Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on modern management of frailty

LIVE: Thursday 17th October 2024, 18:00-19:30 (CEST)

Frailty has a significant impact on health and wellbeing, especially in older adults. Join our experts to understand the factors that contribute to the development of frailty and find out how to manage the condition and reduce the risk of disability, dependency, and mortality.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in:

Open Access 01-12-2023 | Gingiva Index | Research

Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis

Authors: Fangfang Liang, Yuanzhu Zhou, Zhenyu Zhang, Zheng Zhang, Jing Shen

Published in: BMC Oral Health | Issue 1/2023

Login to get access

Abstract

Background

There are differences in vitamin D levels between periodontitis and healthy individuals, but the effect of vitamin D on periodontitis is controversial. The purpose of this Meta-analysis is twofold: (1) compare vitamin D levels in individuals with or without periodontitis; (2) assess the effects of vitamin D supplementation during scaling and root planing (SRP) on periodontal clinical parameters in individuals with periodontitis.

Methods

A systematic search was conducted in five databases (PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library), published from the database inception to 12 September 2022. The Cochrane Collaboration Risk of bias (ROB) assessment tool, the risk of bias in non-randomized studies of intervention (ROBINS-I) tool, the Newcastle–Ottawa Quality Assessment Scale (NOS), and Agency for Healthcare Quality and Research (AHRQ) were used to evaluate randomized controlled trial (RCT), non-RCT, case–control study, and cross-sectional study, respectively. Statistical analysis was performed using RevMan 5.3 and Stata 14.0 software, with weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence intervals (CI) as the effect measures, and heterogeneity was tested by subgroup analysis, sensitivity analysis, Meta-regression.

Results

A total of 16 articles were included. The results of Meta-analysis showed that periodontitis was associated with lower serum vitamin D levels compared to normal population (SMD = -0.88, 95%CI -1.75 ~ -0.01, P = 0.048), while there was no significant difference in serum or saliva 25(OH)D levels between periodontitis and normal population. Additionally, the Meta-analysis showed that SRP + vitamin D and SRP alone had a statistically significant effect on serum vitamin D levels in individuals with periodontitis (SMD = 23.67, 95%CI 8.05 ~ 32.29, P = 0.003; SMD = 1.57, 95%CI 1.08 ~ 2.06, P < 0.01). And SRP + vitamin D could significantly reduce clinical attachment level compared to SRP alone (WMD = -0.13, 95%CI -0.19 ~ -0.06, P < 0.01), but had no meaningful effect on probing depth, gingival index, bleeding index, respectively.

