{
  "abstract": "Type 2 diabetes mellitus (T2DM) and periodontitis are bidirectionally linked. Systemic glucose-lowering drug classes differ in their extra-glycaemic effects on inflammation and bone, which could plausibly modify periodontal and peri-implant health; however, this evidence has not been synthesised across drug classes. We conducted a systematic review and evidence gap map (EGM), with sodium-glucose cotransporter-2 (SGLT2) inhibitors examined as a pre-specified evidence gap. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus were searched and cross-checked against the Consensus academic corpus. Eligible studies enrolled adults with T2DM, evaluated a systemic glucose-lowering drug as the exposure, and reported a periodontal or peri-implant outcome. Studies of local drug delivery and periodontal therapy aimed at improving glycaemic control were excluded from the systematic-review layer; all study designs, including preclinical studies, were charted in the EGM. Risk of bias was assessed using the Cochrane risk-of-bias 2 (RoB 2) tool and the Newcastle-Ottawa Scale. Four studies were included: one randomised controlled trial and three observational studies. These comprised a trial of a dipeptidyl peptidase-4 (DPP-4) inhibitor (sitagliptin) added to metformin, which reported improvements in probing depth, clinical attachment level, bleeding on probing, and alveolar bone density; a cohort study comparing peri-implant marginal bone loss among users of glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists), metformin, and insulin, with the least bone loss observed among glucagon-like peptide-1 receptor agonist users; a large pharmacoepidemiological cohort evaluating DPP-4 inhibitor exposure; and a cross-sectional survey of glucagon-like peptide-1 receptor agonist users. Meta-analysis was not feasible because of substantial heterogeneity. The EGM, comprising eight drug classes and six outcome domains, showed that evidence was concentrated in glucagon-like peptide-1 receptor agonists and metformin and was almost entirely preclinical; the only high-level evidence cell was represented by a single DPP-4 inhibitor randomised controlled trial, while SGLT2 inhibitors constituted a complete evidence gap across all outcome domains. Based on the four included studies, human evidence linking systemic glucose-lowering therapy with periodontal outcomes in adults with T2DM is sparse, heterogeneous, and of low certainty, with weak signals favouring incretin-based therapies. SGLT2 inhibitors remain entirely unstudied in this context despite biological plausibility. The EGM identifies specific, high-value priorities for future randomised trials and prospective cohort studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Jazan Health Cluster, Jazan, SAU.",
    "Clinical Pharmacy Program, College of Health Sciences, Taibah University, Madinah, SAU.",
    "College of Medicine, Al-Baha University, Al-Baha, SAU.",
    "Faculty of Medicine, Tabuk University, Tabuk, SAU.",
    "College of Medicine, Majmaah University, Majmaah, SAU.",
    "College of Medicine, Taif University, Taif, SAU.",
    "Faculty of Dentistry, Jazan University, Jazan, SAU.",
    "Faculty of Medicine, Jazan University, Jazan, SAU."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abadi A Hakami"
    },
    {
      "affs": [
        1
      ],
      "name": "Lina A Alamri"
    },
    {
      "affs": [
        2
      ],
      "name": "Shahad A Alghamdi"
    },
    {
      "affs": [
        3
      ],
      "name": "Hala T Alanazi"
    },
    {
      "affs": [
        4
      ],
      "name": "Ali A Alqahtani"
    },
    {
      "affs": [
        4
      ],
      "name": "Waleed K Almutairi"
    },
    {
      "affs": [
        5
      ],
      "name": "Turki R Alzahrani"
    },
    {
      "affs": [
        3
      ],
      "name": "Fatma M Toonisi"
    },
    {
      "affs": [
        3
      ],
      "name": "Maram A Alsamti"
    },
    {
      "affs": [
        6
      ],
      "name": "Abdulmalik M Mossa"
    },
    {
      "affs": [
        7
      ],
      "name": "Amirah Y Hakami"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/35nfhtb870ds1.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117011",
  "fulltext_url": "https://europepmc.org/articles/PMC13712486",
  "id": "35nfhtb870ds1",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948780",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Family/General Practice"
    ],
    [
      "heading",
      "Osteopathic Medicine"
    ],
    [
      "openalex",
      "3506|Oral microbiology and periodontitis research"
    ]
  ],
  "openalex": "W7214532327",
  "pdf_url": "https://europepmc.org/articles/PMC13712486?pdf=render",
  "pmcid": "PMC13712486",
  "pmid": "42948780",
  "published": "2026-09-27",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/35nfhtb870ds1.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948780",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948780"
    },
    {
      "first_seen": "2026-10-31T12:23:02Z",
      "native_id": "PMC13712486",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117011"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Systemic Glucose-Lowering Therapies and Periodontal and Peri-Implant Outcomes in Adults With Type 2 Diabetes Mellitus: A Systematic Review.",
  "title_text": "Systemic Glucose-Lowering Therapies and Periodontal and Peri-Implant Outcomes in Adults With Type 2 Diabetes Mellitus: A Systematic Review.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:02Z",
  "url": "https://research.draconitic.com/paper/35nfhtb870ds1",
  "venue": "Cureus",
  "versions": []
}