An evaluation of periimplant tissues with and without application of 1 percent metformin gel on dental implant surface and in osteotomy site during implantation A Randomized clinical controlled trial

Modern dentistry aims to restore the oral health of patients in a predictable fashion. Depending on an individual’s local, environmental, physiological, mental, and financial status, the lost teeth are replaced with the best possible alternative.The use of dental implants for treating complete or partial edentulism is a widely accepted treatment option as a result of its high rate of success. Metformin is an oral biguanide antidiabetic drug. It is a commonly used medication administered to patients with DM2, polycystic ovarian syndrome, and metabolic syndrome. Metformin improves periodontal health by controlling blood sugar levels and increasing the outcomes of periodontal therapy. More recent studies have indicated that it may have a direct antiresorptive effect on periodontal bone. Metformin inhibits bone resorption by reducing receptor activator of nuclear factor kappa B ligand (RANKL) expression and increasing osteoprotegerin (OPG) expression. Enhancing osteoblast proliferation and reducing osteoclast activity are two possible mechanisms of action for metformin’s osteogenic impact. Given its capacity to regulate blood glucose levels and promote bone repair, investigating the potential of metformin (MF) in bone physiology holds significant value. The potential application of metformin as an adjunct to dental implants could offer novel insights into bone physiology. The impact of locally applying metformin to the implant surface during implantation has not been extensively studied in the literature, so the aim of this study is to evaluate the clinical and radiographic effectiveness of 1% metformin gel when applied over the implant surface and at the osteotomy site.