Introduction
aggression, Periodontal disease, PD, tooth
PERIODONTAL DISEASE, PERIODONTAL DISEASE, OXIDATIVE STRESS, INFLAMMATORY DISEASE, INFLAMMATORY RESPONSE
Periodontal disease (PD) is a multifactorial inflammatory disease associated with microbial dysbiosis that requires cell turnover and inflammatory regulation for coping with the natural bacterial aggression against the supporting tissues of the tooth [The biofilm-driven PD treatments currently offered in day-to-day practices do not directly address the host’s metabolic-mediated inflammatory response driving PD progression. Several metabolic factors can affect the inflammatory response, tissue healing, and immune function that are crucial for the management of periodontal disease. Among them are sugar metabolism, adipose-led inflammatory reaction, nutrition, and oxidative stress [It is estimated that approximately 50% of the adult population over 30 years have some form of PD, and this figure increases to 70% in adults over 65 years and older [Glucose metabolism has been shown to orchestrate the behaviour of inflammatory cells [Systemic Metformin has been previously shown in vivo to improve bone levels in a periodontal treatment model [