Low serum vitamin D and early dental implant failure: Is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients

Abstract

Background. Since osseointegration depends on bone metabolism, low levels of vitamin D in the blood may negatively affect bone formation around dental implants. To date, only a few studies have investigated the possible connection between serum levels of vitamin D and early dental implant failure (EDIF), i.e. failure that occurs within 4 months after placement, before the connection of the prosthetic abutment. The aim of this study was to investigate whether there is a relationship between low serum levels of vitamin D and EDIF. Methods. Data used for this retrospective study were derived from the records of a private dental clinic. Inclusion criteria were patients who had been treated with dental implants, inserted with a submerged technique from January 2003 to December 2017. EDIF was the outcome of this study. Chi-squared test was used to investigate the effect of patient-related variables (age, gender, smoking habit, history of periodontal disease and serum levels of vitamin D) on EDIF. Results. Originally, 885 patients treated with 1,740 fixtures were enrolled in this study. Overall, 35 EDIFs (3.9%) were reported. No correlation was found between EDIF and the patients' gender (P=0.998), age (P=0.832), smoking habit (P=0.473) or history of periodontal disease (P=0.386). Three EDIFs (11.1%) were reported in 27 patients with serum levels of vitamin D <10 ng/mL, 20 EDIFs (4.4%) in 448 patients with levels between 10 and 30 ng/mL, and 12 EDIFs (2.9%) in 410 patients with levels >30 ng/mL. Although there was a clear trend toward an increased incidence of EDIF with lowering of serum vitamin D levels, no statistically significant difference (P=0.105) was found among these three groups. Conclusion. Within its limitations (retrospective design, low number of patients with severe blood levels of vitamin D enrolled), this study failed to demonstrate a significant relationship between low serum levels of vitamin D and increased risk of EDIF. However, since a dramatic increase in EDIFs with lowering of vitamin D levels in the blood has been reported, further clinical studies with appropriate design (prospective or randomized controlled studies on a larger sample of severely deficient patients) are needed to better investigate this topic

The role of vitamin D in dental implants osseointegration

“…In 2018, the same team of researchers 68 , in a retrospective study of 885 patients, confirms the data from their previous study. Patients with satisfactory vitamin D levels (>30 ng / mL) reported low failure rates (12/410 patients, 2.9%).…”

“…The incidence of early failures almost doubled (20/448 patients, 4.4%) in the group of patients with inadequate vitamin D levels (10-30 ng/ mL) and was nearly four times higher in patients with severe vitamin D deficiency (<10 ng / mL), which had an early failure rate of 11.1% (3/27 patients). Once again, the study showed an increase in early implant failures in patients with insufficiency, although the difference between the three groups (P = 0.105) were not statistically significant 68 .…”

Levels of smoking and dental implants failure: A systematic review and meta‐analysis

“…In one article, information on implant failure in smoker subgroups was extracted from the chart (van Steenberghe et al, ). Finally, 23 publications, including one clinical trial (Agliardi, Clericò, Ciancio, & Massironi, ), 6 prospective studies (Brizuela, Martín, Fernández, Larrazábal, & Anta, ; Cercadillo‐Ibarguren, Sánchez‐Torres, Figueiredo, & Valmaseda‐Castellón, ; Franceschetti et al, ; Gherlone et al, ; Hinze, Thalmair, Bolz, & Wachtel, ; Strietzel & Reichart, ) and 16 retrospective studies (Alsaadi et al, ; Alsaadi, Quirynen, Komarek, & van Steenberghe, ; Arora et al, ; Balderas Tamez, Neri Zilli, Fandiño, & Guizar, ; Bornstein, Halbritter, Harnisch, Weber, & Buser, ; Correia, Gouveia, Felino, Costa, & Almeida, ; Guido Mangano & Ghertasi Oskouei, ; Habsha, ; Kan, Rungcharassaeng, Lozada, & Goodacre, ; Nitzan, Mamlider, Levin, & Schwartz‐Arad, ; Noguerol, Munoz, Mesa, de Dios Luna, & O'Valle, ; Peñarrocha, Guarinos, Sanchis, & Balaguer, ; Sanchez‐Perez, Moya‐Villaescusa, & Caffesse, ; van Steenberghe et al, ; Testori, Weinstein, Taschieri, & Del Fabbro, ; Twito & Sade, ) were included in this systematic review and meta‐analysis (31,129 implants).…”

“…In four papers, the patients received implants in areas with sinus lifting procedures (Brizuela et al, 2014;Franceschetti et al, 2014;Kan et al, 1999;Testori et al, 2012); three studies reported the results of immediate implant loading (Agliardi et al, 2010;Cercadillo-Ibarguren et al, 2017;Hinze et al, 2009), one study recruited patients with history of periodontal disease (Correia et al, 2017), and one paper studied implant placement in the HIV-positive patients (Gherlone et al, 2015). Depending on definition of patient smoking status, the included studies were classified into four categories according to the number of cigarettes smoked per day; studies categorizing patients into three subgroups: non-smokers, <10 or >10 cigarettes per day (Agliardi et al, 2010;Balderas Tamez et al, 2017;Bornstein et al, 2008;Brizuela et al, 2014;Correia et al, 2017;Gherlone et al, 2015;Hinze et al, 2009;Peñarrocha et al, 2002;van Steenberghe et al, 2002), and none, <15 or >15 cigarettes per day (Franceschetti et al, 2014;Guido Mangano & Ghertasi Oskouei, 2018;Habsha, 2000;Kan et al, 1999;Testori et al, 2012), and none, <20 or >20 cigarettes per day (Agliardi et al, 2010;Arora et al, 2017) and studies categorizing patients in four subgroups (none, 1-10, 10-20 or >20 cigarettes per day) (Alsaadi et al, 2007(Alsaadi et al, , 2008Cercadillo-Ibarguren et al, 2017;Nitzan et al, 2005;Noguerol et al, 2006;Sanchez-Perez et al, 2007;Twito & Sade, 2014). The NOS score of the one relevant article was less than six poin...…”

Do Dietary Supplements and Nutraceuticals Have Effects on Dental Implant Osseointegration? A Scoping Review

“…From the retrospective studies of Mangano et al of 2016 [31] and 2018 [29], it emerged that, in patients with vitamin D deficiency, there were a higher percentage of early dental implant failures (failures that occurred before prosthesis positioning, EDIF). However, although there was a clear trend toward an increased incidence of EDIF with lower serum 25(OH)D, no statistically significant difference was found among the three groups with different vitamin D status.…”