Vitamins in the Treatment of Periodontitis: Molecular Mechanism and Network Pharmacological Analysis.

Abstract

Periodontitis manifests as a chronic inflammatory condition triggered by pathogenic microbial colonisation, and its pathogenesis involves the interaction of multiple factors such as oxidative stress, immune imbalance and abnormal bone metabolism. In recent years, the role of nutritional factors, especially vitamins, in regulating inflammation, oxidative stress and bone regeneration has gradually attracted attention, but their specific mechanisms and clinical application potential still need to be systematically explored. We hypothesised that vitamins A, C, D, E, and K confer protection against periodontitis by synergistically modulating a shared network of targets central to inflammatory and bone metabolic pathways. This study is a review that includes computer simulation analysis. The objective of this research is to analyse the role of vitamins (D, C, E, A, and K) in the prevention and management of periodontitis, and to reveal their potential molecular targets through network pharmacological analysis, so as to provide a theoretical basis for the clinical application of vitamins. Studies have shown that vitamins affect periodontal health in a number of ways: anti-inflammatory and antioxidant effects; vitamin C and E reduce oxidative stress by scavenging reactive oxygen species (ROS) and by inhibiting the release of inflammatory factors; vitamin D regulates immune cell function and reduces the production of pro-inflammatory mediators. Regulation of bone metabolism: vitamins D, K, and A can improve alveolar bone resorption by promoting osteoblast differentiation and inhibiting osteoclast activity. Network pharmacology analysis further screened out the core targets and verified their association with inflammation and bone metabolism pathways through molecular docking. Clinical studies have shown that vitamin supplementation can significantly improve periodontal probing depth, loss of attachment, and bleeding index. Vitamins have multiple potentials in the prevention and treatment of periodontitis, such as anti-inflammatory, antioxidant and bone regeneration, but their clinical application needs to consider individual differences, bioavailability and synergistic effects. Vitamins D and C emerge as the most critically supported micronutrients for adjunctive periodontitis management. For clinical practitioners, ensuring patients' adequacy in vitamin D is paramount for its immunomodulatory and bone-stabilising benefits, while vitamin C supplementation is strongly indicated for its antioxidant capacity and role in collagen synthesis. While vitamins K, A, and E show promising mechanistic roles, their routine supplementation requires more targeted evidence. Clinical application must consider individual nutritional status, bioavailability, and synergistic effects within a precision nutrition strategy. In the future, it is necessary to combine precision nutrition strategies and clinical validation to promote the transformation of vitamins from basic research to personalised treatment.