Pathogenesis of diabetic periodontitis and its local drug delivery treatment strategies

Yang Xirui; He Jinfeng

doi:10.12307/2026.109

Abstract：BACKGROUND:Periodontitis is the sixth most common complication of diabetes.The complex two-way relationship between diabetes and periodontitis poses a challenge to the treatment of diabetic periodontitis. OBJECTIVE:To systematically summarize the types of drugs and carriers that can be used for the topical treatment of diabetic periodontitis from the perspective of the pathogenesis of diabetic periodontitis and the special pathological microenvironment. METHODS:We searched the databases of PubMed,Web of Science,and CNKI from database inception to February 2025 with the search terms of"periodontitis,diabetes,hydrogel,fiber,film,microparticle,nanoparticle,microneedle"in both Chinese and English,and 119 articles were finally included for review and analysis. RESULTS AND CONCLUSION:Diabetic periodontitis involves a complex pathological microenvironment of hyperglycemia,bacterial infection,inflammatory microenvironment,oxidative stress,immune dysregulation,and bone loss.For the unique pathological microenvironment of diabetic periodontitis,a variety of drugs such as blood glucose control drugs,antibacterial and anti-infection drugs,anti-inflammatory and immunomodulatory drugs,anti-oxidative stress drugs,and periodontal tissue regeneration drugs are available for the local treatment of diabetic periodontitis from multiple perspectives.Among them,hydrogel plays an important role in the treatment of diabetic periodontitis with its advantages of good biocompatibility,highly adjustability,and diversity of functions.Safer,smarter,and more controllable local drug delivery systems adapted to the pathological microenvironment of diabetic periodontitis are expected to play a significant role in the future treatment of diabetic periodontitis.