Assessment of the state of mineral metabolism in patients with tooth loss during dental implantation against the background of vitamin D deficiency

   Background. The widespread occurrence of mineral metabolism disorders in the modern world, including those due to vitamin D deficiency, affects the results of patient rehabilitation performed by dental surgeons using dental implants.

   The aim of the study was to assess the state of mineral metabolism during dental implantation in young and middle-aged patients with tooth loss due to vitamin D deficiency.

   Materials and methods. From 2011 to 2024, 450 patients aged 25–50 years with tooth loss due to identified vitamin D deficiency in the absence of other somatic pathology were examined and treated at Sechenov University and a private clinic. All patients underwent laboratory examination, including assessment of mineral metabolism indicators – the level of total calcium, vitamin D (25 (OH) D), parathyroid hormone, thyroid stimulating hormone. Also, 30 randomly selected patients underwent assessment of osteogenesis markers (bone matrix formation marker P1NP, serum cross-linked C-telopeptide of type I collagen CTX). Patients were referred to an endocrinologist due to detected vitamin D deficiency, therapy was prescribed. All patients underwent dental implantation and concomitant surgeries to increase bone volume, if necessary, considering the study group: in group 1 – until reference values of vitamin D were achieved, in group 2 – after. Comparison of parameters before and after drug therapy was performed using Student’s T-test or Mann-Whitney, the results were considered statistically significant at p < 0.05.

   Results. In the examined sample, 2.1 % of patients had a pronounced deficiency of (25(OH)D) (< 10 ng/ml), 60.4 % had a deficiency (< 20 ng/ml), and 37.5 % had insufficiency (20–30 ng/ml), with the initial level of vitamin D in both study groups not statistically different (< 20 ng/ml, p < 0.05). After the treatment, the level of (25(OH)D) in all patients reached the reference values (30–60 ng/ml, p < 0.05) also without statistically significant difference when compared by groups (median 1 = 42.75 and median 2 = 43.65, respectively, p > 0.05), but was significantly higher when assessed dynamically within each
group (p < 0.05). No deviations from reference values for osteogenesis markers were found over time, although a statistically significant slight decrease in both parameters within the normal range was noted after treatment compared to the initial level (p < 0.05).

   Conclusion. In young and middle-aged patients with tooth loss due to vitamin D deficiency, no significant changes in laboratory parameters (blood calcium levels, parathyroid hormone, and osteogenesis markers over time) were found during dental implantation and concomitant surgeries.

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