Evaluation of dental implant stability in the posterior mandible via resonance frequency analysis in patients treated with vitamin D3 (25-hydroxycholecalciferol) and vitamin K2 (menaquinone) for vitamin D deficiency

Abstract Objectives The aim of this prospective clinical comparative study is to comparatively evaluate the effect of Vitamin D3 with and without Vitamin K2 supplementation on dental implant stability in the posterior mandible during the osseointegration process in patients with Vitamin D deficiency, using Resonance Frequency Analysis (RFA). Materials and methods In this observational clinical study included 60 patients with indications for dental implants who had no systemic diseases and were diagnosed with Vitamin D deficiency. Participants were recruited from those either receiving treatment in Endocrinology clinics or remaining untreated. The patients were divided into three groups ( n = 20 per group): an untreated control group, a group treated only with Vitamin D3, and a group treated with Vitamin D3 + Vitamin K2. Radiographic evaluations were performed prior to implant surgery. Clinical evaluations and implant stability measurements (ISQ values) were recorded on the day of surgery, at the 8th week (placement of the healing abutment), and at the 12th week (impression taking for functional loading). Data analysis was performed using ANOVA, Kruskal-Wallis H, Repeated Measures ANOVA, and Friedman tests. The significance level was set at p < 0.05. Results ISQ values showed a statistically significant increase over time in the untreated group, the Vitamin D3 group, and the Vitamin D3 + K2 group ( p < 0.001). While there was no statistically significant difference between the median ISQ values of the groups on Day 1 based on vitamin usage ( p = 0.064). However, at Week 8, the Vitamin D3 and Vitamin D3 + K2 groups reached ISQ levels of 77.15 and 77.45 respectively, both of which were significantly higher than the 69.9 recorded in the control group ( p < 0.001). At the final 12-week measurement, the Vitamin D3 + K2 group achieved the highest stability at 82.25, while the Vitamin D3 group followed at 81.3, and the control group remained at 78.1 ( p < 0.001). The overall rate of stability increase was significantly more pronounced in the vitamin-supplemented groups compared to the untreated control. Conclusion Systemic Vitamin D3 supplementation significantly enhances early osseointegration and initial implant stability. Although the combined Vitamin D3 and K2 group yielded the highest numerical ISQ values, the addition of Vitamin K2 did not confer a statistically significant additional benefit over Vitamin D3 alone. Preoperative vitamin screening is recommended to optimize early clinical outcomes.