Conclusion

The evidence from this Meta-analysis suggests that the serum vitamin D concentration of individuals with periodontitis is lower than that of normal people, and SRP along with vitamin D supplementation has been shown to play a significant role in improving periodontal clinical parameters. Therefore, vitamin D supplementation as an adjuvant to nonsurgical periodontal therapy has a positive impact on the prevention and treatment of periodontal disease in clinical practice.
Appendix
Available only for authorised users
Literature
1.
Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017;44(Suppl 18):S94-s105.PubMedCrossRef
2.
Yang H, Xiao L, Zhang L, Deepal S, Ye G, Zhang X. Epidemic trend of periodontal disease in elderly Chinese population, 1987–2015: a systematic review and meta-analysis. Sci Rep. 2017;7:45000.PubMedPubMedCentralCrossRef
3.
Bernabe E, Marcenes W, Hernandez CR, et al. Global, Regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic Analysis for the Global Burden of Disease 2017 Study. J Dent Res. 2020;99(4):362–73.PubMedCrossRef
4.
World Health O, International Telecommunication U. Mobile technologies for oral health: an implementation guide. Geneva: World Health Organization; 2021.
5.
Aral K, Milward MR, Kapila Y, Berdeli A, Cooper PR. Inflammasomes and their regulation in periodontal disease: a review. J Periodontal Res. 2020;55(4):473–87.PubMedCrossRef
6.
7.
Adegboye AR, Boucher BJ, Kongstad J, Fiehn NE, Christensen LB, Heitmann BL. Calcium, vitamin D, casein and whey protein intakes and periodontitis among Danish adults. Public Health Nutr. 2016;19(3):503–10.PubMedCrossRef
8.
Zhang JC. Consideration for impacts of periodontitis on systemic health. Zhonghua Kou Qiang Yi Xue Za Zhi. 2021;56(6):507–9.PubMed
9.
Sassi F, Tamone C, D’Amelio P. Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients. 2018;10(11):1656.
10.
11.
Trimboli F, Rotundo S, Armili S, et al. Serum 25-hydroxyvitamin D measurement: comparative evaluation of three automated immunoassays. Pract Lab Med. 2021;26: e00251.PubMedPubMedCentralCrossRef
12.
Fernández-Lázaro D, Hernández JLG, Lumbreras E, Mielgo-Ayuso J, Seco-Calvo J. 25-Hydroxyvitamin D serum levels linked to Single Nucleotide Polymorphisms (SNPs) (rs2228570, rs2282679, rs10741657) in skeletal muscle aging in institutionalized elderly men not supplemented with Vitamin D. Int J Mol Sci. 2022;23(19):11846.
13.
Jimenez M, Giovannucci E, Krall Kaye E, Joshipura KJ, Dietrich T. Predicted vitamin D status and incidence of tooth loss and periodontitis. Public Health Nutr. 2014;17(4):844–52.PubMedCrossRef
14.
Khammissa RAG, Ballyram R, Jadwat Y, Fourie J, Lemmer J, Feller L. Vitamin D deficiency as it relates to oral immunity and chronic periodontitis. Int J Dent. 2018;2018:7315797.PubMedPubMedCentralCrossRef
15.
Perić M, Cavalier E, Toma S, Lasserre JF. Serum vitamin D levels and chronic periodontitis in adult, Caucasian population-a systematic review. J Periodontal Res. 2018;53(5):645–56.PubMedCrossRef
16.
Machado V, Lobo S, Proenca L, Mendes JJ, Botelho J. Vitamin D and Periodontitis: A systematic review and meta-analysis. Nutrients. 2020;12(8):2177.
17.
Olszewska-Czyz I, Firkova E. Vitamin D3 serum levels in periodontitis patients: a case-control study. Medicina (Kaunas). 2022;58(5):585.
18.
Agrawal AA, Kolte AP, Kolte RA, Chari S, Gupta M, Pakhmode R. Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy, chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus - a cross-sectional study. Acta Odontol Scand. 2019;77(8):592–9.PubMedCrossRef
19.
Isola G, Alibrandi A, Rapisarda E, Matarese G, Williams RC, Leonardi R. Association of vitamin D in patients with periodontitis: a cross-sectional study. J Periodontal Res. 2020;55(5):602–12.PubMedCrossRef
20.
Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol  2000. 2013;62(1):59–94.PubMedCrossRef
21.
Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B. Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med. 2001;111(6):452–6.PubMedCrossRef
22.
Costantini E, Sinjari B, Piscopo F, et al. Evaluation of salivary cytokines and Vitamin D levels in periodontopathic patients. Int J Mol Sci. 2020;21(8):2669.
