Title	Vitamin D Supplementation May Reduce the Risk of Early Dental Implant Failure in Vitamin D-Deficient Patients
Clinical Question	Does treatment of Vitamin D deficiency reduce the rate of early implant failure?
Clinical Bottom Line	Vitamin D supplementation may reduce the risk of early dental implant failure in Vitamin D-deficient patients.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 30443302 Mangano/2018 885 patients treated with 1,740 dental implants Retrospective Cohort Study Key results This study did not demonstrate a significant relationship between low serum Vitamin D levels and early dental implant failure; however, there was a trend toward an increased incidence of early implant failure with lowering of serum vitamin D levels. 27888492 Fretwurst/2016 Two patients Case report Key results With the limitation of this study, vitamin D deficient patients treated with vitamin D supplementation following early implant failure subsequently obtained successful implant placement. 25895415 Bryce/2014 One patient Case report Key results Osseointegration of dental implants may fail in the presence of vitamin D deficiency.
Evidence Search	“Dental implant vitamin D failure”
Comments on The Evidence	The role of Vitamin D in the regulation of bone metabolism is well established. However, the potential effects of a Vitamin D deficiency in dentistry, and in the particular area of implant dentistry, is garnering clinical interest. Several modest case reports cite a potential association between low levels of serum vitamin D and failure of osseointegration of dental implants. These studies support the hypothesis that patients treated for a serum Vitamin D deficiency can be successfully rehabilitated with dental implants if the Vitamin D deficiency is corrected prior to implant placement. However, as this evidence is derived from case reports, and consequently represents a low quality of evidence, the results must be interpreted with a degree of caution. A larger, more robust, retrospective clinical study failed to establish a direct association between Vitamin D deficiency and early failure of dental implants. Nevertheless, the author did note a trend towards an increased incidence of early implant failure with lowering of serum vitamin D levels, which was not statistically significant (P=0.105). However, the study (n=885) also included a small number of patients (n=27) with severe Vitamin D deficiency (serum levels of vitamin D <10 ng/mL), who had an 11% early implant failure rate within the cohort. A direct association between early implant failure and serum Vitamin D level cannot be established; however, based on weak evidence there may be an association. Robust assessment of a patient’s medical history and general health is recommended prior to rehabilitation with dental implants.
Applicability	Patients requiring dental implant treatment should have a comprehensive medical history taken, and where indicated be assessed for Vitamin deficiencies to improve overall health, and potentially increase the success of treatment.
Specialty	(General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords	Vitamin D, dental implant failure
ID#	3441
Date of submission	12/03/2020
E-mail	Kataoka@livemail.uthscsa.edu
Author	Satoru Kataoka, DDS
Co-author(s)	Brandon M. Wilburn, DMD
Co-author(s) e-mail	wilburnb1@livemail.uthscsa.edu
Faculty mentor	Dr. Robert Taft
Faculty mentor e-mail	Taftr@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available