Evaluation of Horizontal Ridge Augmentation Using 1% Metformin Gel and PRF in Split Crest Technique: A Randomized Controlled Clinical Trial.

El-Destawy, Mahmoud T, AbdelAziz Aka AboAmo, Mahetab M Abdel-Wahab, Mostafa M Hosny, Ahmed M Bilal, Samy Saeed, Abd El-Latif G Borhamy, Ahmed M Elshamy, Ahmed Halim, and Aya Ali Hussien. 2025. “Evaluation of Horizontal Ridge Augmentation Using 1% Metformin Gel and PRF in Split Crest Technique: A Randomized Controlled Clinical Trial.”. The Journal of Contemporary Dental Practice 26 (8): 759-66.

Abstract

AIM: To evaluate the efficacy of ridge splitting through the split crest method incorporating 1% metformin (MF) and platelet-rich fibrin (PRF) in comparison to the split crest technique (SCT) utilizing PRF alone.

MATERIALS AND METHODS: A total of 24 patients were recruited and randomly assigned to three distinct groups. Group I consisted of patients who underwent the SCT with implant placement alone. Group II included patients who received SCT with both implant placement and PRF, while group III comprised patients who experienced SCT with implant placement supplemented by a 1% MF gel combined with PRF. Clinical parameters, such as implant stability and crestal bone width, were measured for each implant immediately after insertion and again after a period of 6 months.

RESULTS: The combination of MF and the PRF group exhibited the lowest level of crestal bone loss (CBL) relative to the other two groups. There was a notable increase in implant stability in both the control group and the study group (PRF + MF). Although there was also an increase in the PRF group, this change was not statistically significant.

CONCLUSION: This study indicates that, within its limitations, the concurrent application of 1% MF and PRF in ridge splitting procedures may lead to a reduction in CBL and an enhancement in implant stability.

CLINICAL SIGNIFICANCE: The introduction of a novel biomaterial has shown promise in enhancing the predictability of horizontal ridge augmentation procedures. Metformin 1%, a second-generation biguanide primarily utilized for blood glucose regulation, has been documented to promote osteoblast differentiation and proliferation, facilitate new bone formation, and increase type I collagen levels. This study seeks to evaluate the effectiveness of MF 1% in horizontal ridge augmentation procedures, both as a standalone treatment and in conjunction with a well-established PRF material. The findings aim to expand the array of biomaterials available for alveolar ridge augmentation. How to cite this article: El-Destawy MT, AboAmo AAKA, Abdel-Wahab MM, et al. Evaluation of Horizontal Ridge Augmentation Using 1% Metformin Gel and PRF in Split Crest Technique: A Randomized Controlled Clinical Trial. J Contemp Dent Pract 2025;26(8):759-766.

Last updated on 10/28/2025
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