Patient
Implant region
(FDI)
Implant parameters
Dimensions of implant
Diameter [mm]/length [mm]
...
Fretwurst, T., Grunert, S., Woelber, J.P. et al. Vitamin D deficiency in early implant failure: two case reports. Int J Implant Dent 2, 24 (2016). https://doi.org/10.1186/s40729-016-0056-0
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Received: 04 August 2016
Accepted: 16 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0056-0
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral- and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, Freiburg, D-79106, Germany
Tobias Fretwurst, Sebastian Grunert, Katja Nelson & Wiebke Semper-Hogg
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
Tobias Fretwurst
Department of Operative Dentistr...
We would like to thank Dr. John Nelson for his resourceful and constructive ideas.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg do...
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno-modulator. Immunology. 2011;134(2):123–39.
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Hewison M, Freeman L, Hughes SV, Evans KN, Bland R, Eliopoulos AG, Kilby MD, Moss PA, Chakraverty R. Differential regulatio...
Hong HH, Chou TA, Yang JC, Chang CJ. The potential effects of cholecalciferol on bone regeneration in dogs. Clin Oral Implants Res. 2012;23(10):1187–92.
Hong HH, Yen TH, Hong A, Chou TA. Association of vitamin D3 with alveolar bone regeneration in dogs. J Cell Mol Med. 2015;19(6):1208–17.
Schulze-Späte U, Dietrich T, Wu C, Wang K, Hasturk H, Dibart S. Systemic vitamin D supplementation and ...
Gallagher JC, Sai AJ. Vitamin D insufficiency, deficiency, and bone health. J Clin Endocrinol Metab. 2010;95(6):2630–3.
Ning Z, Song S, Miao L, Zhang P, Wang X, Liu J, Hu Y, Xu Y, Zhao T, Liang Y, Wang Q, Liu L, Zhang J, Hu L, Huo M, Zhou Q. High prevalence of vitamin D deficiency in urban health checkup population. Clin Nutr. 2016;35(4):859–63.
Spiro A, Buttriss JL. Vitamin D: an overview o...
Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U. Is there an association between periprosthetic joint infection and low vitamin D levels? Int Orthop. 2014;38(7):1499–504.
Alvim-Pereira F, Montes CC, Thomé G, Olandoski M, Trevilatto PC. Analysis of association of clinical aspects and vitamin D receptor gene polymorphism with dental implant loss. Clin Oral Implants Res. 2008;19(8):786–...
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115(2):150–5.
Wenn...
To overcome the shortcomings of this case reports, prospective, multicenter, and controlled studies must follow to affirm a potential relationship between vitamin D deficiency, osteoimmunology, and the early failure of dental implants. Currently, a general recommendation for a standardized vitamin D screening in dental implantology cannot be stated due to lack of evidence.
Nevertheless, the vitamin D deficiency prevalence in the European population indicates that a vitamin D deficiency is probably not a sole causative factor for early implant failure; otherwise, the early implant failure rate would be significantly higher. However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing ...
Local and systemic factors can affect the survival rate of dental implants [30–33]. The causes of early implant failure are not fully clarified and an association between vitamin D and dental implant osseointegration has not been investigated properly [8, 13–16]. Some recent animal studies in rodents demonstrated a relationship between vitamin D supplementation and an increased bone to implant...
In this 51-year-old male patient, no grafting procedure was performed as vertical and horizontal alveolar ridge dimension was adequate for implant placement. The implant placement in regions 36 and 37 was performed as guided surgery (Fig. 2a, Table 1). The implant placement was uneventful and the bone appeared clinically healthy. A cortical bone profiling was performed during implant placement. ...
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a postoperative o...
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51Â years of age) were not immunosuppressed, irradiated or received chemotherapy. Written...
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 [1, 2]. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabetes, wear...
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants from different...
Fig. 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1 year after loa...
Fig. 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at 1 year after loa...
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter i...
Diameter 2.75Â mm
Â
 Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
...
Follow-up
Mean bone level (mm) (n = 124)
Time
0–6 months (95% CI) (n = 121)
0–12 months (95% CI) (n = 121)
...
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
...
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
...
Grandi, T., Svezia, L. & Grandi, G. Narrow implants (2.75 and 3.25Â mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study.
Int J Implant Dent 3, 43 (2017). https://doi.org/10.1186/s40729-017-0102-6
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Received: 23 March 2017
Accepted: 29 August 2017
Published: 08 September 2017
...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Tommaso Grandi serves as a consultant for JDentalCare. Luigi Svezia and Giovanni Grandi declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Private practice, Via Contrada 323, 41126, Modena, Italy
Tommaso Grandi & Luigi Svezia
Department of Obstetrics, Gynecology and Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
Giovanni Grandi
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmentation procedures for...
Within the limits of this prospective cohort study, narrow-diameter implants (2.75 to 3.25Â mm) can be successfully used as a minimally invasive alternative to horizontal bone augmentation in posterior mandible up to 1Â year of function. This outcome could be related to the fact that these implants have been all splinted to other implants by a fixed prosthesis. These preliminary results must be co...
On the one hand, due to the small sample size of this study and moreover, the short follow-up (only 1Â year after loading), it would be hazardous to conclude that the placement of NDIs to support fixed prostheses in posterior mandible is a predictable treatment modality. In order to draw more reliable conclusions, we need to wait for longer follow-ups, since it may be possible that after several y...
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizontally augment bon...
The radiographic data are summarized in Tables 3 and 4. The group lost statistically significant marginal peri-implant bone at 6 months (−0.20; 95% C −0.14: −0.26, pÂ
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to the allocat...
