Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the “sixth complication” of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long‐term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri‐implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri‐implant disease in diabetic patients and the potential role of the dental professional in the diabetes‐periodontal interface.

Background: It is thought that infrabony defect morphology affects the outcome of periodontal regenerative surgery. However, this has not been systematically investigated.Aims: To investigate how well defect morphology is described in papers reporting regenerative therapy of periodontal infrabony defects and to investigate its effect on clinical and radiographic outcomes.Materials and Methods: A search was conducted in 3 electronic databases for publications reporting clinical and radiographic outcomes of periodontal intra‐bony defects after regenerative therapy, divided by defect morphology.Results: The initial search resulted in 4487 papers, reduced to 143 after first and second screening. Fifteen of these publications were suitable for a fixed‐effects meta‐analysis. Initial defect depth was found to influence radiographic bone gain 12 months post‐surgery, while narrower angles and increased number of walls influenced both radiographic bone gain and clinical attachment level (CAL) gain at 12 months. These associations seemed to occur irrespective of biomaterials used. Risk of bias ranged from low to high.Conclusion: Deeper defects with narrower angles and increased number of walls exhibit improved CAL and radiographic bone gain at 12 months post‐regenerative surgery. More data are needed about other aspects of defect morphology such as extension to buccal/lingual surfaces.

Aim: To determine the accuracy of biomarker combinations in gingival crevicular fluid (GCF) and saliva through meta‐analysis to diagnose periodontitis in systemically healthy subjects.Methods: Studies on combining two or more biomarkers providing a binary classification table, sensitivity/specificity values or group sizes in subjects diagnosed with periodontitis were included. The search was performed in August 2022 through PUBMED, EMBASE, Cochrane, LILACS, SCOPUS and Web of Science. The methodological quality of the articles selected was evaluated using the QUADAS‐2 checklist. Hierarchical summary receiver operating characteristic modelling was employed to perform the meta‐analyses (CRD42020175021).Results: Twenty‐one combinations in GCF and 47 in saliva were evaluated. Meta‐analyses were possible for six salivary combinations (median sensitivity/specificity values): IL‐6 with MMP‐8 (86.2%/80.5%); IL‐1β with IL‐6 (83.0%/83.7%); IL‐1β with MMP‐8 (82.7%/80.8%); MIP‐1α with MMP‐8 (71.0%/75.6%); IL‐1β, IL‐6 and MMP‐8 (81.8%/84.3%); and IL‐1β, IL‐6, MIP‐1α and MMP‐8 (76.6%/79.7%).Conclusions: Two‐biomarker combinations in oral fluids show high diagnostic accuracy for periodontitis, which is not substantially improved by incorporating more biomarkers. In saliva, the dual combinations of IL‐1β, IL‐6 and MMP‐8 have an excellent ability to detect periodontitis and a good capacity to detect non‐periodontitis. Because of the limited number of biomarker combinations evaluated, further research is required to corroborate these observations.