{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:25:47Z","timestamp":1777479947786,"version":"3.51.4"},"reference-count":69,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Breast cancer (BC) survivors treated with aromatase inhibitors (AIs) commonly show several pathological issues, including poor oral health, bone health impairment, and vitamin D deficiency. However, to date, oral health issues in BC survivors treated with AIs have been poorly investigated and their relationship with vitamin D deficiency are far from being understood. This study aimed to evaluate the correlation between oral health and vitamin D status in BC survivors undergoing treatment with AIs through a machine learning approach. In this cross-sectional study, we included post-menopausal BC women with vitamin D deficiency undergoing AIs therapy. The outcome measures were the following: oral health indexes as the Decayed, Missing, and Filled Permanent Teeth Index (DMFT); serum levels of 25(OH)D3; Bone Mineral Density (BMD); and the diagnosis of osteoporosis. We included 41 post-menopausal BC women, mean aged 66.10 \u00b1 8.47 years, with mean serum levels of vitamin D of 14.63 \u00b1 6.62 ng\/mL. Furthermore, 56.10% of patients had a diagnosis of osteoporosis and 36.59% were osteopenic. DMFT was significantly related to smoking (p-value = 0.005) and dental floss use (p-value = 0.001). There was a significant correlation between DMFT and vitamin D levels (Pearson\u2019s r: \u22120.73; p-value = 0.001). The regression machine learning model showed that vitamin D status and the use of dental floss were the most relevant variables in terms of correlation with DMFT. In conclusion, vitamin D deficiency, inadequate use of dental floss, and smoking had a negative impact on oral health in BC women. Thus, vitamin D deficiency screening and supplementation and a prompt oral rehabilitation plan should be suggested and implemented in the complex treatment framework of BC survivors undergoing treatment with AIs.<\/jats:p>","DOI":"10.3390\/jcm11164662","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T02:42:53Z","timestamp":1660099373000},"page":"4662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Oral Health in Breast Cancer Women with Vitamin D Deficiency: A Machine Learning Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1878-4694","authenticated-orcid":false,"given":"Martina","family":"Ferrillo","sequence":"first","affiliation":[{"name":"Dentistry Unit, Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-4164","authenticated-orcid":false,"given":"Mario","family":"Migliario","sequence":"additional","affiliation":[{"name":"Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5568-7909","authenticated-orcid":false,"given":"Nicola","family":"Marotta","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-1485","authenticated-orcid":false,"given":"Lorenzo","family":"Lippi","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy"},{"name":"Translational Medicine, Dipartimento Attivit\u00e0 Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Dentistry Unit, Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9221-2497","authenticated-orcid":false,"given":"Dario","family":"Calafiore","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Ammendolia","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8701-5018","authenticated-orcid":false,"given":"Leonzio","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Dentistry Unit, Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-4966","authenticated-orcid":false,"given":"Filippo","family":"Ren\u00f2","sequence":"additional","affiliation":[{"name":"Innovative Research Laboratory for Wound Healing, Health Sciences Department, Universit\u00e0 del Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9374-0566","authenticated-orcid":false,"given":"Amerigo","family":"Giudice","sequence":"additional","affiliation":[{"name":"Dentistry Unit, Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5091-6979","authenticated-orcid":false,"given":"Marco","family":"Invernizzi","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy"},{"name":"Translational Medicine, Dipartimento Attivit\u00e0 Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5541-8346","authenticated-orcid":false,"given":"Alessandro","family":"de Sire","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21551","article-title":"Cancer statistics, 2019","volume":"69","author":"Siegel","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/S0959-8049(01)00267-2","article-title":"Cancer burden in the year 2000. The global picture","volume":"37","author":"Parkin","year":"2001","journal-title":"Eur. J. