Systematic Evaluation Of The Clinical Efficacy Of Metformin In The Treatment Of Chronic Periodontitis

Objective:To evaluate the clinical efficacy of topical application of metformin in the treatment of chronic periodontitis under the treatment of underarm axillary and root planing.Methods:Meta-analysis method was used to systematically search eb of Science,Cochrane Library,Pubmed,Embase,China Biomedical Literature Database(CBM),China Knowledge Network CNKI,Wanfang,and Weipu Eight Databases,and included local application of metformin in the underarms and roots.A clinical controlled trial of adjuvant treatment of chronic periodontitis with a flat periodontal treatment.Inclusion studies were evaluated according to the quality criteria of randomized controlled trials.Statistical analysis was performed using Review Manager version 5.3 software.Results:A total of 6 articles were included,312 patients with chronic periodontitis,157 patients in the metformin group,and 155 patients in the control group.The overall quality of the included study was good.The meta-analysis showed:(1)Periodontal probing depth: There was a statistically significant difference between the two groups after 3 months [SMD=-1.71,95% CI(-2.04,-1.37),P<0.00001].the difference between the two groups was statistically significant after 6 months [SMD=-2.31,95% CI(-2.93,-1.70),P<0.00001].the difference between the two groups was statistically significant after 9 months [SMD=-3.22,95% CI(-3.94,-2.50),P<0.00001].There was a statistically significant difference between the two groups after 12 months [SMD=-2.88,95% CI(-3.88,-1.99),P<0.00001].(2)Clinical attachment level: There was a statistically significant difference between the two groups after 3 months [SMD=-4.26,95% CI(-6.83,-1.70),P<0.00001].the difference between the two groups after 6 months Statistically significant [SMD=-2.45,95% CI(-3.19,-1.72),P<0.00001].the difference between the two groups was statistically significant after 9 months [SMD=-2.97,95% CI(-3.66,-2.28),P <0.00001].the difference between the two groups was statistically significant after 12 months [SMD=-3.22,95% CI(-4.20,-2.24),P<0.00001].(3)Intrabony defects: The difference between the two groups was statistically significant after 6 months [SMD=-2.99,95% CI(-4.24,-1.74),P<0.00001].there was a difference between the two groups after 9 months [SMD=-2.47,95% CI(-3.10,-1.84),P<0.00001].there was no significant difference between the two groups after 12 months [SMD=-3.70,95% CI(-7.76,-0.36),P>0.05].(4)Plaque index: There was no significant difference between the two groups at 3 months [SMD=-0.04,95% CI(-0.24,0.33),P>0.05].The difference between the two groups was statistically significant after 6 months [SMD=-0.48,95% CI(-0.70,-0.25),P<0.0001].The difference between the two groups was statistically significant after 9 months [SMD=-0.64,95% CI(-1.12,-0.16),P<0.05].The difference between the two groups was statistically significant after 12 months [SMD=-0.80,95% CI(-1.18,-0.43),P<0.0001].(5)Modified sulcus bleeding index: There was a statistically significant difference between the two groups after 3 months [SMD=-1.03,95% CI(-1.69,-0.38),P<0.05].The difference between the two groups was statistically significant after 6 months [SMD=-0.74,95% CI(-1.33,-0.16),P<0.05].There was a statistically significant difference between the two groups after 9 months [SMD =-0.82,95% CI(-1.31,-0.33),P<0.05].There was a statistically significant difference between the two groups after 12 months [SMD=-0.71,95% CI(-1.08,-0.34),P<0.05].Conclusion: Local adjuvant use of metformin in the treatment of chronic periodontitis can reduce the depth of periodontal probing,increase the clinical adhesion level,promote bone regeneration,reduce oral plaque index and sulcus bleeding index.