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维生素D筛查与补充——提高成功率的新方法:当前文献的更新与综述

Vitamin D Screening and Supplementation-A Novel Approach to Higher Success: An Update and Review of the Current Literature.

作者信息

Wiedemann Thomas G, Jin Hyun Woo, Gallagher Brendan, Witek Lukasz, Miron Richard J, Talib Huzefa S

机构信息

Department of Oral and Maxillofacial Surgery, NYU Dentistry, New York, New York, USA.

BA/DDS Joint Program, NYU Dentistry, New York, New York, USA.

出版信息

J Biomed Mater Res B Appl Biomater. 2025 Mar;113(3):e35558. doi: 10.1002/jbm.b.35558.

Abstract

In recognizing the critical role of vitamin D in bone metabolism and osseointegration, research aims to identify whether preoperative vitamin D deficiency serves as a risk factor for early implant failure. By analyzing patient outcomes and their serum vitamin D levels, studies seek to establish evidence-based recommendations for vitamin D assessment and management in the preoperative period, with the ultimate goal of enhancing implant success rates and patient outcomes in dental implantology. Given these insights, it is important for clinicians to incorporate the preoperative evaluation of vitamin D serum levels into their standard protocol for patients undergoing dental implant procedures. The objective of this study is to review and investigate the correlation between early dental implant failure (EDIF) and reduced serum levels of vitamin D, and to evaluate the potential benefits of preoperative screening and supplementation of vitamin D in patients undergoing dental implant surgery. A literature review was performed using a selected database-PubMed, Google Scholar, Cochrane, and SCOPUS-to assess the effect of vitamin D3 level on EDIF and biological factors (i.e., peri-implant bone level). Studies were limited to peer-reviewed, indexed journals. Subsequently, a hypothesis was proposed that vitamin D3 supplementation would mitigate the negative effect of vitamin D3 deficiency. The potential benefit of vitamin D3 supplementation-systemic and topical-was assessed in terms of bone-to-implant contact (BIC) and peri-implant bone level. The deleterious effects of low vitamin D serum levels on osseointegration of dental implants and immune system modulation are increasingly accepted. Evidence has displayed that deficiency of this vitamin can result in impaired peri-implant bone formation. Vitamin D deficiency resulted in nearly a fourfold increase in overall EDIF incidence. Presurgical supplementation of vitamin D3 demonstrated increased levels of implant osseointegration, increased bone-implant contact, enhanced bone level maintenance, and decreased EDIF even in at-risk demographics (i.e., diabetic subjects). The findings of this study reinforce the role of vitamin D in dental implant osseointegration. Our study, particularly, emphasizes the necessity of vitamin D supplementation for individuals with sub-physiologic vitamin D serum levels (≤ 30 ng/mL) and those within specific risk categories: smokers, diabetics, obese individuals, and those with compromised immune systems. Adopting a proactive management plan, including screening and supplementation in these patients, may substantially enhance the clinical outcomes in dental implant surgery.

摘要

认识到维生素D在骨代谢和骨结合中的关键作用后,研究旨在确定术前维生素D缺乏是否是早期种植失败的危险因素。通过分析患者的预后情况及其血清维生素D水平,研究试图为术前维生素D评估和管理建立循证建议,最终目标是提高牙种植学中的种植成功率和患者预后。基于这些见解,临床医生将术前血清维生素D水平评估纳入接受牙种植手术患者的标准方案非常重要。本研究的目的是回顾和调查早期牙种植失败(EDIF)与血清维生素D水平降低之间的相关性,并评估术前筛查和补充维生素D对接受牙种植手术患者的潜在益处。使用选定的数据库——PubMed、谷歌学术、Cochrane和SCOPUS进行文献综述,以评估维生素D3水平对EDIF和生物学因素(即种植体周围骨水平)的影响。研究限于同行评审的索引期刊。随后,提出了一个假设,即补充维生素D3将减轻维生素D3缺乏的负面影响。从骨与种植体接触(BIC)和种植体周围骨水平方面评估了全身和局部补充维生素D3的潜在益处。血清维生素D水平低对牙种植体骨结合和免疫系统调节的有害影响越来越受到认可。有证据表明,这种维生素缺乏会导致种植体周围骨形成受损。维生素D缺乏导致总体EDIF发生率增加近四倍。术前补充维生素D3显示种植体骨结合水平增加、骨与种植体接触增加、骨水平维持增强,甚至在高危人群(即糖尿病患者)中也降低了EDIF。本研究结果强化了维生素D在牙种植体骨结合中的作用。我们的研究特别强调了对血清维生素D水平低于生理水平(≤30 ng/mL)的个体以及特定风险类别中的个体(吸烟者、糖尿病患者、肥胖个体和免疫系统受损者)补充维生素D的必要性。在这些患者中采用积极的管理计划,包括筛查和补充,可能会显著提高牙种植手术的临床效果。

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