Evaluation of Local and Systemic Levels of Vitamin D3 and Fibroblast Growth Factor 23 After Non-Surgical Periodontal Therapy

Abstract
Background: Vitamin D is an important micronutrient possessing valuable and diverse biological effects that are related to periodontal disease pathogenesis. Vitamin D levels are regulated by fibroblast growth factor 23 (FGF23) which is strongly associated with inflammation. The aim of the present study was to explore the relation of vitamin D and FGF23 with periodontal disease through the assessment of their levels in gingival crevicular fluid (GCF) and serum in periodontitis patients before and after non-surgical periodontal therapy and to compare those levels with healthy controls in order to identify any possible correlation between them. Methods: Serum and GCF samples were collected at baseline and 3 months after therapy to evaluate levels of vitamin D3 and FGF23 using enzyme-linked immunosorbent assay (ELISA) in both study groups. Group I consisted of 15 controls who were systematically and periodontally healthy, while group II consisted of 15 subjects who were systematically healthy with stage II periodontitis. Results: A significant elevation in vitamin D3 levels in both GCF and serum were recorded 3 months after therapy with a 25.98% and 39.29% increase respectively. On the contrary, a significant reduction in mean values of FGF23 in both GCF and serum were found after treatment with a 49.75% and 39.28% decrease respectively. Conclusion: The results of the present investigation have shed light on a vital association of both FGF23 and vitamin D3 with periodontitis, where FGF23 is associated with periodontal inflammation and vitamin D3 is associated with periodontal health.