局部应用1%二甲双胍凝胶可改善牙周参数：一项系统评价和荟萃分析。
Locally delivered 1% metformin gel improves periodontal parameters: A systematic review and meta-analysis.
作者信息
Haba Kata Sára, Bencze Bulcsú, Kammerhofer Gábor, Ujpál Márta, Bányai Dorottya, Hermann Péter, Antal Sarolta, Lipták Klaudia, Lipták Laura, Géczi Zoltán, Hegedüs Tamás, Végh Ádám, Haluszka Dóra, Végh Dániel, Alghamdi Hamdan
机构信息
Department of Prosthodontics, Semmelweis University, Szentkirályi Street 47, 1088, Budapest, Hungary.
Institute of Biophysics and Radiational Biology, Semmelweis University, Tűzoltó Str. 37-47, 1094, Budapest, Hungary.
出版信息
Saudi Dent J. 2025 Aug 20;37(7-9):40. doi: 10.1007/s44445-025-00045-8.
PURPOSE
Approximately 19% of the global adult population is affected by periodontal diseases. Healing is a protracted process that is significantly influenced by the patient's motivation, proficiency, and cooperation. The prevalence of periodontal diseases in patients with diabetes mellitus is extremely high, and the relationship is bidirectional. In previous investigations, metformin (MF), a biguanide antidiabetic medicine, has demonstrated promising results when administered locally to periodontal defects. The study aimed to systematically assess available literature that evaluate the effectiveness of 1% metformin gel in the treatment of periodontal disease. We attempted to include clinical trials on patients with periodontitis treated with local administration of 1% metformin gel, compared to a placebo.
METHODS
Using identical MeSH terms, we conducted a systematic search in three databases. Our analysis encompassed human studies that measured the periodontal pocket depth, the clinical attachment level, and the depth of the intra-bony defect. Meta-analyses were carried out using random effects model to compare the mean differences between the study group, which received 1% MF gel locally in addition to traditional scaling and root planing (SRP), and the control group, which received a placebo in addition to conventional treatment.
RESULTS
Following the selection procedure, six articles were selected for inclusion in our meta-analysis, out of the 246 articles identified through the systematic search. After three and six months of follow-up, meta-analyses revealed statistically significant differences between the control and study groups. The overall effect for PD was a 1.33 mm reduction (95% confidence interval (CI): -1.66; -1.01) after three months and 1.87 mm (-2.24; -1.39) after six months. The overall effect of CAL was 1.80 mm (-2.26; -1.34) after three months and 2.14 mm (-2.71; -1.58) after six months. The change in IBD after a six-month follow-up was 1.16 mm (-1.40; -0.92).
CONCLUSION
The application of 1% MF gel enhances the healing process in periodontal diseases, when employed in conjunction with conventional therapy.
目的
全球约19%的成年人口受牙周疾病影响。愈合是一个漫长的过程，会受到患者的积极性、熟练程度和配合程度的显著影响。糖尿病患者中牙周疾病的患病率极高，且这种关系是双向的。在之前的研究中，双胍类抗糖尿病药物二甲双胍（MF）局部应用于牙周缺损时已显示出有前景的结果。本研究旨在系统评估评估1%二甲双胍凝胶治疗牙周疾病有效性的现有文献。我们试图纳入对用1%二甲双胍凝胶局部治疗的牙周炎患者与安慰剂进行比较的临床试验。
方法
使用相同的医学主题词（MeSH），我们在三个数据库中进行了系统检索。我们的分析涵盖了测量牙周袋深度、临床附着水平和骨内缺损深度的人体研究。采用随机效应模型进行荟萃分析，以比较研究组（除接受传统龈上洁治和根面平整（SRP）外还局部接受1% MF凝胶）和对照组（除常规治疗外接受安慰剂）之间的平均差异。
结果
经过筛选程序，在通过系统检索确定的246篇文章中，有6篇文章被选入我们的荟萃分析。经过3个月和6个月的随访，荟萃分析显示对照组和研究组之间存在统计学显著差异。牙周袋深度（PD）的总体效应是3个月后减少1.33毫米（95%置信区间（CI）：-1.66；-1.01），6个月后减少1.87毫米（-2.24；-1.39）。临床附着水平（CAL）的总体效应是3个月后为1.80毫米（-2.26；-1.34），6个月后为2.14毫米（-2.71；-1.58）。6个月随访后骨内缺损（IBD）的变化为1.16毫米（-1.40；-0.92）。
结论
当与传统治疗联合使用时，1% MF凝胶的应用可增强牙周疾病的愈合过程。
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