23.
Cai T, Yang ZY, Nie L, Zhen JX, Deng L, Zhou Z. Association between vitamin D receptor BsmI gene polymorphism and periodontitis: a meta-analysis in a single ethnic group. Cell Mol Biol  (Noisy-le-grand). 2017;63(11):1–4.PubMedCrossRef
24.
Mashhadiabbas F, Neamatzadeh H, Nasiri R, et al. Association of vitamin D receptor BsmI, TaqI, FokI, and ApaI polymorphisms with susceptibility of chronic periodontitis: a systematic review and meta-analysis based on 38 case -control studies. Dent Res J (Isfahan). 2018;15(3):155–65.PubMedCrossRef
25.
Zhuang C, Yuan J, Du Y, et al. Effects of oral carotenoids on oxidative stress: a systematic review and meta-analysis of studies in the recent 20 years. Front Nutr. 2022;9: 754707.PubMedPubMedCentralCrossRef
26.
27.
Wells GA, Wells G, Shea B, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. 2014.
28.
Front Matter. In: Cochrane Handbook for Systematic Reviews of Interventions.2019:i-xxviii.
29.
Baima G, Corana M, Iaderosa G, et al. Metabolomics of gingival crevicular fluid to identify biomarkers for periodontitis: a systematic review with meta-analysis. J Periodontal Res. 2021;56(4):633–45.PubMedCrossRef
30.
Abreu OJ, Tatakis DN, Elias-Boneta AR, et al. Low vitamin D status strongly associated with periodontitis in Puerto Rican adults. BMC Oral Health. 2016;16(1):89.PubMedPubMedCentralCrossRef
31.
Alzahrani AAH, Alharbi RA, Alzahrani MSA, et al. Association between periodontitis and vitamin D status: a case-control study. Saudi Journal of Biological Sciences. 2021;28(7):4016–21.PubMedPubMedCentralCrossRef
32.
Anbarcioglu E, Kirtiloglu T, Öztürk A, Kolbakir F, Acıkgöz G, Colak R. Vitamin D deficiency in patients with aggressive periodontitis. Oral Dis. 2019;25(1):242–9.PubMedCrossRef
33.
Gao WM, Tang HL, Wang DY, Zhou X, Song YQ, Wang ZM. Effect of short-term vitamin D supplementation after nonsurgical periodontal treatment: a randomized, double-masked, placebo-controlled clinical trial. J Periodontal Res. 2020;55(3):354–62.PubMedCrossRef
34.
Ketharanathan V, Torgersen GR, Petrovski BE, Preus HR. Radiographic alveolar bone level and levels of serum 25-OH-Vitamin D-3 in ethnic Norwegian and Tamil periodontitis patients and their periodontally healthy controls. Bmc Oral Health. 2019;19(1):83.PubMedPubMedCentralCrossRef
35.
Laky M, Bertl K, Haririan H, et al. Serum levels of 25-hydroxyvitamin D are associated with periodontal disease. Clin Oral Invest. 2017;21(5):1553–8.CrossRef
36.
Liu KN, Meng HX, Lu RF, et al. Initial periodontal therapy reduced systemic and local 25-Hydroxy Vitamin D-3 and interleukin-1 beta in patients with aggressive periodontitis. J Periodontol. 2010;81(2):260–6.PubMedCrossRef
37.
Miley DD, Garcia MN, Hildebolt CF, et al. Cross-sectional study of Vitamin D and calcium supplementation effects on chronic periodontitis. J Periodontol. 2009;80(9):1433–9.PubMedPubMedCentralCrossRef
38.
Miricescu D, Totan A, Calenic B, et al. Salivary biomarkers: Relationship between oxidative stress and alveolar bone loss in chronic periodontitis. Acta Odontol Scand. 2014;72(1):42–7.PubMedCrossRef
39.
Pai S, Shenoy N, John DS. Evaluation of IL-6, vitamin D level in chronic periodontitis patients after non-surgical periodontal therapy. Romanian Journal of Diabetes, Nutrition and Metabolic Diseases. 2021;28(4):376–82.
40.
Perayil J, Menon KS, Kurup S, et al. Influence of Vitamin D & calcium supplementation in the management of periodontitis. J Clin Diagn Res. 2015;9(6):Zc35-38.
41.
Peric M, Maiter D, Cavalier E, Lasserre JF, Toma S. The Effects of 6-Month Vitamin D supplementation during the non-surgical treatment of periodontitis in Vitamin-D-deficient patients: a randomized double-blind placebo-controlled study. Nutrients. 2020;12(10):2940.
42.
Pradhan S, Agrawal S. Serum Vitamin D in patients with chronic periodontitis and healthy periodontium. J Nepal Health Res Counc. 2021;18(4):610–4.PubMedCrossRef
43.
Rafique S, Hingorjo MR, Mumtaz M, Qureshi MA. The relationship of 1,25-dihydroxyvitamin D and Vitamin D binding protein in periodontitis. Pakistan Journal of Medical Sciences. 2019;35(3):847–51.PubMedPubMedCentralCrossRef
