Vitamin D and Its Role in Oral Diseases Development. Scoping Review

Evaluation of Serum Vitamin D and C Concentrations in Cats With Gingivostomatitis

AIM OF STUDY

To investigate serum vitamin C and D concentrations of cats suffering from gingivostomatitis.

MATERIALS AND METHODS

Serum concentrations of vitamins C and D were evaluated in 30 cats of various breeds, including 15 healthy cats and 15 with gingivostomatitis.

RESULTS

Serum vitamin D concentration in the healthy cats (35.36 ± 15.39 ng/mL) was significantly higher than that of the cats with gingivostomatitis (17.54 ± 10.50 ng/mL) (p < 0.05). There was no difference in serum vitamin C concentration between the healthy cats (3.7 ± 0.74 mg/100 mL) and those with gingivostomatitis (3.1 ± 0.72 mg/100 mL) (p < 0.05).

CONCLUSION

The results of this study suggest that cats with gingivostomatitis are predisposed to vitamin D deficiency. Further studies are required to confirm this finding in a larger study sample and to investigate the potential utility of vitamin D supplementation.

Impact of Advanced Platelet-Rich Fibrin on Early Bone Healing After Endodontic Microsurgery: A Randomized Controlled Trial

Background: Apical surgery can address periapical pathologies when conventional endodontic treatments fail. Advanced platelet-rich fibrin (A-PRF) has emerged as a regenerative material with the potential to enhance healing in periapical surgery. In this study, we evaluated the effect of A-PRF on periapical lesion healing using cone beam computed tomography (CBCT). Methods: A randomized controlled trial at Rīga Stradiņš University Institute of Stomatology included 43 participants (15 males, 28 females; mean age: 44 years) with periradicular lesions. Participants were divided into experimental and control groups. Baseline and follow-up CBCT imaging assessed lesion volumes at 6 and 12 months post-surgery. Results: Mean lesion volumes significantly decreased from 431.4 mm3 at baseline to 102.8 mm3 at 6 months and 49.2 mm3 at 12 months (p < 0.001). A-PRF did not significantly reduce the lesion sizes compared to the controls (p = 0.043), but was associated with reduced inflammation and enhanced soft tissue healing. Key confounders included gender and baseline lesion volume, with males exhibiting smaller lesion sizes postoperatively. Conclusions: The results suggest that A-PRF may not offer a significant advantage in terms of reducing defect size or improving radiographic resolution.

Analysis of Biomarker Levels in Nasopharyngeal Swabs, Serum, and Saliva Across Different Health Conditions

BACKGROUND

Coronavirus disease 2019 (COVID-19) is associated with a wide variety of clinical manifestations.

AIM

This study aims to evaluate the levels of angiotensin-converting enzyme 2 (ACE2), metalloprotease 17 (ADAM17), Interleukin-17A (IL-17A), transmembrane serine protease 2 (TMPRSS2), apelin (AP), and vitamin D (VD) biomarkers in nasopharyngeal swab (NPS), serum, and saliva, as well as the change in their values depending on the health status of individuals.

MATERIAL AND METHODS

The analysis was performed by using enzyme-linked immunosorbent assay (ELISA) methods.

RESULTS

Comparing the levels of the investigated markers in saliva, we found significantly elevated ACE2 values in vaccinated patients, followed by those with severe COVID-19, compared to healthy, previously infected, and mild COVID-19 groups. For TMPRSS2, IL-17A, ADAM-17, and AP, values were significantly higher in all non-healthy groups (previously infected, mild, and severe COVID-19) compared to healthy individuals. Serum levels of VD were consistently low across all five studied groups, suggesting values below normal ranges. Analysis of marker data in saliva, NPS, and serum revealed a positive correlation between NPS and serum and saliva and serum, as well as between saliva and NPS for all studied markers.

CONCLUSIONS

In summary, monitoring changes in biomarkers present in Saliva holds promise as a predictive tool for various diseases. This approach enables the early implementation of preventive measures and protective strategies, potentially improving overall health outcomes.

