Guido Mangano Francesco, Ghertasi Oskouei Sina, Paz Ana, Mangano Natale, Mangano Carlo
Department of Medicine and Surgery, Dental School, University of Varese, Italy.
Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
J Dent Res Dent Clin Dent Prospects. 2018 Summer;12(3):174-182. doi: 10.15171/joddd.2018.027. Epub 2018 Sep 18.
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. 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. 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. 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.
由于骨结合依赖于骨代谢，血液中维生素D水平较低可能会对牙种植体周围的骨形成产生负面影响。迄今为止，仅有少数研究调查了血清维生素D水平与早期牙种植体失败（EDIF）之间的可能联系，即种植体植入后4个月内、修复基台连接之前发生的失败。本研究的目的是调查血清维生素D水平低与EDIF之间是否存在关联。本回顾性研究使用的数据来自一家私立牙科诊所的记录。纳入标准为2003年1月至2017年12月期间采用潜入式技术植入牙种植体的患者。EDIF是本研究的结果。采用卡方检验来调查患者相关变量（年龄、性别、吸烟习惯、牙周疾病史和血清维生素D水平）对EDIF的影响。最初，本研究纳入了885例接受1740颗种植体治疗的患者。总体而言，报告了35例EDIF（3.9%）。未发现EDIF与患者的性别（P = 0.998）、年龄（P = 0.832）、吸烟习惯（P = 0.473）或牙周疾病史（P = 0.386）之间存在相关性。27例血清维生素D水平<10 ng/mL的患者中报告了3例EDIF（11.1%），448例水平在10至30 ng/mL之间的患者中报告了20例EDIF（4.4%），410例水平>30 ng/mL的患者中报告了12例EDIF（2.9%）。尽管随着血清维生素D水平降低，EDIF发生率有明显上升趋势，但这三组之间未发现统计学上的显著差异（P = 0.105）。在其局限性（回顾性设计、纳入的血清维生素D水平严重异常的患者数量较少）范围内，本研究未能证明血清维生素D水平低与EDIF风险增加之间存在显著关联。然而，由于已有报告称随着血液中维生素D水平降低EDIF显著增加，因此需要进一步开展设计合理的临床研究（对大量严重缺乏患者的前瞻性或随机对照研究）以更好地研究这一课题。
