二甲双胍在口腔疾病治疗中的应用研究进展

Research progress on metformin in the prevention and treatment for oral diseases

二甲双胍是目前治疗糖尿病的一线药物,除降血糖作用外,其还被发现有促成牙本质分化、促成骨分化、抗肿瘤、抗炎等作用。已有研究表明二甲双胍可以促进根尖周病变组织愈合,其机制可能与二甲双胍激活腺苷酸活化蛋白激酶促进成骨分化与诱导牙髓细胞分化有关。应用二甲双胍辅助治疗的牙周炎患者探诊深度、附着丧失水平以及探诊出血指数等临床指标明显改善,其可能是通过促进牙周膜干细胞的增殖、迁移和成骨分化发挥防治牙周炎的作用。二甲双胍已被证实可抑制肿瘤细胞生长增殖等,在防治口腔肿瘤如口腔鳞状细胞癌中有重要作用。然而,目前大部分的研究仍处于体外和动物试验阶段,二甲双胍防治口腔疾病的具体分子作用机制尚未阐明;临床试验停留在对临床指标的评价方面,需进一步开展大规模、长期、多中心、随机对照的临床试验。

Metformin is currently the first⁃line drug for the treatment of diabetes.In addition to its hypoglycemic ef⁃fect,it has also been found to have other potential effects,such as anti⁃inflammatory,odontogenic differentiation⁃promot⁃ing,osteogenic differentiation⁃promoting,and antitumor effects.Previous studies have shown that metformin can pro⁃mote the healing of periapical lesions,and its mechanism may be related to the promotion of osteogenic differentiation and the induction of dental pulp cell differentiation by activation of adenylate⁃activated protein kinase by dimethyl⁃diphosphate.Clinical indexes,such as the probing depth,attachment loss level and probing bleeding index,were signifi⁃cantly improved in patients with periodontitis treated with metformin,which may play a role in the prevention and treat⁃ment of periodontal disease by promoting the proliferation,migration and osteogenic differentiation of periodontal liga⁃ment stem cells.Metformin has been proven to inhibit the growth and proliferation of tumor cells and plays an important role in the prevention and treatment of oral tumors such as oral squamous cell carcinoma.At present,research remains in the in vitro and animal experimental stage,and the related mechanism needs to be further explored.Clinical trials re⁃main in the evaluation of clinical indicators,so large⁃scale,long⁃term,multicenter,randomized controlled clinical trials need to be further developed.