Clinico‐radiographic comparative evaluation of 1% metformin gel plus platelet‐rich fibrin over platelet‐rich fibrin alone in the treatment of Grade II furcation defects: A randomized controlled double‐blind clinical trial

Abstract

Background: The present study was aimed to evaluate and compare the effects of 1% MF plus PRF over PRF alone in treatment of Grade II furcation defects, clinically and radiographically by using cone-beam computed tomography.Methods: This split-mouth clinical trial randomly allotted 21 patients with 42 bilateral Grade II furcation defects into two groups. Group I was treated with PRF alone while Group II with 1% MF gel and PRF. The primary outcome parameters were clinical attachment level (CAL) and horizontal probing depth (HPD) while the secondary outcome parameters were probing depth (PD) and defect volume (DV). The clinical parameters were evaluated at 3, 6, and 12 months and the radiographic parameters at 12 months.Results: Both the study groups yielded improvements in assessed parameters; however, significantly greater mean reduction of PD, HPD, and CAL gain was observed in Group II (3.90 ± 0.78 mm, 2.94 ± 0.80 mm, and 3.42 ± 0.93 mm) in comparison with Group I (3.23 ± 0.90 mm, 1.96 ± 0.80 mm, and 2.67 ± 0.88 mm) at 12 months, respectively. A significant reduction of DV was exhibited radiographically in Group II (12.61 ± 4.01 mm 3 ) as compared with Group I (9.14 ± 4.31 mm 3 ) at the end of 12 months. Conclusions:Better clinical and radiographic findings in terms of reduction in PD, HPD, CAL gain, and significant reduction in DV in Group II patients indicated that the combination therapy of 1% MF + PRF promotes regenerative ability within the periodontal tissues in Grade II furcation defects to a greater extent.

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

“…[ 283 , 284 , 285 , 286 , 287 , 288 , 289 ] These host modulators include statins like atorvastatin, rosuvastatin, and simvastatin, as well as alendronate and metformin. [ 80 , 89 , 92 , 95 , 96 , 98 , 99 , 105 , 290 , 291 , 292 , 293 , 294 , 295 , 296 ] Statins exhibit anti‐inflammatory and immunomodulatory properties while inhibiting osteoclasts and stimulating bone morphogenetic proteins. [ 297 ] Metformin, commonly prescribed for type 2 diabetes patients, reduces the inflammatory response and oxidative stress and stimulates osteoblastic activity.…”

“…[ 66 , 71 , 75 ] Clinically, PRF and L‐PRF have been extensively applied to periodontal regeneration, alone or in combination with other regenerative materials, with PRF particularly favoring soft tissue over hard tissue regeneration. [ 70 , 72 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 ] In a randomized clinical trial on 3‐wall intra‐bony defects, Sharma et al. found that PRF combined with open flap debridement (OFD) yields significantly better results than OFD alone for probing pocket depth reduction (PRF + OFD: 4.55 ± 1.87 mm; OFD: 3.21 ± 1.64 mm), clinical attachment level gain (PRF + OFD: 3.31 ± 1.76 mm; OFD: 2.77 ± 1.44 mm) and percentage bone fill (PRF + OFD: 48.26% ± 5.72%; OFD: 1.80% ± 1.56%).…”

Regeneração de lesões em área de furca grau II através do uso de concentrados plaquetários autólogos: Uma revisão narrativa

“…Portanto, segundo o estudo, defeitos tratados com PRF + ALN exibiram melhores resultados clínicos e radiográficos sugestivos de regeneração periodontal aprimorada quando comparados aos locais tratados apenas com PRF. Swami (2022), avaliou e comparar os efeitos de 1% de metformina (MF) mais PRF sobre PRF sozinho no tratamento de defeitos de furca grau II, clínica e radiograficamente por meio de tomografia computadorizada de feixe cônico. Nesses estudos o PRF é utilizado como uma matriz tridimensional atuando como um sistema de "drug delivery" (PEPLASSI, 2022).…”

“…Research, Society and Development, v. 12, n. 9, e13212943325, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i9.43325 4 Além de classificar a lesão clinicamente, um exame de imagem, como a radiografia periapical, pode ser importante para avaliar o acometimento do periodonto, a verificação de quais estruturas foram acometidas é fundamental para estabelecer um correto diagnóstico, prognóstico e um plano de tratamento (Rodrigues, 2020). A tomografia computadorizada de feixe cônico também constitui uma importante ferramenta para diagnóstico e plano de tratamento das lesões de furca, já que o exame auxilia na identificação dos defeitos de furca e possui maior precisão que a radiografia intraoral (Swami, 2022).…”

Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade-II Furcation Defects: A Quasi-Experimental Study

“…Many studies have been conducted to evaluate the efficacy of PRF and DFDBA in the treatment of intra-bony defects and statistically significant results in probing pocket depth reduction, and clinical attachment level gain for the PRF+DFDBA group have been found [12]. Swami et al [13] reported that PRF, along with 1% Metformin, has yielded satisfactory clinical and radiological improvements compared to PRF alone in grade II furcation defects. Also, in grade II furcation defects DFDBA along with amniotic membrane has resulted in greater volumetric changes than DFDBA alone [14].…”