Long-term stable osseointegrated implants are the primary goal in dental implantology. Although dental implants have proven clinical reliable in the long term, the failure of implants at a very early stage of osseointegration has been described. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabetes, wear particle release and foreign body reaction, local bone necrosis due to heat generation during bone preparation or implant placement. Systematic reviews demonstrated that an antibiotic regimen before dental implant placement subtly reduces the early implant infection and consequently implant failure. In orthopedics, the risk to develop a periprosthetic joint infection has been associated with a low vitamin D level. A relationship between bone metabolism, vitamin D, and early implant failure in human has not been proven to date. Vitamin D induces bone formation around implants in rodents. Besides the classical function, findings of the last decades indicate vitamin D as an important immune regulator targeting both, the innate and adaptive immune response, since all cells of the immune system express vitamin d receptor (VDR).

The definition of vitamin D serum level is discussed in the literature. Currently, vitamin D insufficiency is defined as serum level ranges between 21 and 29 μg/l, a serum level below <20 μg/l as vitamin D deficiency (severe deficiency <10 μg/l). The prevalence of vitamin D deficiency in Europe varies widely with ranges between 2 to 30% in adults and up to 80% in elderly patients. Malnutrition, insufficient sun exposure, premature and dysmature birth, pigmented skin, obesity and advanced age are known as factors for a vitamin D deficiency.

A current review article demands the investigation of vitamin D deficiency in the context of dental implant failures. To address this demand, the present case reports raised the question if vitamin D deficiency influences implant survival in the early stages of healing. This article illustrates two apparently healthy patients with vitamin D deficiency and early implant failure and demonstrates that implant placement was successful after vitamin D supplementation.