EVALUATION OF SALIVARY VITAMIN D3 LEVELS AND ITS ROLE IN THE PATHOGENESIS OF ORAL SUBMUCOUS FIBROSIS- A CASE CONTROL STUDY

Background: Oral Submucous Fibrosis (OSMF) is a chronic, progressive disorder characterized by fibrosis of the oral mucosa, leading to restricted mouth opening and significant functional impairment. It is strongly associated with areca nut consumption and is classified as a potentially malignant disorder. Vitamin D, known for its pleiotropic effects, has been implicated in modulating fibrosis, inflammation, and oxidative stress, which are key factors in OSMF pathogenesis. Objective: The aim of the study was to evaluate the salivary levels of 25(OH)D3 in patients with OSMF and explore a potential correlation between vitamin D3 deficiency and the progression of OSMF. Methods: A comparative analysis was conducted to assess salivary Vitamin D levels in OSMF patients and healthy controls. The potential mechanisms by which Vitamin D influences collagen metabolism, immune responses, and oxidative stress were reviewed in the context of existing literature. Results: The study revealed significantly lower salivary Vitamin D levels in OSMF patients (mean: 36.39 ng/ml) compared to healthy controls (mean: 54.01 ng/ml), with a statistically significant difference (p-value = 0.010). Vitamin D deficiency was associated with increased fibrosis due to dysregulated fibroblast activity, impaired matrix metalloproteinase (MMP) expression, and upregulated transforming growth factor-beta (TGF-β). Additionally, low Vitamin D levels correlated with enhanced inflammation, oxidative stress, and a higher potential for malignant transformation. Conclusion: The findings highlighted a strong association between Vitamin D deficiency and OSMF pathogenesis. Given its antifibrotic, anti-inflammatory, and antioxidant properties, Vitamin D supplementation may serve as a potential adjunctive therapy for OSMF management. Future research should explore the therapeutic benefits of Vitamin D in preventing disease progression and reducing the risk of malignant transformation.