4. Discussion
bone disease, RCDs, denture, masseter muscle thickness, tooth loss, deficiency-related ailments, eating habits
BONE DISEASE, OTHER NUTRITIONAL DEFICIENCY
In the present study, it was found that demographic and occupational variations have an impact on S Vit D levels [At enrolment, S Vit D levels ranged from 5.5 to 41.5 ng/mL in the study population. After intervention at 3 months, S Vit D levels range improved from 12.5 to 75.80 ng/mL. Initially, only 3 (2.3%) had S Vit D sufficiency, but after administrating Vitamin D therapy, we found the majority (63.1%) were vitamin D sufficient. After the intervention of 3 months, none of the patients had very severe S Vit D deficiency (In the present study, improvement was observed in the values of S Vit D, USG, and sEMG measured masseter muscle thickness and activity after 3-month intervention among group B subjects, which was in line with the study conducted by CegliaL [In vitamin D insufficiency, the effect on muscle function and physical function mostly appeared before the clinical signs of bone disease were evident [Regarding the association between S Vit D status and masticatory musculature efficiency at all three levels, after the intervention, both masseter muscle thickness and sEMG values showed a significant increase during the period (The present study shows vitamin D as one of the most important factors affecting masticatory muscle activity, thus showing the need to include vitamin D assessment and supplementation as an important measure while planning the prosthodontic rehabilitation of the edentulous patient. However, it is the need of the hour to systematically evaluate the role of various other micro-nutrients on the various oral health-related issue at a global platform.The present study had certain limitations, which include the short duration of the study. Furthermore, S Vit D levels are not only dependent upon Vitamin D supplementation only but are also dependent on a host of other factors such as season, dietary intake, level of sun exposure, etc. Similarly, the retention of dentures may also be affected by other factors which were not considered in the study, such as muscle activity and the quality of old dentures. The time and cause of tooth loss were not recorded, which might have affected the bony contour of the edentulous ridges. Furthermore, due to some reasons, muscle insertion might vary in a few patients, so it can be considered a physiological limitation. The effect of old dentures on ridges, soft tissues, and muscle activity was not evaluated in the study so as to simplify the study and establish a relationship between S Vit D levels and muscle thickness and activity, which play an important role in prosthodontics rehabilitation by RCDs. Thus, further studies are recommended to assess the need for long-term requirements of vitamin D therapy during the maintenance phase of deficiency-related ailments. Furthermore, the effect of various factors affecting RCDs including parameters such as edentulous ridge height, other nutritional deficiency, eating habits, education levels, etc., should be correlated in future studies for a better understanding of the role of vitamin D in denture retention. Along with all these, to avoid the Hawthorne effect in further studies, it is recommended to use either placebo tablets in the control group or administer vitamin D in the treatment group confined to dietary essentials.