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ARTICLE
Year : 2011  |  Volume : 9  |  Issue : 18  |  Page : 849-856

The optimum serum vitamin d level needed to initiate anti - Inflammatory effect on gingivitis. A dose response randomised controlled trial


1 Professor, Dept. of Community Dentistry, Maratha Mandal Dental College, Belgaum, India
2 Director, S.D.M Dental College, Dharwar, India
3 Professor and Head, Dept. of Community Medicine JNMC, Belgaum, India
4 Professor and Head, Dept. of Public Health Dentistry, S.D.M.C, Dharwar, India

Correspondence Address:
Vishwanath P Hiremath
Professor, Dept. of Community Dentistry, Maratha Mandal Dental College, Belgaum
India
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Source of Support: None, Conflict of Interest: None


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Purpose: Decreased serum vitamin D levels have been linked with gingivitis. Also studies have shown that vitamin D has anti inflammatory effect at higher dose. The objective of this study was to determine the optimum level of vitamin D that could initiate an anti inflammatory effect on gingivitis after oral supplementation. Materials and methods: After collecting the baseline serum vitamin D and gingival status in the 96 subjects of the 451 screened, a double blind randomized controlled trial was conducted in Maratha Mandal Dental College Belgaum.. The subjects were divided into four groups and later randomly given a daily oral vitamin D3 supplementation in dose of 2000 IU for Group A, 1000 IU for Group B , 500 IU for Group C and placebo for Group D over three months period. The changes in gingival scores were measured at the period of 1st, 2nd and 3rd month to assess the anti inflammatory effect. Results: Group A which had mean baseline serum vitamin D of 22.46 ± 6.97 had a final visit scores of 52.20 ± 10.17. An average increase of 9.91 was seen per month. The mean baseline gingival scores in this group of 2.4 got reduced to 1.7 at end of first month and later to 0.8 at end of two months and 0.3 at the end of third month. When baseline scores were compared with subsequent visit scores by Wilcoxon paired test, Group A showed significant anti inflammatory effect at end of first month itself with P<0.0001. The group B with baseline serum vitamin D levels of 26.50 ± 3.68 had an average increase of 5.62 per month with final visit scores of 43.67 ± 8.80. The mean baseline gingival scores in this group from 2.3 got reduced to 2.0 at end of first month and later to 1.1 at end of two months and 0.5 at the end of third month. This group showed anti inflammatory effect at the end of 2nd month with P<0.0001.Group C had significant anti inflammatory effect at the end of the 3rd month with P<0.0001 having baseline gingival scores as 2.2 after one month as 1.9, after two months as 1.4 and 0.8 at the last visit. Also baseline vitamin D scores was 23.98 ± 5.65 and final visit score of 36.81 ± 6.13 respectively, a monthly increase of.4.27. However Group D did not show significant anti inflammatory effect. The anti inflammatory was initiated when serum vitamin D level in the groups reached 30-32 ng/ml. Conclusion: An optimum level of 30-35 ng/ml of serum vitamin D can initiate an anti inflammatory effect on gingivitis.


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