44.
Zhu A, Kuznia S, Niedermaier T, Holleczek B, Schöttker B, Brenner H. Distribution and determinants of Vitamin D-Binding Protein, Total, “Non-Bioavailable”, Bioavailable, and Free 25-Hydroxyvitamin D concentrations among older adults. Nutrients. 2021;13(11):3982.
45.
Millen AE, Hovey KM, LaMonte MJ, et al. Plasma 25-Hydroxyvitamin D Concentrations and periodontal disease in postmenopausal women. J Periodontol. 2013;84(9):1243–56.PubMedCrossRef
46.
Antonoglou G, Knuuttila M, Niemea O, et al. Serum 1,25(OH)D level increases after elimination of periodontal inflammation in T1DM Subjects. J Clin Endocrinol Metab. 2013;98(10):3999–4005.PubMedCrossRef
47.
Amaliya A, Laine ML, Delanghe JR, Loos BG, Van Wijk AJ, Van der Velden U. Java project on periodontal diseases: periodontal bone loss in relation to environmental and systemic conditions. J Clin Periodontol. 2015;42(4):325–32.PubMedCrossRef
48.
Wu Y, Shu R, Luo LJ, Ge LH, Xie YF. Initial comparison of proteomic profiles of whole unstimulated saliva obtained from generalized aggressive periodontitis patients and healthy control subjects. J Periodontal Res. 2009;44(5):636–44.PubMedCrossRef
49.
Matarese G, Isola G, Anastasi GP, et al. Immunohistochemical analysis of TGF-β1 and VEGF in gingival and periodontal tissues: a role of these biomarkers in the pathogenesis of scleroderma and periodontal disease. Int J Mol Med. 2012;30(3):502–8.PubMedCrossRef
50.
Isola G, Giudice AL, Polizzi A, Alibrandi A, Patini R, Ferlito S. Periodontitis and tooth loss have negative systemic impact on circulating progenitor cell levels: a clinical study. Genes (Basel). 2019;10(12):1022.
51.
Jagelavičienė E, Vaitkevičienė I, Šilingaitė D, Šinkūnaitė E, Daugėlaitė G. The relationship between Vitamin D and periodontal pathology. Medicina (Kaunas). 2018;54(3):45.
52.
Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011;55(1):96–108.PubMedCrossRef
53.
Matarese G, Ramaglia L, Fiorillo L, Cervino G, Lauritano F, Isola G. Implantology and periodontal disease: the panacea to problem solving? Open Dent J. 2017;11:460–5.PubMedPubMedCentralCrossRef
54.
Mishra SM, Ravishankar PL, Pramod V, et al. Effect of supplementation of Vitamin D in patients with periodontitis evaluated before and after nonsurgical therapy. Biomed Res Int. 2022;2022:5869676.
55.
Hiremath VP, Rao CB, Naiak V, Prasad KV. Anti-inflammatory effect of vitamin D on gingivitis: a dose response randomised controlled trial. Indian J Public Health. 2013;57(1):29–32.PubMedCrossRef
56.
Cobb CM, Sottosanti JS. A re-evaluation of scaling and root planing. J Periodontol. 2021;92(10):1370–8.PubMedCrossRef
57.
Ribeiro LSFE, Araujo NS, Zilli Vieira CL, Dos Santos JN, Cury PR. Impact of serum vitamin D levels on periodontal healing outcomes: a preliminary cohort study. Int J Dent Hyg. 2022.
58.
Jagelaviciene E, Vaitkeviciene I, Silingaite D, Sinkunaite E, Daugelaite G. The Relationship between Vitamin D and Periodontal Pathology. Medicina-Lithuania. 2018;54(3).
59.
Metadata
Title
Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis
Authors
Fangfang Liang
Yuanzhu Zhou
Zhenyu Zhang
Zheng Zhang
Jing Shen
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Gingiva Index
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03120-w

Other articles of this Issue 1/2023

BMC Oral Health 1/2023 Go to the issue

Research

The application of a fully digital approach in the treatment of skeletal class III malocclusion: a preliminary study

Research

Household smoking impact on the oral health of 5- to 7-years-old children

Research

Correlation between serum α-Klotho levels and different stages of periodontitis

Research

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

Research

Direct and residual antimicrobial effect of 2% chlorhexidine gel, double antibiotic paste and chitosan- chlorhexidine nanoparticles as intracanal medicaments against Enterococcus faecalis and Candida albicans in primary molars: an in-vitro study

Research

Impact of COVID-19 on patient follow-up during supportive periodontal therapy: a retrospective study based on phone call survey