Primary outcome measures were as follows:
Implant failure: evaluated as implant mobility and removal of stable implants dictated by progressive marginal bone loss or infection. The stability of each implant was measured manually by tightening the abutment screw with a wrench delivering a torque of 20Â Ncm. Implant stability assessment was performed at delivery of definitive crowns (3Â months afte...
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8Â mm and a thickness of at least 4Â m...
The aim of this cohort study was to evaluate the outcome of narrow-diameter implants (2.75 and 3.25 mm diameter) used as definitive implants in patients with insufficient bone ridge thickness for placing standard-diameter implants in posterior regions of the mandible. The present study reports the clinical outcome up to 1 year after loading. It is planned to follow up this patients’ cohort to ...
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3Â mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimensions of the alveo...
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their outcomes in this set up to 1Â year after loading.
Forty-two patients with a mean age of 61.3 years old (range 49–73) in need of fixed prosthetic implant-supported rehabilitations in the posterior...
Â
Figure 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1Â...
Â
Figure 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at ...
Diameter 2.75Â mm
Â
 Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
p inter-groups
 Baseline
0.02 ± 0.07
−0.18 (−0.09; −0.27)
−0.47 (−0.27; −0.67)
p = 0.786
 6 months
0.20 ± 0.12
p intra-group
 12 months
0.49 ± 0.30
pÂ
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
43 (34.7%)
13
7 (5.6%)
Diameter (mm)
2.75
69 (55.6%)
3.25
55 (44.4%)
Insertion torque (Ncm)
30
21 (16.9%)
35
16 (12.9%)
40
10 (8.1%)
45
11 (8.9%)
50
32 (25.8%)
55
7 (5.6%)
60
16 (12.9%)
65
5 (4.1%)
70
6 (4.8%)
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
Mean age at insertion (range)
62.6 (49–73)
Smokers (less than 10 cigarettes/die)
12 (28.6%)
Diseases in history
 Controlled diabetes type 2
11 (26.2%)
 Hypertension
19 (45.2%)
Site of insertion
 Premolar
81 (65.3%)
 Molar
43 (34.7%)
Opposite dentition
...
Â
Figure 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
References
Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmenta...
Klein et al., in a recent systematic review, reported that the survival rate of implants with a diameter of
Discussion
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizo...
Results
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to ...
Secondary outcome measures were as follows:
Peri-implant marginal bone level changes: evaluated on intraoral radiographs taken with the paralleling technique at implant placement, 6Â months and 1Â year after loading. All measurements were taken by an independent assessor (LS). Radiographs were scanned, digitized in JPG format, converted to TIFF format with a 600Â dpi resolution, and stored in...
On the day of surgery, patients were treated under local anesthesia.
Full-thickness crestal flaps were elevated with a minimal extension to reduce patient discomfort. The implant sites were prepared according to the procedure recommended by the implant manufacturer (JDentalCare, Modena, Italy).
Tapered narrow-diameter implants titanium grade 5 (2.75 and 3.25 mm diameter, respectively, JDIcon Ult...
Methods
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at ...
Background
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3Â mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimension...
Narrow implants (2.75 and 3.25Â mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study
Â
Abstract
Background
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their out...
Patient
Implant region(FDI)
Implant parameters
Dimensions of implantDiameter [mm]/length [mm]
Explantation[Days after placement]
1
3637
First placementStraumannRN SLactive®(TiZr)
First placementØ: 4.1; L: 10Ø: 4.1; L: 8
3
Â
3637
Second placementStraumannTissue level(TiZr)
Second placementØ :4.1, L: 8Ø :4.1, L: 8
3
Â
36
Third placementConelog ScrewLine(...
Â
Figure 2. a Patient 2. Postoperative orthopantomogram one day after implant placement. b Patient 2. Postoperative orthopantomogram after second Implant placement
Â
Figure 1. a Patient 1. Post grafting orthopantomogram. The bone block was secured with a single microscrew. b Patient 1. The radiograph demonstrates veritable inserted Straumann bone level implants after the first implant placement (1 day after implant placement). A peri-implant osteolysis is not visible. c Patient 1. Postoperative orthopantomogram (1 day after implant placement) afte...
References
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115...
However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing phenomenon but rather complex foreign body reaction with activation of the immune system. Titanium and metal particle release is discussed as cause for implant failure as well as implant dentistry. It is assumed that metal particles influence the ma...
However, a present human study cannot confirm an effect due to vitamin D supplementation on bone formation or graft resorption after maxillary sinus augmentation. Satue et al. found a positive influence of 7-dehydrocholesterol (7-DHC), the precursor of vitamin D, coated implants on osteoblast differentiation in vitro. But whether vitamin D-coated dental implants have an effect of osseo...
Discussion
This article demonstrated that implant placement was successful after vitamin D supplementation in patients with vitamin D deficiency and early failed implants. None of the patients showed systemic disease or did take regular medication, alcohol, nicotine, or drugs. The patients were not immunosuppressed, irradiated, or received chemotherapy. All implants were inserted with the s...
After vitamin D supplementation and a healing period of 6 months, a third surgical intervention was planned and one implant (Conelog ScrewLine) was inserted in region 36 (see Table 1 and Fig. 1d). During implant placement, the former explantation site appeared clinically fully re-ossified. The patient received an intraoperative intravenous single-dose antibiotic therapy with Isocillin 1.2 mega. At...
Â
Patient
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a pos...
Case presentation
Patients and surgical procedure
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51Â years of age) were not immunosu...
Background
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, diabete...
Abstract
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants fr...