Local Effect of Metformin Gel (1%) as an Adjuvant in the Periodontal Treatment of Patients with Type II Diabetes Mellitus with Periodontitis: A Double-Blind Randomized Clinical Trial

Abstract

Aims: The aim of this study was to evaluate the efficacy of 1% metformin gel administered locally as an adjunct to basic periodontal treatment in patients with periodontitis at different stages, with type II diabetes mellitus, who were using oral metformin. Study Design:  This is a randomized, parallel, double-blind, clinical and laboratory-based clinical study. Place and Duration of Study: It was carried out from April 2022 to March 2023. Study carried out in Cascavel-PR, Brazil. Methodology: Total of 39 patients were evaluated, divided into two groups, CM (n=20): Periodontal therapy with an association of 1% metformin gel and SM (n=19): Periodontal therapy with placebo gel association. The patients were evaluated at 0, 3 and 6 months, through the following exams: clinical exams (clinical probing depth, bleeding on probing, clinical attachment loss and plaque index), hematological exams (fasting glucose, glycosylated hemoglobin, creatinine and total cholesterol and fractions) and collection of gingival crevicular fluid for evaluation of IL-17 by means of the ELISA test and to determine the amount of fluid absorbed (mm2). Results: Both groups significantly reduced the amount of plaque, bleeding on probing and the amount of gingival crevicular fluid in mm2 (p<0.05) while CPD (clinical probing depth) was significantly reduced (p<0.05) only in the CM group. When evaluating the different probing depths, pockets <5 and ≥ 5 mm reduced significantly (p<0.05) in the CM group, while in the SM group, only pockets <5 mm were significantly reduced. The results of the hematological exams did not show statistical difference in this period and the same occurred with the amount of IL-17 present in the gingival crevicular fluid. Conclusion: According to the results obtained in the present study, the local application of 1% metformin gel in patients with PD and type II DM was effective when associated with basic periodontal treatment over periodontal clinical parameters, compared to the placebo gel.