Limb Osseointegration-How Important Is the Role of Nutrition in the Process?

BACKGROUND AND AIMS

Osseointegration (OI) surgery of the appendicular skeleton for repair in amputees is a treatment in which a metal implant is directly fixed to the residual bone and subsequently connected to a prosthetic limb via a transcutaneous connector through a small incision in the skin. Current treatment does not consider nutritional advice for patients undergoing the OI procedure. However, since the group of patients is very heterogeneous, the results may not be always satisfactory for patients and clinicians. Furthermore, in some individuals, incorrect nutrition and diet habits may lead to complications and rejection of the implant.

METHODS

We created an extensive narrative evaluation by conducting a methodical search. A comprehensive search was conducted across three major databases: PubMed, Embase, and Scopus. The search was carried out in October 2024 with no time limit specified. The approach involved using specific, pre-defined search terms, which were first applied in PubMed, followed by Embase and Scopus to ensure a broad and diverse range of articles was captured. The search process was refined by considering studies published in high-impact journals, as identified based on impact factors and subject relevance. To ensure consistency and rigor, the selection criteria were applied uniformly across all databases, and irrelevant or incomplete articles were excluded.

RESULTS

Based on the specific nature of the OI procedure, it is crucial to adapt patients' diets and nutrition after the process. To translate the findings from the reviewed literature into practical clinical guidance for osseointegration (OI) procedures, we developed dietary recommendations for both patients and clinicians, presented as proposed dietary plans and summarized in tables. These recommendations were informed by evidence from various studies, highlighting findings that were supported by randomized controlled trials (RCTs) as well as areas where the evidence remains inconclusive or unsupported by RCTs. Major vitamins and micro- and macroelements were distinguished and presented as guidelines for clinicians.

CONCLUSIONS

OI is currently the most promising therapeutic options for amputees. To promote efficient tissue healing and provide energy for rehabilitation, it is recommended to follow a healthy, well-balanced diet that contains all the essential micronutrients, macronutrients, vitamins, and minerals. We also provide suggestions for future studies.

Hypovitaminosis and its association with recurrent aphthous stomatitis: a comprehensive review of clinical correlations and diagnostic considerations

Background

Hypovitaminosis, or vitamin deficiency, has been increasingly recognized as a potential contributing factor in the development of recurrent aphthous stomatitis (RAS), a condition characterized by the periodic formation of painful ulcers in the oral mucosa.

Materials and methods

This mini review includes a literature search on PubMed, Web of Science, and Scopus databases using keywords "hypovitaminosis AND aphthous ulcers."

Results

There is a growing body of evidence supporting the link between various vitamin deficiencies-particularly vitamins B12, C, and folate-and the prevalence of RAS, with implications for both diagnosis and management.

Conclusion

This review aims to outline the clinical and biochemical findings associated with hypovitaminosis in individuals presenting with RAS, emphasizing the diagnostic importance of recognizing vitamin deficiencies in these patients and exploring possible therapeutic approaches.

[Vitamin D role in oral cavity diseases]

The purpose of this scientific article is to analyze the scientific literature aimed at identifying the relationship between vitamin D levels in the body and diseases of the oral organs, in order to determine the potential impact of vitamin D deficiency on their development. Special attention is paid to the development of recommendations for maintaining optimal vitamin D levels for various population groups in order to strengthen both general health and prevent diseases of the oral cavity.

Can Vitamin D Levels Influence Bone Metabolism and Osseointegration of Dental Implants? An Umbrella Review

INTRODUCTION

Due to the large amount of scientific evidence on the subject and the limitations and incongruities in previous reviews, the primary aim of this umbrella review is to gather all the information regarding the importance of vitamin D levels in the osseointegration of dental implants.

METHODS

The literature search was performed in PubMed, Web of Science, CINAHL Plus, Cochrane Library, and Academic Search Complete throughout the search expression ["vitamin D" AND ("dental implant" OR "dental implants")].

RESULTS

The initial search yielded 351 results, but at the end of the process, only five systematic reviews were selected.

