The Effect of Vit D3 (1,25 dihydroxy cholicalciferol) on Serum Level of Human Tumor Necrosis Factor Alpha (TNF α) Following Apicoectomy

Abstract

Aims: To evaluate the efficacy of Vit D3 on serum level of human TNF α in patients with chronic periapical lesion that intended to undergo apicoectomy and compare the results with a group of placebo control. Materials and Methods: The investigation was carried out on 50 subjects of different age(16- 45) and sex(27 male,23 female) complain of chronic periapical lesion were divided into two groups ) study and placebo group). Study group consist of 25 subject received Vit D3 ampoule(300000 IU) orally 24 hrs before apicoectomy procedure and placebo group consist of 25 subject received distal water ampoule orally 24 hrs before apicoectomy procedure. Peripheral venous blood samples were collected preoperatively , 3hrs postoperatively and 24 hrs postoperatively from each subject of both group to evaluate serum TNF α level by Enzyme Linked Immunosorbent Assays (ELISA) device. Patients subjectively assessed the strength the post operative pain by using Visual Analogue Scale (VAS). Data were analyzed using paired t-test and A NOVA test. Results: The results showed that the serum TNF α levels were decreased significantly in the study group after 3hrs of surgical procedure to (22.62 ± 4.58 Pg/ml) following Vit D3 treatment comparing with TNF α level pretreatment (28.33 ± 10.16 Pg/ml) whereas the TNF α level were increased from (33.38 ± 23.92 Pg/ml) preoperative to (51.11 ± 9.05 Pg/ml) 3hrs postoperative in placebo group. Serum TNF α level after 24hrs of surgical procedure in study group decreased significantly to( 28.24± 7.35Pg/ml) pg/ml) comparing with the postoperative 24 hrs TNF α of placebo group (66.15 ± 13.02 pg/ml),this indicated that the level of TNF α were increased in placebo group after 3hrs and 24hrs postoperatively in comparison to the same time of operation in study group. The number of analgesic tablet (acetaminophen) significantly decreased in study group to (1.24 ± 1.01 ) comparing with placebo group (2.24 ± 1.23). Duration of analgesia post operatively increase significantly to (308.20± 144.43) min in study group compared with placebo group (228.44 ±123.02) min. The intensity of postoperative pain decrease significantly after 8hrs (VAS1), 12 hrs (VAS2) of surgical operation in study group (1.16 ± 2.27), (0.44 ± 0.96) compared with placebo group (2.92 ± 1.87), ( 1.52 ± 1.78) respectively. Conclusion: data indicated that Vit D3 have anti inflammatory effect that can decrease level of TNF α so reduced pain and inflammation after apicoectomy .