Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords ‘metformin’, ‘diabetes’, ‘periodontitis’, ‘implant’, and ‘peri-implantitis’ via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.
Background and Objectives: Labial alveolar bone thickness in the maxillary anterior region is the key factor in the placement of implants. Differences in the thickness of the bone are reported among different ethnic groups. Thus, the present study was aimed at assessing labial alveolar bone thickness in the maxillary anterior region in the population of the eastern province of Saudi Arabia. Materials and Methods: The six anterior teeth in each of the 186 CBCT sagittal images were analyzed at three points: Point A from the facial plate at the level of the bone crest to the coronal root third, Point B to the mid-root surface, and Point C to the apical third. Crest height (Point D) was measured as the distance from the CEJ to the alveolar bone crest. The analysis was done using SPSS version 20. A p-value of <0.05 was considered statistically significant. Results: The bone thickness at any given point (Point A, Point B, or Point C) was less than the preferred bone thickness of 2 mm in all six teeth. The thickness was minimum at Point B, maximum at Point C, and intermediate at Point A. This difference was found to be statistically significant (p-value < 0.05). The crestal height (Point D) was less than 3 mm, and it was not statistically significant. Comparison of bone thickness on the right and left sides for any given point was not statistically significant except at Point A in the central incisor, where it was statistically significant (p-value = 0.035). Gender comparison of bone thickness showed no difference at Point A; however, at Points B and C, it showed statistical significance (p-value < 0.05). Conclusions: The alveolar bone thickness being <2 mm in the labial anterior region warns of the importance of the proper assessment of bone during implant placement to have a predictable outcome.
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