CONCLUSIONS

Vitamin D seems to have a positive effect on the osseointegration of dental implants and on the reduction of dental implant failures; however, it is recommended that future studies take into account the limitations mentioned in this study in order to increase the validity and quality of scientific evidence on the subject.

A Systematic Review of the Relationship between Serum Vitamin D Levels and Caries in the Permanent Teeth of Children and Adolescents

This systematic review critically evaluates the association between serum Vitamin D levels and dental caries incidence in the permanent teeth of children and adolescents. The search strategy comprised three databases (PubMed, Scopus, Embase), up to November 2023, targeting studies on the correlation between Vitamin D and dental caries in permanent dentition. The eligibility criteria focused on observational studies involving children and adolescents aged 12 to 19 years with permanent dentition. The screening process, guided by the PRISMA guidelines and the Newcastle-Ottawa Scale for quality assessment, resulted in the inclusion of eight studies conducted across various global regions from 2013 to 2023. The analysis revealed that Vitamin D insufficiency and deficiency were prevalent among the study populations, ranging from 17.3% to 69.4%. Specifically, children and adolescents with Vitamin D insufficiency (<50 nmol/L) were found to have significantly higher odds of developing caries, with odds ratios (ORs) ranging from 1.13 to 2.57. Conversely, two studies indicated a protective effect of higher Vitamin D levels, with an OR of 0.80 and 0.59, respectively, for caries among children and adolescents with serum levels ≥ 50 nmol/L, suggesting an inverse relationship between Vitamin D status and caries risk. The results indicate both the protective role of adequate serum levels of Vitamin D above 20 ng/mL and the increased risk associated with insufficient levels below this threshold. However, the variations in study quality, methodologies and geographic settings underscore the challenges in drawing universal conclusions. Despite these limitations, our review suggests that improving Vitamin D status could be a beneficial component of preventive strategies against dental caries in children and adolescents, warranting further research to clarify the clinical significance of our findings.

Examining the Role of Vitamin D in Caries Susceptibility in Children's Deciduous Teeth: A Systematic Review

The global prevalence of dental caries in deciduous teeth remains a significant health concern, affecting almost 70% of children by the age of six in specific regions. This systematic review aspired to methodically investigate the association between vitamin D levels and susceptibility to caries in children's deciduous teeth. A detailed search, guided by the PRISMA and PROSPERO guidelines, was conducted across three prominent electronic databases: PubMed, Web of Science, and Scopus, culminating in August 2023. The search integrated various keywords related to vitamin D and dental caries in primary dentition, yielding an initial pool of 1678 articles. After meticulous scrutiny, seven studies with a total of 7655 participants were deemed suitable for inclusion. The studies represented diverse geographical regions, showcasing varied vitamin D levels and sun exposure. Patient habits like brushing frequency, dental visits, and vitamin consumption also varied across studies. The analysis pinpointed vitamin D deficiency as a potential risk factor in some of the studies, with Odds Ratios (OR) ranging from 0.68 to 2.15. Statistically significant associations between vitamin D deficiency and caries susceptibility were documented in three studies (ORs of 2.15, 1.98, and 1.70). This comprehensive review elucidates the complex relationship between vitamin D levels and dental caries in children's deciduous teeth. While some studies spotlight vitamin D's pivotal role in dental health, inconsistencies across studies and regional differences necessitate more in-depth, globally representative investigations. Ensuring optimal vitamin D levels may play an integral role in dental health strategies. However, it is important to highlight that the roles of these studied factors might differ in deciduous teeth compared to permanent teeth.

Polymorphism but not methylation status in the vitamin D receptor gene contributes to oral mucositis in children

OBJECTIVE

To investigate the relationship between the polymorphisms rs1544410 (BsmI), rs2228570 (FokI) and rs731236 (TaqI) and DNA methylation status in the VDR gene (vitamin D receptor) with oral mucositis (OM) in oncopaediatric patients treated with methotrexate (MTX®).

