Caries status influence GCF MMP-9 in association with serum vitamin D: an exploratory retrospective cross-sectional study.

Abstract

Background: MMP-9 contributes to tissue destruction in dental caries, and vitamin D deficiency may exacerbate this by increasing MMP-9 expression.

Objective: This study aimed to compare matrix metalloproteinase-9 (MMP-9) levels in gingival crevicular fluid (GCF) among healthy, carious, and filled teeth, and assess the association between serum vitamin D levels and site-specific GCF MMP-9 concentrations.

Materials and methods: This cross-sectional study enrolled 117 participants with gingival health or gingivitis, excluding individuals with clinical attachment loss. GCF samples were collected from the first molars. Participants' periodontal status was categorized as healthy or gingivitis, and the sampled teeth were classified as healthy (no caries/restorations), carious (active decay), or filled. Serum vitamin D levels were measured using electrochemiluminescence immunoassay (ECLIA), and MMP-9 levels in GCF were assessed via enzyme-linked immunosorbent assay (ELISA).

Results: Among the participants, 62 had gingivitis and 55 were periodontally healthy. MMP-9 levels were significantly higher in carious teeth (26.6 ± 9.9 ng/30 sec) compared to healthy (17.4 ± 8.7 ng) and restored teeth (18.9 ± 8.7 ng). No significant difference was observed between healthy and restored teeth. Vitamin D deficiency was prevalent (90%). Regression analysis, adjusted for periodontal status, age, and gender, confirmed that caries status, periodontal condition, and Vitamin D levels significantly influenced MMP-9 levels.

Conclusion: MMP-9 levels in GCF were significantly elevated in carious teeth, indicating a potential role in caries progression. Vitamin D deficiency may exacerbate this process by enhancing MMP-9 production. Elevated MMP-9 could accelerate tissue breakdown, increasing vulnerability to deeper decay and pulp involvement. These findings suggest a link between Vitamin D levels, MMP-9 activity, and caries severity. Further studies with larger samples are needed to validate these results.