Metformin and nano-metformin gels as adjuncts to periodontal therapy: A split-mouth trial

Vollständiger Abstract

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Chronic periodontitis produces persistent periodontal inflammation, pocket formation, attachment loss and intrabony defects, while scaling and root planing alone may have limited access in deep and anatomically complex sites. Thirty systemically healthy participants contributed 90 intrabony defect sites in a split-mouth randomized design allocated to SRP with placebo gel, SRP with 1% metformin gel, or SRP with 1% nano-metformin gel; plaque index, gingival index, probing pocket depth and clinical attachment level were recorded at baseline, 1 month and 3 months and radiographic intrabony defect depth at baseline and 6 months. Plaque reduction was comparable among groups, whereas gingival inflammation, pocket depth, attachment level and radiographic defect depth improved significantly more with metformin-containing gels. The greatest improvements were observed with 1% nano-metformin, with mean reductions of 3.20 ą 0.49 mm in probing depth, 2.78 ą 0.68 mm in clinical attachment level and 2.35 ą 0.38 mm in intrabony defect depth. Thus, subgingival 1% metformin gel enhanced the effect of scaling and root planing and nano-metformin provided superior clinical and radiographic outcomes, suggesting a promising locally delivered regenerative adjunct for chronic periodontitis.