DIABETES AND PERIODONTAL DISEASE: INTERCONNECTED PATHOPHYSIOLOGY AND CLINICAL IMPLICATIONS: A COMPREHENSIVE REVIEW
Authors:   Prince Abdulrahman Advanced Dental Institute, Riyadh, Saudi Arabia., Abdulaziz Aldawish Abdulrahman , Mohammed Alzaben Nawaf ,   Prince Abdulrahman Advanced Dental Institute, Riyadh, Saudi Arabia., Mohammed Alzain Lulya ,   Prince Abdulrahman Advanced Dental Institute, Riyadh, Saudi Arabia., Saad Alsumaihan Haitham ,   Prince Abdulrahman Advanced Dental Institute, Riyadh, Saudi Arabia., Abdulaziz Alhubaish Saud ,   Prince Abdulrahman Advanced Dental Institute, Riyadh, Saudi Arabia., Saqer Almutairi Turki ,   Nursing Executive Affairs, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Munwikh Al Shammari Dalal ,   Nursing Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Hanouf Saleh AlGoudah Al ,   Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Saleh Alturki Alanoud ,   Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Abdullah AlKhunein Saleh ,   Department of Anesthesia, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Published: August 2024

The bidirectional relationship between diabetes mellitus (DM) and periodontal disease is well-documented, with poor glycemic control exacerbating periodontal inflammation and vice versa. Novel therapies, including anti-inflammatory agents, antioxidants, and biologics, show promise in reducing systemic inflammation and improving glycemic control. Advances in identifying salivary biomarkers such as miRNAs 146a/b and 155, IL-1Î², MMP8, and IL-6 have improved early detection of periodontitis in diabetic patients. Additionally, innovative imaging techniques like Raman spectroscopy and multiplex hand-held biosensors have enhanced diagnostic accuracy. Longitudinal studies and clinical trials remain essential to validate the long-term benefits and safety of new biomarkers and therapies. Recent studies highlight the importance of integrated care and interdisciplinary collaboration between dental and medical professionals to effectively manage these interrelated conditions. Future research should focus on understanding the biological pathways linking DM and periodontal disease, with a particular emphasis on the roles of inflammatory cytokines, oxidative stress, and the microbiome. Public health initiatives should aim to increase awareness of the bidirectional relationship between DM and periodontal disease through educational campaigns and community-based screening programs. Policy recommendations should encourage integrated health services and interdisciplinary training programs. The integration of artificial intelligence and machine learning in diagnostic tools offers potential for early detection and personalized treatment plans, further improving patient outcomes. Addressing these research gaps through continued investigation and technological innovation is crucial for enhancing the prevention, diagnosis, and management of diabetes and periodontal disease. These efforts will ultimately lead to better health outcomes and quality of life for affected individuals.