Evaluation of the use locally delivered 1% metformin gel in the non surgical management of chronic periodontitis

Objectives: Metformin (MF) (1,1-dimethylbiguanide HCl), is one of the most commonly used oral anti-hyperglycemic agents for the treatment of Type 2 diabetes mellitus. Recently, MF has shown to posses bone sparing actions. The present study is aimed to investigate the clinical effectiveness of 1% MF biodegradable controlled-release gel as an adjunctive modality to mechanical treatment of chronic periodontitis
The aim of this study was to evaluate the clinical effect of locally delivered 1% of Metformin gel as an adjunctive treatment in the non-surgical management of chronic periodontitis
Methods: Thirty chronic periodontitis patients will be categorized into two treatment groups: control group consists of fifteen patients will be treated with scaling and root planing (SRP) plus placebo. The study group of the remaining fifteen patients will be subjected to local application of 1% MF gel as adjunctive treatment to SRP. Clinical parameters will be recorded at baseline and at one, two and three months. They include clinical attachment level and (CAL) and bleeding on probing (BOP)
Results: Statistical analysis of the results of this study revealed significant reduction of the (PPD, BOP) and gain of (CAL) in both groups at six months when compared to the baseline. However, The MF group showed a statistically significant higher reduction of PPD, CAL and BOP when compared to control group at 6 month post treatment. Moreover, the results of the present study indicated an increase in BD and a reduction of IBD depth in the test group, after 6 months of MF gel application. These results were statistically superior to those of the control group applying placebo gel at the same time point. This difference can be explained by the beneficial effect of MF on bone formation.
Conclusions: According to the clinical outcomes, the adjunctive use of metformin gel inside the pocket in addition to conventional SRP showed effective clinical relevance and benefits.Local delivery of 1% MF gel into periodontal pockets stimulated a significant increase in PPD and BOP reduction, CAL gain when compared to SRP + placebo gel. Radiographic examination revealed an increased bone density and reduction in intrabony defect depth in MF gel group when compared to control group