Objective: This trial preformed to evaluate clinically and radiographically, the efficacy of growth factors producing/inducing materials; Advanced-Platelet-Rich Fibrin (A-PRF) and Metformin (MF) respectively, in the surgical treatment of intrabony periodontal defects.

Methods: Forty-eight systemically healthy chronic periodontitis patients with intrabony defect were divided equally into 4 groups. First Group, patients treated by open flap debridement (OFD). Second Group, patients treated by OFD + 1% MF gel. Third Group, patients treated by A-PRF, which inserted into the intra bony defect (IBD). Fourth Group treated by (1% MF + A-PRF). Parameters were gathered at baseline 6 and 9 months.

Results: The reduction in probing depth (PD) and clinical attachment level (CAL) was greater in the A-PRF + 1% MF patients group than other groups. Combination of A-PRF + 1% MF showed statistically significant reduction of IBD greater than all other groups.

Conclusions: Usage of combination of A-PRF + 1% MF seems to be superior in gaining bone than surgical treatment by OFD, OFD + A-PRF or OFD + MF only.