Journal of Oral Implantology February 2014 - (Page 110)

LITERATURE REVIEW Two Neglected Biologic Risk Factors in Bone Grafting and Implantology: High Low-Density Lipoprotein Cholesterol and Low Serum Vitamin D Joseph Choukroun1* Georges Khoury, DDS2 Fouad Khoury, MD, PhD3 Philippe Russe, DDS4 Tiziano Testori, MD5 Yataro Komiyama, DDS, PhD6 Gilberto Sammartino, MD, PhD7 Patrick Palacci, DDS8 Mustafa Tunali, DDS, PhD9 Elisa Choukroun10 Following a failure of a bone graft or an implant placement, the hypothesis of a biological abnormality is rarely considered as a possible cause. A systematic search of peer-reviewed literature for dyslipidemia or vitamin D deficiency may explain this lack of consideration. Excess low-density lipoprotein cholesterol (dyslipidemia) is responsible for a slower bone metabolism or lower dental implant osseointegration. In addition, vitamin D is a key factor for linking innate and adaptive immunity. Both of these factors are compromised under the conditions of vitamin D deficiency. Therefore, vitamin D deficiency slows implant osseointegration and increases the risk of graft infection. Vitamin D is also involved in immune function and therefore allergic reactions. Key Words: cholesterol, LDL cholesterol, vitamin D, failures, implants, bone grafts, infections, immune defense, osseointegration INTRODUCTION T he search for a biological anomaly labeled as a risk factor before oral surgery is limited to disease states such as diabetes. However, it seems in recent years that cholesterol and vitamin D 1 Pain Clinic, Nice, France. University Paris VII, Paris, France. 3 Munster University, Olsberg, Germany. 4 Private practice, Reims, France. 5 Galeazzi Institute, Universita di Milano, Milan, Italy. 6 Branemark Osseointegraion Center, Tokyo, Japan. 7 University Frederico 2, Napoli, Italy. 8 Branemark Osseointegration Center, Marseille, France. 9 Haidarpasa Hospital, Istanbul, Turkey. 10 University of Nice, France. * Corresponding author, e-mail: joseph.choukroun@free.fr DOI: 10.1563/AAID-JOI-D-13-00062 2 110 Vol. XL /No. One /2014 levels should be more systematically investigated. Good cholesterol (high-density lipoprotein [HDL]) and bad cholesterol (low-density lipoprotein [LDL]) need to be included in this investigation because both could have a negative effect on bone growth and osseointegration (high LDL or low HDL). Vitamin D is one the most important hormones involved in bone growth. In addition, vitamin D also plays a role in reducing the effects of inflammation and helps improve the body's natural immune reactions. DYSLIPIDEMIA LDL cholesterol and bone metabolism Cholesterol is transported in the plasma predominantly as cholesteryl esters associated with lipopro-

Table of Contents for the Digital Edition of Journal of Oral Implantology February 2014

Evolution of Bone Grafting for Improved Predictability
Electrochemical Behavior of Titanium in Artificial Saliva: Influence of pH
Efficacy of Antibacterial Sealing Gel and O-Ring to Prevent Microleakage at the Implant
Wired/Classic and Wireless/Periotest ‘‘M’’ Instruments: An In Vitro Assessment of
Altered Position of the Medial Lingual Nutritional Foramina at Different Stages of Alveolar
Genotoxicity of Endosseous Implants Using Two Cellular Lineages In Vitro
Implants With Internal Hexagon and Conical Implant-Abutment Connections: An In Vitro
Stress Distribution Around Maxillary Anterior Implants as a Factor of Labial Bone Thickness
Peri-Implant Biomechanical Responses to Standard, Short-Wide, and Mini Implants
Removal Torque Analysis of Implants in Rabbit Tibia After Topical Application of
Nonprocessed Adipose Tissue Graft in the Treatment of Peri-Implant Osseous Defects in
Assessment of the Effect of Two Occlusal Concepts for Implant-Supported Fixed
Nerve Damage Assessment Following Implant Placement in Human Cadaver Jaws:
Dental Implants: Early Versus Standard Two-Stage Loading (Animal Study)
Intravenous Sedation for Implant Surgery: Midazolam, Butorphanol, and
Nanocrystalline Hydroxyapatite-Based Material Already Contributes to Implant Stability
Two Neglected Biologic Risk Factors in Bone Grafting and Implantology: High Low-Density

Journal of Oral Implantology February 2014