METHODS

The population comprised healthy patients with haematological malignancies aged between 5 and 19 years. An evaluation of oral conditions was performed using the Oral Assessment Guide. Demographic, clinical, biochemical and haematological data were obtained from medical records. Genomic DNA from oral mucosal cells was used for the analysis of polymorphisms (n = 102) (PCR-restriction fragment length polymorphism) and DNA methylation (n = 81) (methylation-specific PCR).

RESULTS

Males predominated (57.8%), and the mean age was 10.3 years (±4.7). OM affected 84.3% of patients, of which 53.1% developed severe oral mucositis (SOM). Patients with OM had lower platelet and leukocyte counts (p < 0.05). The G allele of rs1544410 (p = 0.040) and the CT genotype of rs2228570 polymorphisms were associated with SOM (p = 0.038). A partially methylated status in the VDR promoter was found in all patients.

CONCLUSION

OM is associated with lower leukocyte and platelet counts. SOM is associated with the rs1544410 and rs2228570 polymorphisms. The methylation status of the VDR is not associated with inflammation or exposure to MTX®.

Vitamin D and Periodontal Health: A Systematic Review

The role of vitamin D in maintaining gum well-being is crucial. However, scientific research reported that the connotations of cholecalciferol and periodontal health have been divested in the present literature. However, there is enormous heterogeneity in the data available. The current review aims to systematically review and appraise the available literature investigating the role of vitamin D in maintaining periodontal health. Studies included randomized controlled trials and clinical trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and cohort studies reporting associations between vitamin D and oral health in systemically healthy patients. Databases such as PubMed, Google Scholar, Scopus, Embase, and other sources, including hand search, were searched until May 2023 using together-equipped search sequences. Altogether, scientific articles that conform to the inclusion principles underwent a thorough eminence evaluation. All papers meeting inclusion criteria were subject to quality assessment, and the method used to assess the risk of bias was the Cochrane risk of bias tool. The search identified 1883 papers, among which 1435 were excluded after title evaluation. After abstract and title screening, 455 were excluded, and six full texts were assessed. After full-text evaluation, two articles were excluded, and only four were included. The data shows vitamin D's association with oral health maintenance. Along with its action on bone metabolism, it has extended function, which provides for its action as an anti-inflammatory agent and production of anti-microbial peptides, which help maintain oral health. Although the literature available is immense, there is enormous heterogenicity in the papers conducted to appraise the association between vitamin D and oral health. This systematic review has filtered all the data to review a few essential aspects of the role of vitamin D in maintaining oral physiology. Vitamin D has a linear relationship with periodontal health; however, the evidence is insufficient, and further studies must be done.

The Impact of Prenatal Vitamin D on Enamel Defects and Tooth Erosion: A Systematic Review

Prenatal Vitamin D has been suggested to be critical for dental health in children, affecting outcomes including the prevalence of enamel defects and tooth erosion. This systematic review aimed to evaluate the potential impact of prenatal Vitamin D levels on these dental health outcomes. A total of seven studies, involving 6978 participants, were included after a comprehensive search of PubMed, Web of Science, and Scopus from 2013 to June 2023. The average age of mothers varied across studies, with Vitamin D levels or supplementation practices displaying significant variation among the study populations. The age of children at examination ranged from 3.6 to 6.6 years. The analysis demonstrated a diverse association between Vitamin D levels and dental outcomes, with enamel defects reported in 21.1% to 64% of the children and opacities ranging from 36% to 79.5% across studies. Maternal Vitamin D insufficiency was identified as a significant risk factor for enamel defects in one study (OR: 3.55), whereas high prenatal Vitamin D levels indicated a protective effect against Hypomineralized Second Primary Molars (OR: 0.84) and Molar Incisor Hypomineralization (OR: 0.95) in another. Conversely, low Vitamin D levels increased the risk of enamel hypoplasia (OR: 1.29) and dental decay. The maternal and child demographics varied greatly across the studies, and the assessment and prevalence of Vitamin D deficiency or insufficiency were heterogenous. This review illuminates the potential influence of prenatal Vitamin D on dental health in children, underscoring the importance of adequate Vitamin D levels during pregnancy. However, more robust research is required to establish the optimal Vitamin D intake during pregnancy to ensure healthy dental outcomes in children.

