title: Locally delivered 1% metformin gel in the treatment of smokers with chronic periodontitis: a randomized controlled clinical trial.
abstract: BACKGROUND
  Metformin (MF) (1,1-dimethylbiguanide HCl) is one of the most commonly used oral antihyperglycemic agents for the treatment of type 2 diabetes mellitus. Recently, MF has been shown to have bone-sparing properties. The present study is designed to investigate the effectiveness of MF 1% in an indigenously prepared, biodegradable, controlled-release gel, as an adjunct to scaling and root planing (SRP) in treatment of vertical defects in smokers with generalized chronic periodontitis (CP).
  
  
  METHODS
  Fifty patients were categorized into two treatment groups: SRP plus 1% MF and SRP plus placebo. Clinical parameters were recorded at baseline and at 3 and 6 months; they included plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), and clinical attachment level (CAL). At baseline and after 6 months, intrabony defect (IBD) fill was radiologically assessed using computer software.
  
  
  RESULTS
  Mean PD reduction and mean CAL gain were found to be greater in the MF group than the placebo group at all visits. Furthermore, a significantly greater mean percentage of bone fill was found in the MF group (26.17% ± 6.66%) than the placebo sites (3.75% ± 8.06%) (P <0.001).
  
  
  CONCLUSIONS
  There was greater decrease in mSBI and PD and more CAL gain with significant IBD fill at vertical defect sites treated with SRP plus locally delivered MF, versus SRP plus placebo, in smokers with generalized CP.
authors.affiliation: Department of Periodontics, Government Dental College and Research Institute, Fort, Bangalore, India. periodonticsgdcri@gmail.com
authors.forename: Nishanth S
authors.initials: NS
authors.lastname: Rao
authors.forename: A R
authors.initials: AR
authors.lastname: Pradeep
authors.forename: Minal
authors.initials: M
authors.lastname: Kumari
authors.forename: Savitha B
authors.initials: SB
authors.lastname: Naik
mesh_terms: D000287:Administration, Topical; D000328:Adult; D016301:Alveolar Bone Loss / Q000188:drug therapy / Q000628:therapy; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000628:therapy; D003131:Combined Modality Therapy; D003692:Delayed-Action Preparations; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010919:Placebos; D016300:Radiography, Bitewing / Q000379:methods; D016745:Root Planing / Q000379:methods; D012907:Smoking / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D003692:Delayed-Action Preparations; D010919:Placebos; D008687:Metformin