title: Platelet-rich fibrin with 1% metformin for the treatment of intrabony defects in chronic periodontitis: a randomized controlled clinical trial.
abstract: BACKGROUND
  Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that releases various growth factors that promote tissue regeneration. Metformin (MF), a member of the biguanide group, has been shown to facilitate osteoblast differentiation and thus may exhibit a favorable effect on alveolar bone. The current study is designed to evaluate the efficacy of open-flap debridement (OFD) combined with PRF, 1% MF gel, and PRF + 1% MF gel in the treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP).
  
  
  METHODS
  One hundred twenty patients with single defects were categorized into four treatment groups: OFD alone, OFD with PRF, OFD with 1% MF, and OFD with PRF plus 1% MF. Clinical parameters such as site-specific plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), relative attachment level (RAL), and gingival marginal level (GML) were recorded at baseline (before surgery) and 9 months postoperatively. Percentage radiographic IBD depth reduction was evaluated using computer-aided software at baseline and 9 months.
  
  
  RESULTS
  PRF, 1% MF, and PRF + 1% MF groups showed significantly more PD reduction and RAL gain than the OFD-only group. Mean PD reduction and mean RAL gain were found to be greater in the PRF + 1% MF group compared to just PRF or MF at 9 months. Furthermore, PRF + 1% MF group sites showed a significantly greater percentage of radiographic defect depth reduction (52.65% ± 0.031%) compared to MF (48.69% ± 0.026%), PRF (48% ± 0.029%), and OFD alone (9.14% ± 0.04%) at 9 months.
  
  
  CONCLUSIONS
  The PRF + 1% MF group showed greater improvements in clinical parameters, with greater percentage radiographic defect depth reduction compared to MF, PRF, or OFD alone in treatment of IBDs in patients with CP.
authors.affiliation: *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
authors.forename: A R
authors.initials: AR
authors.lastname: Pradeep
authors.affiliation: *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
authors.forename: Kanika
authors.initials: K
authors.lastname: Nagpal
authors.affiliation: *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
authors.forename: Shruti
authors.initials: S
authors.lastname: Karvekar
authors.affiliation: *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Patnaik
authors.affiliation: †Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute.
authors.forename: Savitha B
authors.initials: SB
authors.lastname: Naik
authors.affiliation: *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
authors.forename: C N
authors.initials: CN
authors.lastname: Guruprasad
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D001792:Blood Platelets / Q000502:physiology*; D055113:Chronic Periodontitis / Q000000981:diagnostic imaging / Q000601:surgery*; D003646:Debridement / Q000379:methods; D003774:Dental Plaque Index; D005260:Female; D005337:Fibrin / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005881:Gingiva / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D013524:Surgical Flaps / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D005337:Fibrin; D008687:Metformin
keywords: Chronic periodontitis; controlled clinical trials; guided tissue regeneration; intercellular signaling peptides and proteins; metformin; oral; periodontal; randomized; scaling; surgery