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Periodontitis results from dysbiotic periodontal microbiota eliciting an exaggerated host immune-inflammatory response within susceptible individuals. With traditional biofilm management only partially effective, it became apparent that the individual's host response played a pivotal role in the pathogenesis of periodontitis. Specific nutritional factors have been found to impact the host response. Understandably, this has contributed to the emerging shift in contemporary research towards biological approaches to novel periodontal therapies. Vitamin D deficiency, a global public health problem, has been linked to numerous inflammatory conditions including periodontitis. The effects of vitamin D are multifaceted, favouring periodontal health and consideration should be given to its application in clinical practice.
CPD/Clinical Relevance: The mechanisms and evidence implicating vitamin D as a host modulator of periodontitis are of relevance in periodontal therapy.
Article
Periodontitis is the comprehensive outcome of microbial dysbiosis eliciting an exaggerated host immune-inflammatory response within susceptible individuals, resulting in substantive attachment loss and alveolar bone resorption.1,2 Individual variability in the host response to periodontitis is modulated by a variety of risk factors: genetic (gene polymorphisms), environmental (stress, bacteria) and/or lifestyle (nutritional).3 Such factors can adversely affect the onset and progression of periodontitis. Recognition, investigation and subsequent modification of the risk factors, wherever possible, is integral in providing a holistic and precise approach to the management of periodontitis.
Vitamin D is a micronutrient required as part of a balanced diet. Investigations to establish the aetiology and concurrent management of rickets and scurvy led to its discovery in 1922.4 Traditionally, the role of vitamin D has been recognized in mineral and skeletal homeostasis. Yet compelling evidence supports the notion of serum vitamin D's ability to demonstrate antimicrobial and anti-inflammatory properties.5,6 Evidence has also emerged implicating it as a modulator of bone metabolism.5,7 With both, the immune response and bone metabolism, pathognomonic of periodontitis, it would be remiss of the field of periodontology not to further research the micronutrient as a host modulator and its deficiency as a risk factor of periodontitis.
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