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Review
. 2025 Oct 30.
doi: 10.1111/prd.70017. Online ahead of print.

Relationship between vitamin D deficiency and early implant failure and osseointegration

Richard J Miron  1 , Nathan E Estrin  2 , Ana Paz  3 , Reinhard Gruber  4 , Nima Farshidfar  1 , Yufeng Zhang  5 , Anton Sculean  1 , Thomas G Wiedemann  6 , Paras Ahmad  7
Affiliations
Review

Relationship between vitamin D deficiency and early implant failure and osseointegration

Richard J Miron et al. Periodontol 2000. .

Abstract

Background: This systematic review investigated the relationship between pre-operative vitamin D levels and implant osseointegration and implant-related outcomes. It also assessed studies involving vitamin D supplementation before implant placement.

Methods: In vivo experimental and clinical studies published up to May 15, 2025, were reviewed. Out of 151 initially identified publications, 43 met the inclusion criteria.

Results: In total, 16 animal and 27 human studies were included. Most animal studies investigated vitamin D supplementation before implant placement (nine studies), whereas six studies explored vitamin D coatings on implant surfaces. Animal models included osteoporosis, diabetes mellitus, ultraviolet (UV) light deficiency, chronic kidney disease-induced uremia, and orchiectomy. A positive effect was found for vitamin D on implant osseointegration in 13 of the 16 studies. The human studies comprised three case reports, 10 retrospective studies, three prospective case series, eight prospective controlled trials (2-4 cohorts), and three randomized clinical trials (RCTs). Collectively, 22 of the 27 human studies supported a beneficial association between adequate vitamin D levels and improved implant osseointegration or reduced early implant failure. Vitamin D deficiency was associated with up to a fourfold increase in early implant failures. Pre-surgical supplementation with vitamin D3 enhanced implant osseointegration, improved bone-implant-contact (BIC), promoted peri-implant bone preservation, and reduced early implant failures, even among high-risk populations (i.e., diabetics). When implant-related parameters such as pocket depths, radiographic marginal bone levels, or implant stability were measured, significantly poorer outcomes were consistently observed in vitamin D-deficient groups.

Conclusions/clinical relevance: Evidence from both animal and human studies strongly indicates that vitamin D deficiency impairs both new bone formation and BIC. Supplementation, particularly in patients with systemic conditions, may improve implant osseointegration outcomes. Pre-operative screening and correction of vitamin D deficiency are recommended to optimize implant success. Additional well-designed prospective clinical trials and RCTs are needed to further elucidate the extent of the correlation between serum vitamin D deficiency and the risk of implant failure.

Keywords: cholecalciferol; osseointegration; peri‐implantitis; systematic review.

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References

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