A Randomized Controlled Clinical Study To Evaluate The Effect Of Vitamin D₃ Supplementation During The Periodontal Initial Therapy For Stage â…¢/â…£ Periodontitis

Objective:Sufficient vitamin D level plays an important role in maintaining periodontal health.Vitamin D has clinical application value,but its timing and dosage are not clear.The level of calcitriol（25-dihydroxyvitamin D₃,25（OH）D₃）and high mobility group protein B1（high mobility group box 1,HMGB1）in gingival crevicular fluid（GCF）were related to periodontal inflammation.A randomized controlled trial is proposed to observe the effect of oral vitamin D₃during periodontal initial therapy on periodontal clinical indicators,serum 25（OH）D₃level,GCF 25（OH）D₃and HMGB1 levels in patients with stageâ…¢/â…£periodontitis,and to evaluate the efficacy of the above indicators in monitoring periodontal inflammation.Methods:This study selected periodontitis patients who visited the Periodontology Departments of the Stomatological Hospital Affiliated to China Medical University.1.Group and treatment:The control group（C group）:periodontal initial therapy.The low dose group（Lo group）:periodontal initial therapy+oral vitamin D₃1200 international unit（IU）/d.The high dose group（Hi group）:periodontal initial therapy+oral vitamin D₃2400 IU/d.We collected 15 patients in C group,14 patients in Lo group,and 12 patients in Hi group.2.Observation time points and observation indicators:（1）Baseline（T0）:The probing depth（PD）,clinical attachment loss（CAL）,bleeding index（BI）,bleeding on probing（BOP）positivity rate of subjects,serum 25（OH）D₃level,GCF 25（OH）D₃and HMGB1 levels were measured.（2）Six weeks after periodontal initial therapy（T1）:The same as T0.The change value of each indicator from T0,namely‘T0-T1’,were compared among three groups.（3）Three months after periodontal initial therapy（T2）:The same as T1.Results:1.T0:The PD was significantly positively associated with 25（OH）D₃and HMGB levels in GCF at the corresponding sites（P<0.001）.T1:The reduction value of PD in deep periodontal pockets showed a significant positive correlation with the reduction rate of GCF 25（OH）D₃levels in the corresponding site（P<0.01）.2.Periodontal clinical indicators:（1）PD reduction:The PD reduction of Hi group at T1was 2.62±0.67 mm,which was significantly greater than 2.02±0.45 mm in group C（P<0.05）;The PD reduction of Hi group at T2 was 3.24±0.66 mm,which was significantly greater than 2.34±0.19 mm in group C（P<0.05）（2）Reduction of BOP positive rate:The reduction of BOP positive rate of Hi group at T1 was 59.20±19.09%,which was significantly greater than 41.82±12.50%in group C（P<0.05）.The reduction of BOP positive rate of Hi group at T2 was 72.20±16.56%,which was significantly greater than 46.60±14.41%in group C（P<0.05）.There was no significant difference between the Lo group and the C group.3.Serum 25（OH）D₃:The serum 25（OH）D₃level of Hi group was significantly increased by 6.32±4.95μg/L at T1（P<0.05）and 9.07±2.66μg/L at T2（P<0.01）.There were no significant changes in the Lo group.In C group,The serum 25（OH）D₃level at T1 was significantly decreased by 2.05±1.41μg/L（P<0.05）.4.GCF index:The reduction rate of 25（OH）D₃in Hi group was 68.61±18.00%,which was significantly higher than C group 40.34±20.53%（P<0.05）.The reduction rate of HMGB1 in Hi group was 81.86±9.07%,which was significantly higher than C group31.97±19.28%（P<0.05）.Conclusion:1.During the periodontal initial therapy,the high dose of vitamin D₃significantly reduced periodontal clinical indicators in patients with stageâ…¢/â…£periodontitis,and reduced the GCF 25（OH）D₃and HMGB1 levels in deep periodontal pockets.2.GCF 25（OH）D₃is a potential indicator to monitor periodontal inflammation and evaluate the effect of periodontal treatment.