title: Vitamin D and bone physiology: demonstration of vitamin D deficiency in an implant osseointegration rat model.
abstract: OBJECTIVE
  The patient population varies in nutritional deficiencies, which may confound the host response to biomaterials. The objective of this study was to evaluate the effect of a common deficiency of vitamin D on implant osseointegration in the rat model.
  
  
  METHODS
  Male Sprague-Dawley rats were maintained under the cessation of vitamin D intake and UV exposure. The serum levels of 1,25(OH)(2)D(3), 25 OHD(3), Ca, and P were determined. Miniature cylindrical Ti6Al4V implants (2-mm long, 1-mm diameter) were fabricated with double acid-etched (DAE) surface or modified DAE with discrete crystalline deposition (DCD) of hydroxyapatite nanoparticles. DAE and DCD implants were placed in the femurs of vitamin D-insufficient and control rats. After 14 days of healing, the femur-implant samples were subjected to implant push-in test and nondecalcified histology. The surfaces of recovered implant specimens after the push-in test were further evaluated by scanning electron microscopy (SEM).
  
  
  RESULTS
  The decreased serum level of 25 OHD(3) demonstrated the establishment of vitamin D insufficiency in this model. The implant push-in test revealed that DAE and DCD implants in the vitamin D-insufficient group (15.94 +/- 8.20 N, n = 7; 15.63 +/- 3.96 N, n = 7, respectively) were significantly lower than those of the control group (24.99 +/- 7.92 N, n = 7, p < 0.05; 37.48 +/- 17.58 N, n = 7, p < 0.01, respectively). The transcortical bone-to-implant contact ratio (BIC) was also significantly decreased in the vitamin D-insufficient group. SEM analyses further suggested that the calcified tissues remaining next to the implant surface after push-in test appeared unusually fragmented.
  
  
  CONCLUSIONS
  The effect of vitamin D insufficiency significantly impairing the establishment of Ti6Al4V implant osseointegration in vivo was unexpectedly profound. The outcome of Ti-based endosseous implants may be confounded by the increasing prevalence of vitamin D insufficiency in our patient population.
authors.affiliation: The Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095, USA.
authors.forename: James
authors.initials: J
authors.lastname: Kelly
authors.forename: Audrey
authors.initials: A
authors.lastname: Lin
authors.forename: Chiachien J
authors.initials: CJ
authors.lastname: Wang
authors.forename: Sil
authors.initials: S
authors.lastname: Park
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nishimura
mesh_terms: D000818:Animals; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D005269:Femur / Q000502:physiology / Q000601:surgery / Q000648:ultrastructure*; D006887:Hydroxycholecalciferols / Q000097:blood*; D008297:Male; D009752:Nutritional Status; D016348:Osseointegration / Q000502:physiology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014808:Vitamin D Deficiency / Q000097:blood / Q000503:physiopathology*
chemical_list: D015921:Dental Implants; D006887:Hydroxycholecalciferols