Effect of Supplementation of Vitamin D in Patients with Periodontitis Evaluated before and after Nonsurgical Therapy

Abstract

Background. Vitamin D has anti-inflammatory properties and the potential to increase the generation of antimicrobial peptides like cathelicidin and defensins that may have a good impact on oral health. Higher vitamin D consumption has also been linked to a reduced risk of periodontal disease progression. Hence, the primary objective of this study was to evaluate and compare the clinical and laboratory parameters of oral supplementation of vitamin D as an adjuvant to scaling and root planing and to assess the bone mineral density via qualitative ultrasound bone density scanner in chronic periodontitis patients. Methodology. This study included 40 patients with periodontitis categorized into 2 groups with twenty patients each, Group I comprising scaling and root planing (SRP) alone and Group II comprising SRP along with vitamin D supplementation. Plaque index, gingival index, probing pocket depth, and clinical attachment loss was measured as clinical parameters. Serum vitamin D levels were assessed before and after SRP at both baseline and 6 weeks. Results. The intergroup comparison of clinical parameters (PI, GI, PPD, and CAL) at 6 weeks for both the groups showed statistical significance. Intragroup comparison of clinical parameters from baseline to 6 weeks showed a statistically significant reduction in both groups. The mean bone mineral density level in both the control and test groups demonstrated a mean T score of –1.3 and –1.21, respectively. The mean vitamin D levels were 27.8460 and 28.1020 for the test and control groups, respectively, which was statistically insignificant ( p = 0.705 ) and those at six-week intervals improved to 31.3650 and 28.0240 which were statistically significant ( p ≤ 0.001 ). Conclusion. It could be stated that a positive relationship exists between periodontitis and osteopenia which could aggravate periodontal destruction. All periodontitis cases should thus be evaluated for BMD and supplemented with vitamin D3 in an appropriate dosage and time frame to treat both these diseases.

Different doses of vitamin D supplementation to nonsurgical treatment for vitamin‐D‐insufficient patients with diabetic periodontitis and the effect on gingival BMP‐2 levels

“…Lower serum vitamin D level was also previously reported to be related to a slightly reduced periodontal healing following nonsurgical treatment in patients with periodontitis, as the mean PPD was reduced more significantly for patients with vitamin D ≥ 30 ng/mL than those with <30 ng/mL 33 . Mishra et al 34 evaluate the clinical parameters of oral supplementation of vitamin D as an adjuvant to SRP for 6 weeks in patients with chronic periodontitis, which found that clinical parameters, PPD, CAL, PLI, and gingival index, were all decreased at 6 weeks for SRP plus vitamin D supplementation and SRP alone. Moreover, they found a more significant reduction in these values after SRP plus vitamin D supplementation than SRP alone, suggesting a better periodontal healing conferred by vitamin D supplementation to nonsurgical treatment for periodontitis patients.…”

“…Lower serum vitamin D level was also previously reported to be related to a slightly reduced periodontal healing following nonsurgical treatment in patients with periodontitis, as the mean PPD was reduced more significantly for patients with vitamin D ≥ 30 ng/mL than those with <30 ng/mL. 33 Mishra et al 34 With the regard to the benefits of vitamin D supplementation or nonsurgical periodontal therapy bringing to glycemic control of T2DM patients, there have been debates according to previous evidence. Krul-Poel et al 23 found intermittent high-dose vitamin D supplementation failed to significantly improve glycemic control in a well-controlled group of T2DM patients.…”

Anti-Inflammatory Benefits of Food Ingredients in Periodontal Diseases

“…Both the experimental and control groups showed improvements in all evaluated clinical parameters (PPD, BOP, PI); however, the reduction in PPD was greater in the test group that received the supplementation of vitamin D [30]. In another RCT, a dose of 400 IU/day of vitamin D supplementation for 6 weeks as an adjunct to nonsurgical periodontal therapy resulted in similar improvements in periodontal indices compared to nonsurgical periodontal treatment [31]. In this study, the authors also evaluated bone mineral density by a qualitative ultrasound; however, no significant difference was observed between comparison groups.…”

Vitamin D Deficiency, Chronic Kidney Disease and Periodontitis

“…One RCT demonstrated that the administration of vitamin D (700 IU/day) and calcium (500 mg/day) significantly reduced tooth loss in older patients during three years of observation [ 146 ]. While some studies have demonstrated moderately improved short-term periodontal outcomes after non-surgical periodontal therapy in patients on vitamin D supplementation [ 147 , 148 , 149 ], others have not [ 150 ]. One RCT demonstrated improved clinical and radiographic outcomes following periodontal surgery in patients where presurgical teriparatide, which is a commercially available PTH, was provided [ 151 , 152 ].…”