{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:31:54Z","timestamp":1786357914985,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dent. J.","Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: Dental implant and guided bone regeneration (GBR) procedures rely on successful bone healing and remodeling. Systemic metabolic factors, including vitamin D deficiency and elevated low-density lipoprotein cholesterol (LDL-C), may adversely affect osseointegration and bone regeneration. This study aimed to investigate the association between implant\/GBR failure and serum vitamin D and LDL-C levels. Methods: A retrospective clinical study was conducted on 40 patients treated with dental implants and\/or GBR procedures between 2023 and 2025 in the Eastern Province of Saudi Arabia. Twenty patients with failed outcomes and twenty patients with successful outcomes were included. Smokers, immunocompromised patients, individuals with a history of radiotherapy or chemotherapy, and patients with uncontrolled diabetes mellitus (HbA1c &gt; 6.5%) were excluded. Failure was defined as progressive bone loss, loss of osseointegration, implant mobility, graft resorption, or persistent infection and was categorized as early or late failure. Serum vitamin D and LDL-C levels were obtained after treatment and analyzed using bivariate and exploratory multinomial logistic regression analyses. Results: Significant differences in serum vitamin D and LDL-C levels were observed among failure groups. Mean vitamin D levels were highest in the non-failure group (91.3 \u00b1 47.9 nmol\/L), followed by early failure (53.3 \u00b1 33.7 nmol\/L) and late failure (28.3 \u00b1 11.3 nmol\/L) (p = 0.001). Mean LDL-C levels increased progressively from the non-failure group (107.0 \u00b1 26.8 mg\/dL) to early failure (137.6 \u00b1 47.3 mg\/dL) and late failure groups (161.3 \u00b1 57.0 mg\/dL) (p = 0.003). Vitamin D status and LDL-C category were significantly associated with failure type (p = 0.001 and p = 0.012, respectively). Conclusions: Lower serum vitamin D levels and higher LDL-C levels were associated with implant and GBR failure, particularly in late failure cases. However, because serum vitamin D and LDL-C levels were measured after treatment outcomes and the study was limited by its retrospective design and relatively small sample size, these findings should be interpreted with caution and do not establish a causal relationship. Larger prospective studies are needed to determine whether preoperative assessment and optimization of vitamin D and lipid status may improve implant and regenerative treatment outcomes.<\/jats:p>","DOI":"10.3390\/dj14080504","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T09:24:53Z","timestamp":1786353893000},"page":"504","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Dental Implant and Bone Graft Failure and the Levels of Vitamin D and LDL Cholesterol: Retrospective Clinical Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Sara","family":"Albasarah","sequence":"first","affiliation":[{"name":"Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bader","family":"Albader","sequence":"additional","affiliation":[{"name":"University Dental Hospital, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9332-3575","authenticated-orcid":false,"given":"Mishali","family":"Alsharief","sequence":"additional","affiliation":[{"name":"Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2552-587X","authenticated-orcid":false,"given":"Khalid","family":"Almas","sequence":"additional","affiliation":[{"name":"Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-5325","authenticated-orcid":false,"given":"Faisal E.","family":"Aljofi","sequence":"additional","affiliation":[{"name":"Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3109\/17453678108991776","article-title":"Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man","volume":"52","author":"Albrektsson","year":"1981","journal-title":"Acta Orthop. Scand."},{"key":"ref_2","first-page":"11","article-title":"The long-term efficacy of currently used dental implants: A review and proposed criteria of success","volume":"1","author":"Albrektsson","year":"1986","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/j.1708-8208.2012.00456.x","article-title":"10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: A retrospective study in 303 partially edentulous patients","volume":"14","author":"Buser","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/jcpe.12898","article-title":"A retrospective study of 30,959 implants: Risk factors associated with early and late implant loss","volume":"45","author":"Lin","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s40729-020-00276-w","article-title":"Potential risk factors for early and late dental implant failure: A retrospective clinical study on 9080 implants","volume":"6","author":"Staedt","year":"2020","journal-title":"Int. J. Implant Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1046\/j.0906-6713.2003.03313.x","article-title":"Impact of systemic diseases and medication on osseointegration","volume":"33","author":"Quirynen","year":"2003","journal-title":"Periodontology 2000"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1563\/AAID-JOI-D-13-00062","article-title":"Two