**8.4 Diabetes mellitus**

Based on the available data, no association was found between diabetes and periimplantitis. Although the role of distinct physiological mediators in pathogenesis is not fully understood, evidence suggests that pro-inflammatory gene expression in peri-implantitis regions is affected by glycemic control [44]. Patients with diabetes mellitus are more prone to peri-implantitis than non-diabetic subjects, and the poor metabolic control has been shown to provide a more favorable environment for infection and loss of implants [45]. Controlling the blood sugar level is critical in increasing the implant success rate in diabetic patients [46].
