PHARMACOLOGICAL AND NON-PHARMACOLOGICAL MODULATION OF THE PERI-IMPLANT INFLAMMATORY RESPONSE IN TYPE II DIABETIC PATIENTS WITH A HISTORY OF PERIODONTITIS: A SYSTEMATIC REVIEW

Authors

  • Rosalba Mazzaglia Universidad de Catania, Itália
  • Jéssika Duyane da Silva Araújo Centro Universitário Maurício de Nassau, Brasil
  • Cristian Duane Pires Faculdade São Leopoldo Mandic, Brasil
  • Giusepp Mazzaglia Università Degli Studi Di Sassari, Itália
  • Izabel Christina Ribeiro Vianna Universidade Paulista, Brasil
  • Cíntia Moreira Gonçalves Universidade de Campinas, Brasil
  • Vitor Rodrigues da Silva Universidade de Campinas
  • Gustavo Henrique de Castro Faculdade Patos de Minas
  • Leonardo Gomes Mendes Centro Universitário do Estado do Pará
  • Anna Beathryz Santana Reis Universidade Federal de Sergipe
  • Marina Paraluppi Universidade Paulista
  • Leonardo Rinaldi São Leopoldo Mandic, Brasil
  • Úrsula Costa Universidade Federal do Rio Grande do Norte
  • Lélia Maria Guedes Queiroz Universidade de São Paulo

DOI:

https://doi.org/10.66104/vgvn3456

Keywords:

Pharmacological Biomarkers; Dental Implants; Inflammation; Peri-implantitis; Diabetes Mellitus.

Abstract

Objective: To analyze the available scientific evidence on pharmacological and non-pharmacological strategies employed in modulating the peri-implant inflammatory response in patients with type II diabetes mellitus and a history of periodontitis, identifying the most effective therapeutic approaches for reducing the risk of peri-implantitis and increasing the success rates of osseointegrated implants in this population with greater biological vulnerability. Methodology: The review was conducted following the PRISMA guidelines, with systematic searches in the PubMed/MEDLINE, Cochrane Library, Scopus, and Web of Science databases, covering publications from the last ten years. The descriptors used included terms related to dental implants, type II diabetes, periodontitis, peri-implant inflammation, and immunological modulation. Randomized clinical trials, cohort studies, and clinical reviews that evaluated outcomes such as marginal bone loss, probing depth, bleeding index, and local and systemic inflammatory markers, such as interleukin-1β, TNF-α, and C-reactive protein, were included. Results: The most investigated pharmacological strategies included the use of adjuvant antibiotic therapy, chlorhexidine-based local antiseptics, sub-dose doxycycline as a modulator of matrix metalloproteinase, and non-steroidal anti-inflammatory drugs. Among the non-pharmacological approaches, rigorous glycemic control, low-intensity laser therapy, the use of probiotics, and an intensive peri-implant hygiene protocol stood out. The combination of adequate metabolic control with mechanical decontamination demonstrated the best clinical outcomes, with a significant reduction in pro-inflammatory cytokine levels and a lower rate of marginal bone loss. Conclusion: Effective modulation of the peri-implant inflammatory response in type II diabetics with a history of periodontitis requires a multidisciplinary and individualized approach. Glycemic control represents the central pillar of treatment, enhanced by adjuvant pharmacological and non-pharmacological interventions. Rigorous and personalized peri-implant maintenance protocols are essential for the longevity of implants in this high-risk population.

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References

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Published

2026-04-09

Issue

Vol. 13 No. 05 (2026): REMUNOM - ISSN 2178-6925

Section

Artigos

License

Copyright (c) 2026 Rosalba Mazzaglia, Jéssika Duyane da Silva Araújo, Cristian Duane Pires, Giusepp Mazzaglia, Izabel Christina Ribeiro Vianna, Cíntia Moreira Gonçalves, Vitor Rodrigues da Silva, Gustavo Henrique de Castro, Leonardo Gomes Mendes, Anna Beathryz Santana Reis, Marina Paraluppi, Leonardo Rinaldi, Úrsula Costa , Lélia Maria Guedes Queiroz

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How to Cite

PHARMACOLOGICAL AND NON-PHARMACOLOGICAL MODULATION OF THE PERI-IMPLANT INFLAMMATORY RESPONSE IN TYPE II DIABETIC PATIENTS WITH A HISTORY OF PERIODONTITIS: A SYSTEMATIC REVIEW. (2026). REMUNOM, 13(05), 1-23. https://doi.org/10.66104/vgvn3456