Comparative Evaluation of Levels of Vitamin D and Cementum Thickness and Clinical Attachment Level in Periodontitis with and without Type 2 Diabetes Mellitus

Abstract

Background: Vitamin D plays a key role in regulating inflammatory cytokines, insulin sensitivity, and immune responses. Its deficiency has been linked to chronic inflammatory conditions such as periodontitis and type 2 diabetes mellitus. Cementum is a dynamic tissue that undergoes structural changes in periodontal disease, but its association with Vitamin D levels and clinical attachment loss (CAL) remains unclear. Aim: To evaluate and correlate serum and gingival crevicular fluid (GCF) Vitamin D levels with cementum thickness, structural changes, and clinical attachment level in healthy individuals, chronic periodontitis patients, and chronic periodontitis patients with type 2 diabetes mellitus. Materials and Methods: Thirty subjects (25–60 years) were divided into three groups (n = 10 each): healthy, chronic periodontitis (CP), and CP with type 2 diabetes mellitus (T2DM). Clinical parameters were recorded. Serum and GCF Vitamin D levels were assessed using radioimmunoassay, and cementum thickness was analysed using scanning electron microscopy. Data were analysed using one-way ANOVA with post hoc tests. Results: Vitamin D levels were significantly higher in healthy subjects and lowest in T2DM (p < 0.001). Cementum thickness was greatest in CP, followed by T2DM and healthy groups (p < 0.001). No significant correlation was found between Vitamin D levels and cementum thickness. Conclusion: Vitamin D deficiency is strongly associated with periodontal disease severity, especially in diabetic patients. Cementum shows increased thickness in periodontitis as a reactive change, while diabetes may impair this response.