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3322\/caac.21203","article-title":"Breast cancer statistics, 2013","volume":"64","author":"DeSantis","year":"2014","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1056\/NEJMoa050518","article-title":"Effect of screening and adjuvant therapy on mortality from breast cancer","volume":"353","author":"Berry","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.ecl.2011.05.008","article-title":"Management of bone disease in patients undergoing hormonal therapy for breast cancer","volume":"40","author":"Mirza","year":"2011","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/S1470-2045(10)70257-6","article-title":"Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial","volume":"11","author":"Cuzick","year":"2010","journal-title":"Lancet Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/S2213-8587(18)30047-0","article-title":"Bone health during endocrine therapy for cancer","volume":"6","author":"Rachner","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.1210\/clinem\/dgaa463","article-title":"Challenges in Preventing Bone Loss Induced by Aromatase Inhibitors","volume":"105","author":"Rachner","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1111\/j.1742-1241.2007.01587.x","article-title":"The what, why and how of aromatase inhibitors: Hormonal agents for treatment and prevention of breast cancer","volume":"61","author":"Fabian","year":"2007","journal-title":"Int. J. Clin. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1093\/annonc\/mdq541","article-title":"Long-term effects of anastrozole on bone mineral density: 7-year results from the ATAC trial","volume":"22","author":"Eastell","year":"2011","journal-title":"Ann. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1093\/jnci\/dji250","article-title":"Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer: Updated findings from NCIC CTG MA.17","volume":"7","author":"Goss","year":"2005","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_12","first-page":"829875","article-title":"Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women with Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials","volume":"21","author":"Lippi","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2567","DOI":"10.1007\/s00198-011-1870-0","article-title":"Guidance for the prevention of bone loss and fractures in postmenopausal women treated with aromatase inhibitors for breast cancer: An ESCEO position paper. European Society for Clinical and Economical aspects of Osteoporosis and Osteoarthritis (ESCEO)","volume":"23","author":"Rizzoli","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4815","DOI":"10.1007\/s00520-016-3336-6","article-title":"Self-reported oral health and quality of life of postmenopausal breast cancer survivors on aromatase inhibitors and women without cancer diagnoses: A longitudinal analysis","volume":"24","author":"Taichman","year":"2016","journal-title":"Support. Care Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s00520-019-04792-3","article-title":"Oral health-related quality of life in breast cancer survivors","volume":"28","author":"Jardim","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s10006-013-0408-3","article-title":"Does dental and oral health influence the development and course of bisphosphonate-related osteonecrosis of the jaws (BRONJ)?","volume":"18","author":"Krimmel","year":"2014","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s10266-019-00411-z","article-title":"Association between breast cancer chemotherapy, oral health and chronic dental infections: A pilot study","volume":"107","author":"Willershausen","year":"2019","journal-title":"Odontology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s00520-010-0873-2","article-title":"Dental Disease Section, Oral Care Study Group, Multi-national Association of Supportive Care in Cancer (MASCC)\/International Society of Oral Oncology (ISOO) 2010. A systematic review of dental disease in patients undergoing cancer therapy","volume":"18","author":"Hong","year":"2010","journal-title":"Support. Care Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s00520-002-0346-3","article-title":"Periodontal infection in cancer patients treated with high-dose chemotherapy","volume":"10","author":"Epstein","year":"2002","journal-title":"Support. Care Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Calafiore, D., Fortunato, L., and Migliario, M. (2022). Vitamin D for Clinical Diseases in Women: An Indispensable Factor in Medicine and Dentistry. J. Clin. Med., 30.","DOI":"10.3390\/jcm11113104"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2772","DOI":"10.1038\/bjc.2014.175","article-title":"Vitamin D intake, blood 25(OH)D levels, and breast cancer risk or mortality: A meta-analysis","volume":"110","author":"Kim","year":"2014","journal-title":"Br. J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"105947","DOI":"10.1016\/j.jsbmb.2021.105947","article-title":"Association of 25-hydroxyvitamin D level with survival outcomes in female breast cancer patients: A meta-analysis","volume":"212","author":"Li","year":"2021","journal-title":"J. Steroid. Biochem. Mol. