Clinical and radiographic evaluation of applying 1% metformin biofilm with plasma rich in growth factor (PRGF) for treatment of two-wall intrabony periodontal defects: A randomized clinical trial.

Shabnam Khalifehzadeh,Sina Haghanifar,Sohrab Kazemi,Niloofar Jenabian,Mahmoud Hajiahmadi

doi:10.15171/joddd.2019.008

Abstract

Background. The ultimate aim of periodontal treatment is to regenerate periodontium and regenerative treatment after that. The aim of this study was to evaluate the effect of PRGF with 1% metformin biofilm in the treatment of two-wall intrabony periodontal defects. Methods. In this clinical trial, 8 patients with moderate chronic periodontitis and two-wall intrabony defect were selected. The defects were assigned to 4 groups: debridement, 1% metformin, PRGF, PRGF and metformin. The parameters of vertical probing depth, vertical clinical attachment level and gingival index were measured at baseline, immediately before surgery, and 3 and 6 months after surgery. In addition, the radiographic changes were evaluated with digital subtraction radiography before and 6 months after surgery. Analysis of the results was performed with repeated measurements, Friedman test and chisquared test. Results. All the groups exhibited improvements in all the clinical parameters after 6 months. Inter-group comparison of GI, CAL and PPD parameters revealed no statistically significant differences. Radiographic changes in the group of 1% metformin with PRGF revealed statistically significant differences compared with other groups; however, there were no statistically significant differences in other groups. Conclusion. Application of PRGF with 1% metformin in intrabony two-wall periodontal defects was effective in improving the clinical parameters but this effect revealed no difference compared with other groups; however, in terms of radiographic changes significant improvements were noted

Highlights

Angular intrabony defects are signs of periodontal disease progression
Application of plasma rich in growth factors (PRGF) with 1% metformin in intrabony two-wall periodontal defects was effective in improving the clinical parameters but this effect revealed no difference compared with other groups; in terms of radiographic changes significant improvements were noted
Eight patients referring to the Periodontology Department of Babol University of Medical Sciences with moderate chronic periodontitis and two-wall intrabony periodontal defects were included in this study

Summary

Introduction

Angular intrabony defects are signs of periodontal disease progression. To date, many techniques, including resective and regenerative procedures, have been applied for the treatment of periodontal intrabony defects. The goal of periodontal treatment is to regenerate the damaged periodontal structures.[1] Many studies have shown that the growth factors play an important role in periodontal healing and regeneration.[2,3] Biologically active endogenous proteins offer a new approach to tissue regeneration.[3] In 1999, Anitua explained a new technique for preparing plasma rich in growth factors (PRGF). This 100% autologous preparation is enriched with biological mediators that accelerate regeneration of both hard and soft tissues.[2] PRGF contains a high concentration of a platelet‐derived growth factor, insulin‐like growth factor, and fibroblast growth factor and due to the lack of leukocyte has a minimum concentration of proinflammatory interleukins.[4,5,6]. The aim of this study was to evaluate the effect of PRGF with 1% metformin biofilm in the treatment of two-wall intrabony periodontal defects

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Methods

Results

Discussion

Conclusion