Periodontal Healing Dynamics and Biomarker Responses Following Non-Surgical Periodontal Therapy in Type 2 Diabetes Mellitus: A Narrative Review

Mastura Norman; Fouad Hussain Al-Bayaty; Mohd Faizal Hafez Hidayat; Hasidah Abdul Hamid; Najwa Baharudin

doi:10.24191/cos.v13i2.10749

Authors

Mastura Norman UiTM , Centre of Periodontology Studies, Faculty of Dentistry , MARA University of Technology
Fouad Hussain Al-Bayaty Department of Postgraduate Study, Faculty of Dentistry , Mahsa University https://orcid.org/0000-0002-3117-595X (unauthenticated)
Mohd Faizal Hafez Hidayat Centre of Periodontology Studies, Faculty of Dentistry , MARA University of Technology
Hasidah Abdul Hamid Faculty of Medicine , MARA University of Technology https://orcid.org/0000-0002-1642-0427 (unauthenticated)
Najwa Baharudin Centre of Periodontology Studies, Faculty of Dentistry , MARA University of Technology

DOI:

https://doi.org/10.24191/cos.v13i2.10749

Keywords:

periodontitis, type 2 diabetes mellitus, nonsurgical periodontal therapy, periodontal healing, glycemic control, biomarkers

Abstract

Periodontitis and type 2 diabetes mellitus are chronic inflammatory conditions linked by a well-established bidirectional relationship. Non-surgical periodontal therapy is effective in improving clinical periodontal parameters, yet conventional clinical measures provide limited insight into the underlying biological healing process, particularly in individuals with type 2 diabetes mellitus. This narrative review focuses on the role of biological biomarkers in characterising periodontal healing following non-surgical periodontal therapy in patients with type 2 diabetes mellitus. Evidence indicates that periodontal healing is a prolonged and multistage biological process involving inflammatory resolution, connective tissue remodelling, and systemic inflammatory modulation. In type 2 diabetes mellitus, chronic hyperglycaemia disrupts these processes, leading to delayed or incomplete biological resolution despite apparent clinical improvement. Biomarkers derived from gingival crevicular fluid, saliva, and serum offer objective measures of inflammatory activity, extracellular matrix turnover, and bone metabolism that are not captured by routine clinical assessment. Current evidence suggests that altered biomarker profiles help explain the dissociation between short term clinical improvement and long-term disease susceptibility in patients with type 2 diabetes mellitus. Integrating biomarker assessment with clinical evaluation may enhance risk stratification, improve monitoring of periodontal healing, and support more individualised periodontal care in this high-risk population.

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