Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis

• Published in: Nutrients 2020-07, Vol.12 (8), p.2177
• Main Authors: Machado, Vanessa, Lobo, Sofia, Proença, Luís, Mendes, José João, Botelho, João
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Bias; Calciferol; Confidence intervals; Databases, Factual; Dietary Supplements; Disease; Gum disease; Humans; Liquid chromatography; Mass spectrometry; Mass spectroscopy; Medical research; Meta-analysis; Non-Randomized Controlled Trials as Topic; Observational Studies as Topic; Periodontitis; Periodontitis - blood; Periodontitis - diagnosis; Periodontitis - prevention & control; Periodontium; Randomized Controlled Trials as Topic; Review; Serum levels; Statistical analysis; Subgroups; Systematic review; Taxonomy; Vitamin D; Vitamin D - administration & dosage; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - prevention & control; Vitamin deficiency
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12082177

To explore the vitamin D levels of periodontitis patients in comparison with periodontally healthy ones, and to assess the influence of vitamin D supplementation as an adjunctive during nonsurgical periodontal treatment (NSPT). Five databases (Pubmed, Embase, Scholar, Web of Sciences, and Cochrane Library) were searched until May 2020. Mean difference (MD) meta-analysis with corresponding 95% confidence interval (95% CI) and sensitivity tests via meta-regression were used. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Sixteen articles were included, fourteen case-control and two intervention studies, all reporting 25-hydroxyvitamin D (25(OH)D) levels. Compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in chronic periodontitis patients (pooled MD = -6.80, 95% CI: -10.59 to -3.02). Subgroup analysis revealed differences among 25(OH)D measurements, with liquid chromatography-mass spectrometry being the most homogeneous method (pooled MD = -2.05, 95% CI: -3.40 to -0.71). Salivary levels of 25(OH)D showed no differences between groups. Due to the low number of studies, conclusions on aggressive periodontitis and in the effect of vitamin D supplementation after NSPT were not possible to ascribe. Compared with healthy controls, 25(OH)D serum levels are significantly lower in chronic periodontitis patients, with an overall SORT A recommendation. Future studies are needed to clarify the effect of vitamin D supplementation and the biological mechanisms linking vitamin D to the periodontium.