Role of Vitamin D in Head and Neck Cancer-Immune Function, Anti-Tumour Effect, and Its Impact on Patient Prognosis

Head and neck squamous cell carcinoma (HNSCC) describes a heterogeneous group of human neoplasms of the head and neck with high rates of morbidity and mortality, constituting about 3% of all cancers and ~1.5% of all cancer deaths. HNSCC constituted the seventh most prevalent human malignancy and the most common human cancer in the world in 2020, according to multi-population observations conducted by the GLOBOCAN group. Since approximately 60-70% of patients present with stage III/IV neoplastic disease, HNSCC is still one of the leading causes of death in cancer patients worldwide, with an overall survival rate that is too low, not exceeding 40-60% of these patients. Despite the application of newer surgical techniques and the implementation of modern combined oncological treatment, the disease often follows a fatal course due to frequent nodal metastases and local neoplastic recurrences. The role of micronutrients in the initiation, development, and progression of HNSCC has been the subject of considerable research. Of particular interest has been vitamin D, the pleiotropic biologically active fat-soluble family of secosteroids (vitamin-D-like steroids), which constitutes a key regulator of bone, calcium, and phosphate homeostasis, as well as carcinogenesis and the further development of various neoplasms. Considerable evidence suggests that vitamin D plays a key role in cellular proliferation, angiogenesis, immunity, and cellular metabolism. A number of basic science, clinical, and epidemiological studies indicate that vitamin D has multidirectional biological effects and influences anti-cancer intracellular mechanisms and cancer risk, and that vitamin D dietary supplements have various prophylactic benefits. In the 20th century, it was reported that vitamin D may play various roles in the protection and regulation of normal cellular phenotypes and in cancer prevention and adjunctive therapy in various human neoplasms, including HNSCC, by regulating a number of intracellular mechanisms, including control of tumour cell expansion and differentiation, apoptosis, intercellular interactions, angio- and lymphogenesis, immune function, and tumour invasion. These regulatory properties mainly occur indirectly via epigenetic and transcriptional changes regulating the function of transcription factors, chromatin modifiers, non-coding RNA (ncRNAs), and microRNAs (miRs) through protein-protein interactions and signalling pathways. In this way, calcitriol enhances intercellular communication in cancer biology, restores the connection with the extracellular matrix, and promotes the epithelial phenotype; it thus counteracts the tumour-associated detachment from the extracellular matrix and inhibits the formation of metastases. Furthermore, the confirmation that the vitamin D receptor (VDR) is present in many human tissues confirmed the physiopathological significance of vitamin D in various human tumours. Recent studies indicate quantitative associations between exposure to vitamin D and the incidence of HNC, i.e., cancer risk assessment included circulating calcidiol plasma/serum concentrations, vitamin D intake, the presence of the VDR gene polymorphism, and genes involved in the vitamin D metabolism pathway. Moreover, the chemopreventive efficacy of vitamin D in precancerous lesions of the head and neck and their role as predictors of mortality, survival, and recurrence of head and neck cancer are also widely discussed. As such, it may be considered a promising potential anti-cancer agent for developing innovative methods of targeted therapy. The proposed review discusses in detail the mechanisms regulating the relationship between vitamin D and HNSCC. It also provides an overview of the current literature, including key opinion-forming systematic reviews as well as epidemiological, prospective, longitudinal, cross-sectional, and interventional studies based on in vitro and animal models of HNSCC, all of which are accessible via the PubMed/Medline/EMBASE/Cochrane Library databases. This article presents the data in line with increasing clinical credibility.

The Role of Vitamin D on the Wound Healing Process: A Case Series

Introduction

Vitamin D is an essential steroid hormone that consists of two forms, namely vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol), which can be obtained from exposure to sunlight, synthesis of vitamin D in the skin, food and dietary supplements. Prevalence of vitamin D deficiency in several countries including Indonesia is still high, while the role of vitamin D is very important including accelerating the wound healing process, increasing the immune system, anti-inflammatory, and anti-bacterial.

