The study answers the PECO question: "In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?". Prediabetes (5.7-6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association. Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c. An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles. Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm. Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases. Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health. PROTOCOL REGISTRATION NUMBER: (CRD42022375263).

Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. Methods: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusions: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.

We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on Streptococcus mutans. The systematic search was performed in three databases (Cochrane Library, EMBASE, and PubMed) and included English-language randomized–controlled trials to compare the efficacy of chitosan in reducing the number of S. mutans. To assess the certainty of evidence, the GRADE tool was used. Mean differences were calculated with a 95% confidence interval for one outcome: bacterial counts in CFU/mL. The protocol of the study was registered on PROSPERO, registration number CRD42022365006. Articles were downloaded (n = 6758) from EMBASE (n = 2255), PubMed (n = 1516), and Cochrane (n = 2987). After the selection process, a total of four articles were included in the qualitative synthesis and three in the quantitative synthesis. Our results show that chitosan reduced the number of bacteria. The difference in mean quantity was −4.68 × 10⁵. The interval of the random-effects model was [−2.15 × 10⁶; 1.21 × 10⁶] and the prediction interval was [1.03 × 10⁷; 9.40 × 10⁶]. The I2 value was 98% (p = 0.35), which indicates a high degree of heterogeneity. Chitosan has some antibacterial effects when used as a component of chewing gum, but further studies are needed. It can be a promising antimicrobial agent for prevention.

Introduction: Dental implantology has seen rapid technological advancements, with artificial intelligence (AI) increasingly integrated into diagnostic, planning, and surgical processes. The release of chat‐generative pretrained transformer (ChatGPT) and its subsequent updates, including the deep research function, presents opportunities for AI‐assisted systematic reviews. However, its efficacy compared to traditional manual research has not been researched. Materials and Methods: A systematic review was conducted on May 6, 2025, to evaluate recent innovations in dental implantology and AI. Two parallel searches were performed: one using ChatGPT 4.1’s deep research tool in the PubMed database and another manual PubMed search by two independent reviewers. Both searches used identical keywords and Boolean operators targeting studies from 2020 to 2025. Inclusion criteria were peer‐reviewed studies related to implant design, osseointegration, guided placement, and other predefined outcomes. Results: The manual search identified 124 articles, of which 23 met the inclusion criteria. ChatGPT retrieved 114 articles, selected 13 for inclusion, yet only included 11 in its synthesis. Two cited articles by the AI software were nonexistent, and numerous relevant studies were not retrieved, whereas the remaining articles were correct and found by manual search as well. ChatGPT had high specificity (98%) and low sensitivity (47.8%), with a statistically significant difference compared to manual search and selection. Discussion: AI tools like ChatGPT show promise in literature search, synthesis, and assistance, especially in improving readability and identifying trending topics in science. Nevertheless, the current state of deep research function lacks the reliability required for conducting systematic reviews due to issues such as made‐up references and missed articles. The results highlight the need for human supervision and improved safeguards. Conclusions: ChatGPT’s deep research function can support, but not replace manual systematic search and selection. It offers substantial benefits in writing support and preliminary synthesis due to acceptable accuracy, but limitations in reliability and low sensitivity (47.8%) require cautious use and transparent reporting of any AI involvement in scientific research.

Purpose: Approximately 19% of the global adult population is affected by periodontal diseases. Healing is a protracted process that is significantly influenced by the patient's motivation, proficiency, and cooperation. The prevalence of periodontal diseases in patients with diabetes mellitus is extremely high, and the relationship is bidirectional. In previous investigations, metformin (MF), a biguanide antidiabetic medicine, has demonstrated promising results when administered locally to periodontal defects. The study aimed to systematically assess available literature that evaluate the effectiveness of 1% metformin gel in the treatment of periodontal disease. We attempted to include clinical trials on patients with periodontitis treated with local administration of 1% metformin gel, compared to a placebo. Methods: Using identical MeSH terms, we conducted a systematic search in three databases. Our analysis encompassed human studies that measured the periodontal pocket depth, the clinical attachment level, and the depth of the intra-bony defect. Meta-analyses were carried out using random effects model to compare the mean differences between the study group, which received 1% MF gel locally in addition to traditional scaling and root planing (SRP), and the control group, which received a placebo in addition to conventional treatment. Results: Following the selection procedure, six articles were selected for inclusion in our meta-analysis, out of the 246 articles identified through the systematic search. After three and six months of follow-up, meta-analyses revealed statistically significant differences between the control and study groups. The overall effect for PD was a 1.33 mm reduction (95% confidence interval (CI): -1.66; -1.01) after three months and 1.87 mm (-2.24; -1.39) after six months. The overall effect of CAL was 1.80 mm (-2.26; -1.34) after three months and 2.14 mm (-2.71; -1.58) after six months. The change in IBD after a six-month follow-up was 1.16 mm (-1.40; -0.92). Conclusion: The application of 1% MF gel enhances the healing process in periodontal diseases, when employed in conjunction with conventional therapy.