Fueling failure or fostering fusion? A critical review of the potential effect of ketogenic, intermittent fasting, and low-carbohydrate diets on dental implant osseointegration

To synthesize current evidence (2010-2025) on ketogenic, intermittent fasting, and low-calorie diets' effects on bone health, inflammation, osseointegration and identifying research gaps relevant to dental implantology. A systematic literature search was conducted across PubMed, Scopus, and Web of Science for human and animal studies, mechanistic work, and systematic reviews. Evidence was extracted and summarized, prioritizing studies on diet patterns, bone biology, and dental implant outcomes. Mechanistic and animal studies suggest dietary influence on bone remodeling, inflammation, and angiogenesis, crucial for osseointegration. Vitamin D level correlates with implant outcomes, and moderate intermittent fasting appears not to harm systemic bone markers short-term. Major gaps include peri-implant mechanistic data, comparative trials, and optimal dietary timing. Current evidence indicates a potential influence of different diets on dental implant success factors. Definitive dietary recommendations for implant patients are premature due to insufficient human clinical data. Comprehensive, implant-specific research is still needed to establish guidelines and integrate nutrition into implant practice.