sociation Between Serum Vitamin D Levels and Temporomandibular Disorders: Pathophysiological Mechanisms, Clinical Evidence, and Therapeutic Perspectives

Abstract

Introduction: Vitamin D, beyond its classical role in mineral homeostasis, modulates immune and inflammatory responses, with potential implications in temporomandibular disorders (TMDs), multifactorial conditions affecting the temporomandibular joint and associated structures. Objectives: To analyze the relationship between serum vitamin D levels and TMDs, exploring pathophysiological mechanisms, clinical evidence, and therapeutic perspectives. Methods: A review of MEDLINE, Scielo, LILACS, Scopus, and Web of Science (2015–2025). Twelve studies were included after a two-step screening (titles/abstracts and full-text reading), excluding works outside inclusion criteria or duplicates. Results: Vitamin D deficiency (<20 ng/mL) was associated with a higher prevalence of TMDs, particularly osteoarthritis and disc displacement, involving mechanisms such as VDR receptor polymorphisms, regulation of metalloproteinases (MMP-3/13), and inflammatory responses. Clinical trials demonstrated that supplementation (60,000 IU/week) combined with splints reduced pain (VAS: 7.61→4.06; p<0.05) and improved masticatory function. Conclusion: Most of the evaluated studies show that patients with TMDs have reduced vitamin D levels compared to healthy individuals, with pathophysiological mechanisms involving the modulation of inflammatory processes, regulation of bone homeostasis, and immune response mediated by VDR receptors. Routine screening of 25(OH)D levels in patients with TMDs is advisable, especially in those with more severe clinical presentations or those refractory to conventional treatment.