neglected biologic risk factors in bone grafting and implantology: High low-density lipoprotein cholesterol and low serum vitamin D","volume":"40","author":"Choukroun","year":"2014","journal-title":"J. Oral Implantol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9933646","DOI":"10.1155\/2024\/9933646","article-title":"Relationship between the level of vitamin D3 deficiency and successful osseointegration: A prospective clinical study","volume":"2024","author":"Jamil","year":"2024","journal-title":"Sci. World J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1563\/aaid-joi-D-23-00168","article-title":"The relationship of low-serum vitamin D and early dental implant failure","volume":"50","author":"Francis","year":"2024","journal-title":"J. Oral Implantol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Buzatu, B.L.R., Buzatu, R., and Luca, M.M. (2024). Impact of Vitamin D on Osseointegration in Dental Implants: A Systematic Review of Human Studies. Nutrients, 16.","DOI":"10.3390\/nu16020209"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4077","DOI":"10.1073\/pnas.95.8.4077","article-title":"The \u201cbest\u201d of cholesterols, the \u201cworst\u201d of cholesterols: A tale of two receptors","volume":"95","author":"Krieger","year":"1998","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S108","DOI":"10.1038\/sj.cdd.4401399","article-title":"Osteoclast formation, survival and morphology are highly dependent on exogenous cholesterol\/lipoproteins","volume":"11","author":"Luegmayr","year":"2004","journal-title":"Cell Death Differ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1007\/s40200-022-01071-7","article-title":"Association of periodontitis with lipid profile: An updated systematic review and meta-analysis","volume":"21","author":"Mirzaei","year":"2022","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40729-019-0170-x","article-title":"The effect of hyperlipidemia on bone graft regeneration of peri-implant created defects in rabbits","volume":"5","author":"Tekin","year":"2019","journal-title":"Int. J. Implant Dent."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Grigora\u0219, R.I., Gasparro, R., Co\u0219arc\u0103, A.S., Dak\u00f3, T., and Ormeni\u0219an, A. (2025). The impact of LDL cholesterol, HDL cholesterol, triglycerides, and vitamin D on short-term implant survival rate: A prospective observational study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14103531"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2464","DOI":"10.6026\/973206300212464","article-title":"Growth factors and osseointegration in dental implants: A review","volume":"21","author":"Chandwani","year":"2025","journal-title":"Bioinformation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/prd.12539","article-title":"Guided bone regeneration in implant dentistry: Basic principles, progress over 35 years, and recent research activities","volume":"93","author":"Buser","year":"2023","journal-title":"Periodontology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/01.id.0000204762.39826.0f","article-title":"\u201cPASS\u201d principles for predictable bone regeneration","volume":"15","author":"Wang","year":"2006","journal-title":"Implant Dent."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Miron, R.J., Estrin, N.E., Paz, A., Gruber, R., Farshidfar, N., Zhang, Y., Sculean, A., Wiedemann, T.G., and Ahmad, P. (Periodontology, 2025). Relationship Between Vitamin D Deficiency and Early Implant Failure and Osseointegration, Periodontology, early view.","DOI":"10.1111\/prd.70017"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes Care, 33, S62\u2013S69.","DOI":"10.2337\/dc10-S062"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","unstructured":"Pagana, K.D., Pagana, T.J., and Pagana, T.N. (2019). Mosby\u2019s Diagnostic & Laboratory Test Reference, Elsevier. [14th ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jsbmb.2016.12.017","article-title":"Vitamin D in Saudi Arabia: Prevalence, distribution and disease associations","volume":"175","year":"2018","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mahmood, M.K., Tassery, H., Tardivo, D., and Lan, R. (2023). Association between vitamin D levels and dental caries: A systematic review and dose-response meta-analysis of cross-sectional studies. Appl. Sci., 13.","DOI":"10.3390\/app13179883"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1902\/jop.2012.120445","article-title":"Plasma 25-hydroxyvitamin D concentrations and periodontal disease in postmenopausal women","volume":"84","author":"Millen","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"282","DOI":"10.15537\/1658-3175.4235","article-title":"Hyperlipidemia in Saudi Arabia","volume":"29","author":"Arafah","year":"2008","journal-title":"Saudi Med. J."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/8\/504\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T09:56:07Z","timestamp":1786355767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/8\/504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":26,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["dj14080504"],"URL":"https:\/\/doi.org\/10.3390\/dj14080504","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]}}}