Vitamin D deficiency in early implant failure: two case reports.

Katja Nelson,Sebastian Grunert,Wiebke Semper-Hogg,Johan P. Woelber,Tobias Fretwurst

doi:10.1186/s40729-016-0056-0

Abstract

An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants from different manufacturers in the molar region of the mandible. In the case of bone grafting in the first patient, all implants were placed in a two-stage procedure. All implants had to be removed within 15 days after implant placement. Vitamin D serum levels were measured: Both patients showed a vitamin D deficiency (serum vitamin D level <20 μg/l). After vitamin D supplementation, implant placement was successful in both patients. Prospective, randomized clinical trials must follow to affirm the relationship between vitamin D deficiency, osteoimmunology, and early implant failure.

Highlights

Long-term stable osseointegrated implants are the primary goal in dental implantology
This article demonstrated that implant placement was successful after vitamin D supplementation in patients with vitamin D deficiency and early failed implants
Other authors cannot confirm an effect of vitamin D supplementation on bone formation around titanium implants in diabetic rats [37]

Summary

Background

Long-term stable osseointegrated implants are the primary goal in dental implantology. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a) This patient received a postoperative oral antibiotic therapy with amoxicillin 750 mg for 3 days. A second implant surgery was scheduled after 6 months with placement of two implants (Straumann, tissue level) in regions 36 and 37 (Fig. 1c). After 3 days, both implants had to be removed because of continuous severe pain in the absence of any sign of soft tissue inflammation, swelling, or abscess formation At this time point, a screening of the relevant parameters for bone metabolism was performed and a vitamin D deficiency (vitamin D serum level 11 μg/l) was diagnosed. After vitamin D supplementation, a second implant placement in region 37 was performed successfully 4 months later. After detailed vitamin D anamnesis malnutrition and insufficient sun exposure could be excluded as cause for vitamin D deficiency in both patients

Discussion

Findings

Conclusions