Purpose

This case report aims to find out the role of vitamin D in the wound-healing process in the oral mucosa.

Case Reports

Two men went to the Oral Disease Clinic with complaints of canker sores on the oral mucosa for more than a month accompanied by pain. Intra-oral condition in the first patient showed multiple ulcers with yellowish white base surrounded by erythematous areas, well-defined, irregular with a size of 1.5 × 1 cm and 1 × 0.5 cm on the right and left buccal mucosa, while intra-oral in the second patient, a single ulcer with a base was found yellowish colour surrounded by erythematous area, oval measuring 3x1 cm, clearly demarcated with induration.

Results

Laboratory examination of vitamin D in both patients showed decreased levels of vitamin D with values of 28.7 and 9.8 ng/mL.

Conclusion

Vitamin D supplementation has shown effectiveness in wound-healing processes in the oral mucosa.

Vitamin D levels among children, adolescents, adults, and elders in Pakistani population: a cross-sectional study

Background

Vitamin D is not only an essential part of a healthy diet but it is also known as the sunshine hormone. It helps to absorb calcium and phosphate within the body and is essential for the development of teeth and bones in growing children. Deficiency in vitamin D causes weak bones, osteoporosis in older individuals, and osteomalacia in children. It also causes loss of alveolar bone around the teeth, increased dental cavities, and other problems associated with gum disease. It can cause depression, fatigue, and appetite loss. This study aims to observe vitamin D deficiency, insufficiency, and sufficiency among children, adults, adolescents, and elders in the Pakistani population.

Methods

A cross-sectional survey was conducted with 27,880 individuals referred from the general out-patient-department (OPD) to Dow Diagnostic Research and Reference Laboratory (DDRRL) units at Dow University of Health Sciences (DUHS) Karachi, Pakistan, for a period of three months from January to March 2017. They were examined for laboratory findings of serum 25 hydroxyvitamin D levels to determine vitamin D deficiency, insufficiency, and sufficiency among all age groups of both male and female genders.

Results

A total of 26,750 individuals with a mean age of 38 ± 18 years were statistically examined for laboratory findings of serum vitamin D levels. Vitamin D deficiency was observed in 56% of individuals with a mean log of 1.01 ± 0.18 ng/ml serum vitamin D levels, vitamin D insufficiency in 20% of individuals with a mean log of 1.38 ± 0.05 ng/ml serum vitamin D levels and vitamin D sufficiency in 24% individuals with a mean log of 1.63 ± 0.12 ng/ml serum vitamin D levels. The highest percentage of individuals deficient in vitamin D were children and adolescents of age ranging between 6 to 18 years.

Conclusion

The findings of vitamin D deficiency in children and adolescents direct higher authorities in the public health sector to take immediate steps to screen, intervene and educate high-risk populations incorporating vitamin D supplements to establish preventive and therapeutic measures.

Calcium and Vitamin D Supplementation as Non-Surgical Treatment for Periodontal Disease with a Focus on Female Patients: Literature Review

Periodontal disease is a complex disease that involves an imbalance between the oral microbiota and an individual's inflammatory response. Moreover, the inflammatory response contributes to further imbalance; if left untreated, periodontal disease may result in tooth loss. Vitamin D is intricately involved in the regulation of calcium-phosphate homeostasis and bone mineral metabolism; considering that periodontal surgery usually includes regenerative therapy, adequate vitamin D and calcium levels are essential. The benefits of vitamin D and calcium supplementation have been demonstrated in situations where deficiency is associated with adverse outcomes, such as periodontal disease and maternal health. However, knowledge and attitudes about supplementation, as well as the actual levels of supplementation, vary greatly in the general population; they also differ between men and women. The aim of this review is to discuss how vitamin D and calcium supplementation affect oral and periodontal health, especially in women. Additionally, this review provides suggestions for public health strategies regarding vitamin D and calcium supplementation, as well as the effects of both types of supplementation on maternal oral health.