INTERNATIONAL ENDODONTIC JOURNAL, 2025 (SCI-Expanded, Scopus)
Aim: This study was conducted to evaluate the effect of maintaining optimal serum vitamin D levels through supplementation on the healing rate and quality of newly formed bone at 3, 6, 9, and 12 months in teeth with periapical lesions following endodontic treatment. Additionally, TNF-alpha levels were measured to investigate whether the potential healing effect was related to the anti-inflammatory properties of vitamin D. Methodology: This study was designed as a parallel, triple-blind, randomised controlled clinical trial registered at the Clinical Trials Registry. Seventy-three male patients with mature mandibular molars presenting with periapical lesions and meeting the inclusion criteria were allocated into two groups: the vitamin D group (n = 37) and the control group (n = 36). All patients received root canal treatment according to a standardised endodontic protocol. The vitamin D group received oral vitamin D supplements to raise serum 25(OH)D level to the optimal range (30-50 ng/mL), while the control group, with insufficient serum 25(OH)D levels (20-30 ng/mL), did not receive any supplementation. Periapical radiographs (pre-op, 3, 6, 9, 12 months), serum 25(OH)D (chemiluminescence), and TNF-alpha (ELISA) levels were assessed. The reduction in lesion area was calculated in mm2 and bone quality was assessed through fractal analysis. The data were statistically analysed using the Mann-Whitney U and Friedman tests (p < 0.05). Results: Lesion area reduction was significantly greater in the vitamin D group versus the control group (p < 0.05). However, no significant difference was found between the vitamin D and control groups in terms of fractal analysis values and TNF-alpha levels (p > 0.05). Conclusions: A more rapid decrease in periapical lesion size was observed in individuals with serum vitamin D levels maintained within the optimal range (30-50 ng/mL). It is concluded that optimising vitamin D levels by supplementation, when appropriate, may be beneficial for the healing process of teeth with periapical lesions.