diagnosed as having stage II periodontitis. Patients were randomly allocated into 4 groups (twenty patients in each group). group I which represented the control group comprised the patients who treated only with SRP while group II, III, and IV represented the study groups. group II, III, and IV involved the patients who treated with SRP followed by local application of hydrogel loaded by aspirin, erythropoietin, and combination respectively. Clinical periodontal parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment loss (CAL) ) were recorded for all groups at baseline (T0), 2 months (T1), and 4 months (T2) post treatment for all groups. GCF samples were collected at T0, T1, and T2 post treatment for all groups. The samples were analyzed using enzyme-linked immunosorbent assay (ELISA) for assessment of the level of GCF IL-1β, and osteocalcin.Results: Gingival index, probing pocket depth, and clinical attachment level in study groups revealed significant improvement after treatment at all periods of observation compared to the control group. Regarding PI, the intragroup comparison in all groups revealed significant difference at T1 and no significant difference at T2, while the intergroup comparison revealed no significant difference at T1 and T2. GI decreased significantly for all groups at T1 while group II, III, IV exhibited significant superior improvement over group I. At T2, there was no significant difference in group I compared to T1, while group II, II, and IV recorded significant difference taking into consideration that group IV had significant difference compared to group II and III. For PPD and CAL, all groups showed significant difference at T1 while only group I showed no significant difference at T2 in comparison to T1. group II, III, and IV gave peerless improvement at T1 and T2 with the superior significance also for group IV. Regarding GCF IL-1ꞵ level in the control groups, there was no significant difference at T1 compared to T0 and the only significant difference was between T0 and T2. Intragroup comparison of GCF IL-1ꞵ level showed significant reduction in the study groups at T1 and T2, however the intergroup comparison revealed no significant difference at all observational intervals. Regarding GCF osteocalcin level, it decreased significantly in all groups at T1 with no intergroup significance difference. At T2, it decreased significantly compared to T1 in group II, and no significant difference was detected in group I. While it astonishingly recorded significant increase in group III and IV.Conclusion: Aspirin and erythropoietin either loaded alone or combined achieved virtuous improvement in all tested clinical parameters. Since, it can represent a possible effective adjunctive therapy to SRP. GCF IL-1ꞵ and osteocalcin provided a clue for screening the inflammatory and bone turnover process during active phase of periodontal disease and post therapy.