Figure 6 - available via license: Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
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Intraoral periapical radiograph with grid showing infrabony defect in Site B at (a) baseline (5 mm) (b) 3 months (2 mm) (c) 6 months (1 mm) c b a
Source publication
Context:
To compare and evaluate clinically and radiographically the efficacy of 1.5% metformin (MF) gel and placebo gel as an adjunct to scaling and root planing (SRP) and Curettage for the treatment of infrabony defects (IBDs) in chronic periodontitis patients.
Subjects and methods:
The study was conducted randomly on 15 patients of both the g...
Context in source publication
Context 1
... depth was measured on the radiograph by measuring the vertical distance from the crest of the alveolar bone to the base of the defect using grid [ Figure 6]. Individually customized bite blocks, grid and a parallel-angle intraoral radiographic technique were used to obtain radiographs as reproducibly as possible. ...
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Background: Nonsurgical periodontal therapy is the first step of periodontal diseases treatment. It could be performed with various instruments and in recent years lasers have been tested too. The aim of the present study is to evaluate the long-term clinical effectiveness of Er:YAG laser monotherapy in the treatment of moderate chronic periodontit...
Citations
... Two studies reported a follow-up of 12 months 22,23 , seven studies reported a follow-up of 9 months 27,[29][30][31]33,35,40 . Sixteen studies had a two arm design [18][19][20][21]25,26,28,30,[32][33][34][35][37][38][39][40] , five studies had a three arm design 22,23,27,29,31 , one study had a four arm design 36 . Characteristics of the included studies are reported in Table 1. ...
... Seven studies reported data on Metformin as an adjunct to nonsurgical/phase 2 periodontal therapy. Only four studies reported included one site for each patient 18,22,23,41 and two reported multiple sites per patient 34,36 . One study only reported data divided by baseline parameters 40 and was not included in the meta-analysis. ...
... An important limitation of this meta-analysis is that smoking status was not settled as an exclusion criteria and this factor must be taken into account in the outcome of treatment; however the use of host-modulators could be particularly important for smokers with impaired healing capacity. Three of the studies had a split-mouth design [18][19][20] ; in this case the same patient serves as both test and control thus increasing the risk of a carry-across effect. Another limitation is that studies including multiple sites for each patient were included in the meta-analysis with an increased risk of a patient-related bias. ...
Background:
This systematic review and meta-analysis aimed at investigate the role of locally delivered host-modulators in combination with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level and reducing bone defect depth in intra-bony defects.
Highlight:
RCT with at least 6 months follow-up were included in this study. Risk of bias assessment was performed with Cochrane collaboration tool and Grade GRADEpro. In addition, meta-analysis and trial sequential analysis were used to aggregate the available evidence. 22 studies met the inclusion criteria and were included in this systematic review. At 6 months locally delivered host-modulators significantly improved PD and CAL and bone defect depth.
Conclusion:
Considering the emerging role of host-inflammatory response in the treatment of periodontitis, several studies are exploring the role of locally delivered host modulators as an adjunct to step 2 of periodontal therapy.
... PLGA simultaneously increases the concentration of Metformin at the action site and decreases the concentration at non-target sites [30]. When the clinical efficacy of Metformin was studied, a significant reduction in pocket depth and increase in clinical attachment level were observed, and results still showed an improvement in periodontal health [31]. This evidence suggests the importance of using biological aids such as Metformin as an adjunct therapy to traditional treatments such as SRP (Scaling and Root Planing) [31]. ...
... When the clinical efficacy of Metformin was studied, a significant reduction in pocket depth and increase in clinical attachment level were observed, and results still showed an improvement in periodontal health [31]. This evidence suggests the importance of using biological aids such as Metformin as an adjunct therapy to traditional treatments such as SRP (Scaling and Root Planing) [31]. The use of local drug delivery into the periodontal pockets is traditional; systemic antimicrobials such as minocycline, doxycycline, chlorhexidine, and tetracycline have been used in patients with periodontal disease [31]. ...
... This evidence suggests the importance of using biological aids such as Metformin as an adjunct therapy to traditional treatments such as SRP (Scaling and Root Planing) [31]. The use of local drug delivery into the periodontal pockets is traditional; systemic antimicrobials such as minocycline, doxycycline, chlorhexidine, and tetracycline have been used in patients with periodontal disease [31]. Recently, adjuvant antibiotic therapy has been studied on periodontal patients with diabetes. ...
Periodontal Disease and Diabetes Mellitus are two chronic systemic diseases that are intimately connected. A bidirectional relationship exists between the two; to study this unique relationship, they must be studied separately as independent malfunctions and in tandem. Patients that experience these conditions exhibit similar innate immune responses, which lead to aggravated dysfunction of specific body systems. In patients where both conditions exist simultaneously, Diabetes and Periodontal Disease can act in a synchronistic manner, worsening symptoms. In this chapter, the epidemiology of the diabetes mellitus and periodontal disease, presence of biomarkers have been reviewed, and the metabolic syndrome, clinical relevance and treatment modalities, complications of diabetes mellitus, and guidelines for the general dentists, primary care physician, periodontist have been discussed.