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5091","DOI":"10.1038\/sj.onc.1203888","article-title":"The anti-proliferative effects of 1alpha,25(OH)2D3 on breast and prostate cancer cells are associated with induction of BRCA1 gene expression","volume":"19","author":"Campbell","year":"2000","journal-title":"Oncogene"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Blasiak, J., Pawlowska, E., Chojnacki, J., Szczepanska, J., Fila, M., and Chojnacki, C. (2020). Vitamin D in Triple-Negative and BRCA1 Deficient Breast Cancer-Implications for Pathogenesis and Therapy. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21103670"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fisher, S.A., Rahimzadeh, M., Brierley, C., Gration, B., Doree, C., Kimber, C.E., Plaza Cajide, A., Lamikanra, A.A., and Roberts, D.J. (2019). The role of vitamin D in increasing circulating T regulatory cell numbers and modulating T regulatory cell phenotypes in patients with inflammatory disease or in healthy volunteers: A systematic review. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222313"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s11914-009-0011-6","article-title":"Vitamin D and immune function: Understanding commonpathways","volume":"7","author":"Bikle","year":"2009","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s00109-010-0590-9","article-title":"Vitamin D and molecular actions on the immune system: Modulation of innate and autoimmunity","volume":"88","author":"Kamen","year":"2010","journal-title":"J. Mol. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/S1471-4914(02)02294-3","article-title":"The coming of age of 1,25-dihydroxyvitamin D(3) analogs as immunomodulatory agents","volume":"8","author":"Mathieu","year":"2002","journal-title":"Trends Mol. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ferrillo, M., Migliario, M., Roccuzzo, A., Molinero-Mourelle, P., Falcicchio, G., Umano, G.R., Pezzotti, F., Foglio Bonda, P.L., Calafiore, D., and de Sire, A. (2021). Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth?. J. Clin. Med., 2.","DOI":"10.3390\/jcm10194578"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"De Sire, A., Ferrillo, M., Lippi, L., Agostini, F., de Sire, R., Ferrara, P.E., Raguso, G., Riso, S., Roccuzzo, A., and Ronconi, G. (2022). Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review. Nutrients, 14.","DOI":"10.3390\/nu14050982"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Peri\u0107, M., Maiter, D., Cavalier, E., Lasserre, J.F., and Toma, S. (2020). The Effects of 6-Month Vitamin D Supplementation during the Non-Surgical Treatment of Periodontitis in Vitamin-D-Deficient Patients: A Randomized Double-Blind Placebo-Controlled Study. Nutrients, 25.","DOI":"10.3390\/nu12102940"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/prd.12181","article-title":"Revisiting the Page & Schroeder model: The good, the bad and the unknowns in the periodontal host response 40 years later","volume":"75","author":"Hajishengallis","year":"2017","journal-title":"Periodontology 2000"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1128\/IAI.00099-11","article-title":"Vitamin D-mediated induction of innate immunity in gingival epithelial cells","volume":"79","author":"McMahon","year":"2011","journal-title":"Infect. Immun."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5558","DOI":"10.1128\/IAI.00648-09","article-title":"Saliva enables the antimicrobial activity of LL-37 in the presence of proteases of Porphyromonas gingivalis","volume":"77","author":"Gutner","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1158\/1055-9965.EPI-15-0750","article-title":"Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women","volume":"25","author":"Freudenheim","year":"2016","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"706","DOI":"10.6061\/clinics\/2014(10)10","article-title":"Oral health after breast cancer treatment in postmenopausal women","volume":"69","author":"Palioto","year":"2014","journal-title":"Clinics"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1586\/era.09.74","article-title":"Osteonecrosis of the jaw and bisphosphonate use in breast cancer patients","volume":"9","author":"Kyrgidis","year":"2009","journal-title":"Expert Rev. Anticancer. