Investigation of the effect of vitamin D supplementation on apical lesion healing rate: Prospective, randomized clinical trial

Aim: This study aimed to evaluate the effect of vitamin D supplementation on the healing rate of periapical lesion and the quality of newly formed bone radiographically and biochemically. Material and Method: Systemically healthy male subjects with a periapical lesion of 5 mm or more in diameter with mandibular molar teeth, and serum 25(OH)D levels in the range of 20-30 ng/mL were included in this study. A total of 73 individuals were randomly divided into study (n=37) and control (n=36) groups. The serum 25(OH)D level was maintained at an optimal level (30-50 ng/mL) by supplementing the study group with vitamin D, while the control group, whose serum 25(OH)D level was <30 ng/mL (deficient), was followed up without any supplementation. Teeth with periapical lesions were treated using a standard endodontic protocol. Pre-operative and 3-6-9-12th monthly control radiographs were obtained with the periapical radiography technique using the parallel technique at the same exposure settings. During the follow-up, serum 25(OH)D levels were measured by chemiluminescence method, while TNF-α levels were measured using an ELISA kit. The reduction in the lesion size was calculated in mm2, and the bone quality was calculated by fractal analysis. Pre-operative and follow-up values were statistically analyzed with the Mann Whitney U test (p<0.05). Results: A significantly greater reduce in the lesion size was identified in the study group compared to the control group (p<0.05). There was no significant difference between the study and control groups in terms of fractal analysis values, Molven criteria scores, and TNF-α levels (p>0.05). Conclusion: It has determined that the optimum vitamin D level (30-50 ng/mL) has a positive effect on the success of endodontic treatment. Within the limits of this study, it can be concluded that optimizing the vitamin D level with supplementation, if appropriate, may be beneficial in the healing process of teeth with periapical lesions. Key words: Root canal treatment, Periapical healing, Periapical lesion, Vitamin D