Ranya Ehab Hossam El Deen¹, Ola Mohamed Ezzatt² and Doaa Adel Khattab³

¹Teaching Assistant of Oral Medicine, Oral Diagnosis and Periodontology, Misr International University, Egypt
²Assistant Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Egypt
³Assistant Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Egypt

*Corresponding Author: Doaa Adel Khattab, Assistant Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Egypt.

Received: March 30, 2023; Published: April 28, 2023

Abstract

Background: Periodontal disease is one of the most common oral diseases that affects the general public, although a number of surgical and pharmacological options are available for the the management of periodontitis yet it still affects a large proportion of population. Metformin is a second-generation biguanide anti-diabetic agent used to treat type II diabetes, Metformin has been used along with surgical and non-surgical periodontal therapy, as treatment for periodontitis. It has been reported to relieve clinical symptoms as BOP, PD and CAL. This study was carried out to investigate the clinical and microbiological effectiveness of 1% Metformin gel on Stage II grade B periodontitis. The rationale behind using Metformin is that it has a potential antimicrobial effect, also, It inhibits osteoclast formation and activity in periodontitis patients at the cellular level as well.

Method: a 37 year old female patient diagnosed with stage II grade B periodontitis, was treated with SRP combined with intrasulcular application of 1% Metformin gel at the deepest pocket of 5 mm PD and 4mm CAL and follow up period 6 months. GCF sample was collected at baseline and 2 weeks and RT-PCR was done to detect A.A and P.gingivalis at different time intervals.

Results. 1% Metformin gel improves the periodontal health with statistically significant improvement in the PPD, CAL, PI and GI values along with a significant decrease in all types of bacteria (A.A., P.gingivalis).

Conclusion: the use of 1% metformin gel as adjunct to non-surgical periodontal therapy (NSPT) provided a significant improvement in the clinical periodontal parameters in stage II grade B periodontitis and showed a statistically significant reduction in the bacteria load of (P.gingivalis ,T.pallidum, A.A. and P. intermedia) from baseline to 2 weeks and 2 months.

Keywords: Metformin; Periodontitis; Bacterial; PPD

References

1. Yücel OO., et al. “Interleukin‐11, interleukin‐1beta, interleukin‐12 and the pathogenesis of inflammatory periodontal diseases”. Journal of Clinical Periodontology 35 (2008): 365‐3
2. J Eberhard., et al “Full-mouth disinfection for the treatment of adult chronic periodontitis”. Cochrane Database of Systematic Reviews 23.1 (2008): CD004622.
3. Kuang Y., et al. “Metformin prevents against oxidative stress-induced senescence in human periodontal ligament cells.” Biogerontology 21.1 (2020): 13-27.
4. Liu L., et al. “Protective effect of metformin on periapical lesions in rats by decreasing the ratio of receptor activator of nuclear factor kappa B ligand/osteoprotegerin”. Journal of Endodontics7 (2012): 943-947.
5. Araújo AA., et al. “Effects of metformin on inflammation, oxidative stress, and bone loss in a rat model of periodontitis”. Plos One8 (2017): e0183506.
6. Pradeep AR., et al. “Efficacy of 1% metformin gel in patients with moderate and severe chronic periodontitis: a randomized controlled clinical trial”. Journal of Periodontology10 (2017): 1023-1029.

Citation

Citation: Doaa Adel Khattab., et al. “Metformin Gel as Locally Delivered Adjunctive Therapy for Periodontitis Stage II, Grade B (A Randomized Controlled Clinical Trial with Quantitative Bacterial Assessment)".Acta Scientific Dental Sciences 7.5 (2023): 60-63.

Copyright

Copyright: © 2023 Doaa Adel Khattab., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.