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/idh.12098","article-title":"The influence of educational level and oral hygiene behaviors on DMFT index and CPITN index in an adult Italian population: An epidemiological study","volume":"13","author":"Vano","year":"2015","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7","DOI":"10.14219\/jada.archive.1964.0034","article-title":"The Simplified Oral Hygiene Index","volume":"68","author":"Greene","year":"1964","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1902\/jop.1972.43.1.38","article-title":"The plaque control record","volume":"43","author":"Drake","year":"1972","journal-title":"J. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1034\/j.1600-051X.2003.00342.x","article-title":"Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridiniumchloride and zinc-lactate on oral halitosis A dual-center, double-blind placebo-controlled study","volume":"30","author":"Winkel","year":"2003","journal-title":"J. Clin. Periodontol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/jcpe.12420","article-title":"Prevalence of periodontitis in an adult population from an urban area in North Italy: Findings from a cross-sectional population-based epidemiological survey","volume":"42","author":"Aimetti","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/0022034516682017","article-title":"Bone density and clinical periodontal attachment in postmenopausal women","volume":"96","author":"Penoni","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_44","first-page":"464","article-title":"Periodontal disease: Mechanisms of infection and inflammation and possible impact on miscellaneous systemic diseases and conditions","volume":"68","author":"Mohangi","year":"2013","journal-title":"S. Afr. Dent. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.jdent.2015.03.003","article-title":"Smoking and dental implants: A systematic review and meta-analysis","volume":"43","author":"Chrcanovic","year":"2015","journal-title":"J. Dent."},{"key":"ref_46","first-page":"7","article-title":"Oral health risks of tobacco use and effects of cessation","volume":"60","author":"Warnakulasuriya","year":"2010","journal-title":"Int. Dent. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbo.2017.03.001","article-title":"Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG","volume":"23","author":"Hadji","year":"2017","journal-title":"J. Bone Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.canlet.2020.03.032","article-title":"Machine Learning in oncology: A clinical appraisal","volume":"481","author":"Cuocolo","year":"2020","journal-title":"Cancer Lett."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"843611","DOI":"10.3389\/fonc.2022.843611","article-title":"Quality of Life Predictors in Patients with Melanoma: A Machine Learning Approach","volume":"12","author":"Pinto","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"De Sire, A., Gallelli, L., Marotta, N., Lippi, L., Fusco, N., Calafiore, D., Cione, E., Muraca, L., Maconi, A., and De Sarro, G. (2022). Vitamin D Deficiency in Women with Breast Cancer: A Correlation with Osteoporosis? A Machine Learning Approach with Multiple Factor Analysis. Nutrients, 11.","DOI":"10.3390\/nu14081586"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3255","DOI":"10.1016\/j.csda.2007.09.023","article-title":"Multiple factor analysis and clustering of a mixture of quantitative, categorical and frequency data","volume":"52","year":"2008","journal-title":"Comput. Stat. Data Anal."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1002\/wics.1246","article-title":"Multiple factor analysis: Principal component analysis for multitable and multiblock datasets","volume":"5","author":"Abdi","year":"2013","journal-title":"Wiley Interdiscip. Rev. Comput. Stat."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Machado, V., Lobo, S., Proen\u00e7a, L., Mendes, J.J., and Botelho, J. (2020). Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis. Nutrients, 22.","DOI":"10.3390\/nu12082177"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/JPER.17-0530","article-title":"Preliminary investigation of the vitamin D pathway in periodontal connective tissue cells","volume":"89","author":"Gao","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.critrevonc.2013.07.002","article-title":"Calcium and vitamin D supplementation and loss of bone mineral density in women undergoing breast cancer therapy","volume":"88","author":"Datta","year":"2013","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Sharma, D.K., Sawyer, R.K., Robertson, T.S., Stamenkov, R., Solomon, L.B., Atkins, G.J., Clifton, P.M., Morris, H.A., and Anderson, P.H. (2019). Elevated Serum 25-Hydroxyvitamin D Levels Are Associated with Improved Bone Formation and Micro-Structural Measures in Elderly Hip Fracture Patients. J. Clin. Med., 15.","DOI":"10.3390\/jcm8111988"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/s41413-020-0088-1","article-title":"Mitigating osteonecrosis of the jaw (ONJ) through preventive dental care and understanding of risk factors","volume":"11","author":"Wan","year":"2020","journal-title":"Bone Res."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Walawska-Hrycek, A., Galus, W., Hrycek, E., Kaczmarczyk, A., and Krzystanek, E. (2021). The Impact of Vitamin D Low Doses on Its Serum Level and Cytokine Profile in Multiple Sclerosis Patients. J. Clin. Med., 24.","DOI":"10.3390\/jcm10132781"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Behm, C., Blufstein, A., Gahn, J., Kubin, B., Nemec, M., Moritz, A., Rausch-Fan, X., and Andrukhov, O. (2019). 1,25(OH)2D3 Differently Affects Immunomodulatory Activities of Mesenchymal Stem Cells Depending on the Presence of TNF-\u03b1, IL-1\u03b2 and IFN-\u03b3. J. Clin. Med., 14.","DOI":"10.3390\/jcm8122211"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"477","DOI":"10.3389\/fimmu.2018.00477","article-title":"Genomic Effects of the Vitamin D Receptor: Potentially the Link betweenVitamin D, Immune Cells, and Multiple Sclerosis","volume":"9","author":"Lu","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"El-Sharkawy, A., and Malki, A. (2020). Vitamin D Signaling in Inflammation and Cancer: Molecular Mechanisms and Therapeutic Implications. Molecules, 25.","DOI":"10.3390\/molecules25143219"},{"key":"ref_62","first-page":"1016","article-title":"Revisiting the hallmarks of cancer","volume":"7","author":"Fouad","year":"2017","journal-title":"Am. J. Cancer Res."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Eldzharov, A., Kabaloeva, D., Nemeryuk, D., Goncharenko, A., Gatsalova, A., Ivanova, E., Kostritskiy, I., Carrouel, F., and Bourgeois, D. (2021). Evaluation of Microcirculation, Cytokine Profile, and Local Antioxidant Protection Indices in Periodontal Health, and Stage II, Stage III Periodontitis. J. Clin. Med., 18.","DOI":"10.3390\/jcm10061262"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Nomura, Y., Morozumi, T., Numabe, Y., Ogata, Y., Nakayama, Y., Sugaya, T., Nakamura, T., Sato, S., Takashiba, S., and Sekino, S. (2021). Estimation of the Periodontal Inflamed Surface Area by Simple Oral Examination. J. Clin. Med., 12.","DOI":"10.3390\/jcm10040723"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1080\/10749357.2019.1673592","article-title":"Buccal hemineglect: Is it useful to evaluate the differences between the two halves of the oral cavity for the multidisciplinary rehabilitative management of right brain stroke survivors? A cross-sectional study","volume":"27","author":"Baricich","year":"2020","journal-title":"Top. Stroke Rehabil."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3233\/NRE-201537","article-title":"Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study","volume":"48","author":"Invernizzi","year":"2021","journal-title":"NeuroRehabilitation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2147\/AMEP.S295728","article-title":"Online Medical Education in India\u2014Different Challenges and Probable Solutions in the Age of COVID-19","volume":"12","author":"Nimavat","year":"2021","journal-title":"Adv. Med. Educ. Pract."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1259\/dmfr\/46589325","article-title":"Comparison of antegonial index, mental index, panoramic mandibular index and mandibular cortical index values in the panoramic radiographs of normal males and male patients with osteoporosis","volume":"39","author":"Dagistan","year":"2010","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Czajkowska, S., Rupa-Matysek, J., Wojtasi\u0144ska, E., Nijakowski, K., Gil, L., Surdacka, A., and Kulczyk, T. (2022). Potential Biochemical Markers and Radiomorphometric Indices as Predictors of Reduced Bone Mass in Patients with Congenital Hemophilia. J. Clin. Med., 11.","DOI":"10.3390\/jcm11123391"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4662\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:06:21Z","timestamp":1760141181000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":69,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jcm11164662"],"URL":"https:\/\/doi.org\/10.3390\/jcm11164662","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,9]]}}}