Is There a Link Between Vitamin D Deficiency and Implant Failure?
Each year, there are some dental implants that, although they are placed in adequate bone volume, fail within two to eight weeks of the implant placement for unknown reasons. Early research suggests that vitamin-D deficiency could be a contributing factor.
Vitamin D supports the immune system and the integration of biomaterials and other metabolic processes, such as new bone formation on the implant surface. It also decreases oxidative stress and minimizes surgical inflammation.
Early studies are suggesting that adequate vitamin D can enhance healing.1 One study of 885 dental implant patients found that patients with vitamin D deficiency (serum levels of vitamin D <10 ng/mL) had an early implant failure rate of 11.1%, compared to a failure rate of 2.9% in patients with normal levels of the vitamin (>30 ng/mL).2 Some experts estimate that vitamin D deficiency is associated with an up to 300% increase in early implant failure.3
But the data must be interpreted with caution. “This research is interesting, but the data is really new and has not yet been published in any of our peer-reviewed oral surgery journals,” says Roseanna P. Noordhoek, DDS, an oral surgeon at the Center For Oral Surgery & Dental Implants. “Yet, we’re excited to follow the developing research.” More research on the relationship between vitamin D, healing and dental implant failure is needed.
Deficient, Insufficient and Optimal Vitamin D Levels
Vitamin D deficiency is most common in older adults, people who are obese, nursing home residents and hospitalized patients. In the United States, 61% of older adults, a group that receives many dental implants, are vitamin D deficient.4
Serum 25-hydroxy vitamin D (25-OH) is used to reliably measure vitamin D. According to the National Institutes of Health:
- <12 ng/mL = Deficient
- 12-20 ng/mL = Insufficient
- >20 ng/mL = Optimal.5
Causes of Vitamin D Deficiency
The most common causes of vitamin D deficiency are an unhealthy diet, lack of sun exposure and certain medical conditions. A leading dietary cause of vitamin D deficiency is the consumption of unhealthy foods and fast foods. Even when patients have a healthy diet, it’s very difficult to get sufficient vitamin D—600 IU/day for adults up to age 69, and 800 IU/day starting at age 706—from food.
Natural sunlight is a key source of vitamin D. Exposing the face, arms and hands to the sun for about 15 minutes two to three times a week should provide sufficient vitamin D for light-skinned patients in Michigan. Patients with darker skin need 30 minutes to three hours longer in the sun to get sufficient vitamin D. The season and time of day also impact the length of time required for adequate sunlight exposure.
Obese patients with a body mass index greater than 30 are at higher than average risk for vitamin D deficiency.7 Patients with kidney disease, celiac disease, cystic fibrosis and Crohn’s disease are also at increased risk.
If you’d like to read more, the first three references below link to articles that provide more detailed information about this topic. Also, you can share our lay article about vitamin D and implants with your patients: Can Lack of Vitamin D Affect Your Dental Implants?
For more information about dental implants at the Center For Oral Surgery & Dental Implants, call 616-361-7327.
1 Forum S. Vitamin D deficiency: Impact on wound healing and implant failure. Perio-Implant Advisory. Feb 3, 2020. Accessed 8/5/20.
2 Mangano FG, Oskouei SG, Paz A, Mangano N, Mangano C. Low serum vitamin D and early dental implant failure: is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients. J Dent Res Dent Clin Dent Prospects. 2018;12(3):174-182. doi:10.15171/joddd.2018.027. Accessed 8/5/20.
3 Miron RJ, Pikos MA, and Bishara M. Vitamin D Deficiency and Early Implant Failure: What Every Clinician Should Know. Dentistry Today, April 1, 2020. Accessed 8/5/20.
4 Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J. Steroid Biochem Mo. Biol. 2014 Oct;144 Pt A:138-45. Accessed 8/5/20.
5 NIH Fact Sheet for Health Professionals, Vitamin D. March 24, 2020. Accessed 8/5/20.
6 The National Academics of Science, Engineering and Medicine. Dietary Reference Intakes for Calcium and Vitamin D. 2011. Accessed 8/5/20.
7 Khosravi ZS, Kafeshani M, Tavasoli P, Zadeh AH, Entezari MH. Effect of vitamin D supplementation on weight loss, glycemic indices, and lipid profile in obese and overweight women: a clinical trial study. Int J Prev Med. 2018;9(1):63. doi:10.4103/ijpvm.IJPVM_329_15. Accessed 8/5/20.