Periodontal disease is a multifactorial inflammatory condition associated with bacterial dysbiosis and results in the progressive destruction of the supporting tissues of the teeth. It is one of the most common oral diseases worldwide. Despite advancements in treatment strategies, gingivitis is known to affect over 90% of the global population, making periodontal disease one of the most prevalent conditions and the sixth most common disease worldwide.
Amidst this burden, metformin, previously well known as an oral hypoglycemic agent, has emerged as a promising non-invasive therapeutic approach. The rationale behind its use lies in its ability to influence glucose metabolism pathways that also regulate inflammatory responses. In addition, metformin has been shown to promote stem cell proliferation and guide lineage commitment, both of which can contribute to tissue regeneration.
Importantly, when used locally in periodontal therapy, metformin may help harness these benefits while avoiding the systemic effects that could occur in non-diabetic individuals.
Although this approach is still under clinical investigation and has not yet been commercially marketed for this indication, the findings so far are noteworthy and highlight a potentially innovative direction in the management of periodontal disease.