GAP Australasian-Dentist-May June 2019

Category 64 AustrAlAsiAn Dentist Aim: To investigate whether there is a correlation between early dental implant failure and low serum levels of vitamin D. Methods. All patients treated with dental implants in a single centre, in the period 2003–2015, were considered for enrolment in this study. The main outcome was early implant failure. The influence of patient-related variables on implant survival was calculated using the Chi-square test. Results. 822 patients treated with 1625 implants were selected for this study; 27 early failures (3.2%) were recorded. There was no link between gender, age, smoking, history of periodontitis, and an increased incidence of early failures. Statistical analysis reported 9 early failures (2.2%) in patients with serum levels of vitamin D > 30 ng/mL, 16 early failures (3.9%) in patients with levels between 10 and 30 ng/mL, and 2 early failures (9.0%) in patients with levels <10 ng/mL. Although there was an increasing trend in the incidence of early implant failures with the worsening of vitamin D deficiency, the difference between these 3 groups was not statistically significant (P = 0.15). Conclusions: This study failed in proving an effective link between low serum levels of vitamin D and an increased risk of early implant failure. Further studies are needed to investigate this topic. 1. Introduction Dental implants are now a reliable solution for the functional and esthetic rehabilitation of partially and completely edentulous patients; this has been demonstrated by long-term clinical trials, with survival rates of greater than 95% [1–3]. in order to achieve long-term survival, osseointegration of the dental implant needs to occur; that is, a direct connection must be established between the bone and the implant surface, without the interposition of fibrous tissue [4]; once established, this close bond must be maintained over time, resulting in a clinically asymptomatic fixation of the implant under functional load [5]. Osseointegration is a complex phenomenon and depends onmany factors; some are related to the implant (material, macroscopic design, and implant surface), others to the surgical-prosthetic protocol (surgical technique, loading conditions, and time), and others to the patient (quantity/quality of bone at the receiving site and the host response) [4, 5]. Although survival rates of dental implants are now high, there still remains a seemingly unavoidable number of failures: either cases in which correctly placed implants do not integrate with the bone or cases of peri-implant tissue infection [6, 7]. to be specific, failure to osseointegrate and peri-implantitis are the most frequent causes of early implant failure [3, 6, 7]. such events occur during the early stages of healing (within 2-3 months of implantation) and therefore before the implant is functionally loaded with the prosthetic restoration; these failures are unevenly distributed within the general population and tend to occur in some subjects in particular. in these individuals multiple or repeated failures over time are possible [6, 7]. early failures occur even when optimal materials are used, surgical protocols are strictly followed, and the quantity/quality of bone at the recipient site is sufficient [6–8]. All these observations would suggest the existence of specific patient-related risk factors; this prompts an investigation into the regulatory mechanisms controlling bone metabolism, bone remodelling, and bone turnover [9, 10]. Vitamin D plays a fundamental role in bone metabolism [11–13]. it is a fat-soluble vitamin which promotes the absorption of calcium in the intestine and regulates calcium and phosphate homoeostasis in the tissues and it is a fundamental element in the mineralization of bones and teeth [11–13]. it also acts as a hormone and is vital for the health of the blood vessels and the brain [14, 15]. it has been demonstrated that vitamin D plays a crucial role in the health of the cardiovascular tract [16], the immune system [17], and the respiratory tract [18, 19]. Vitamin D in an inactive form (cholecalciferol or vitamin D3) is ingested or produced in the skin on exposure to sunlight [11, 12]. this inactive form undergoes double hydroxylation in the liver and the kidneys and is thereby Research Article Is Low Serum Vitamin D Associated with Early Dental Implant Failure? A Retrospective Evaluation on 1625 implants placed in 822 patients FrancescoMangano, 1 Carmen Mortellaro, 2 Natale Mangano, 3 and CarloMangano 4 1 Department of surgical and Morphological science, Dental school, university of insubria, 21100 Varese, italy 2 Department of Health sciences, university of eastern Piedmont, 28100 novara, italy 3 Division of endocrinology and Metabolism, Moriggia Pelascini Hospital, 22015 Gravedona ed uniti, italy 4 Department of Dental sciences, university Vita salute san raffaele, 20132 Milan, italy Correspondence should be addressed to Francesco Mangano; francescomangano1@mclink.net received 1 June 2016; revised 22 July 2016; Accepted 30 August 2016 Academic editor: Marcos Minicucci Copyright © 2016 Francesco Mangano et al. this is an open access article distributed under the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly lInICal