Vitamin D Deficiency as a Potential Systemic Risk Indicator for Periodontal Disease and Fixed Dental Prosthesis Failure: A Systematic Literature Review

Abstract

Vitamin D has an important role in calcium metabolism, bone remodeling, immune regulation, and control of inflammatory responses. These functions are closely related to periodontal health, alveolar bone stability, and the biological support of teeth carrying fixed dental prostheses. Previous studies have suggested that vitamin D deficiency may be associated with periodontal inflammation, clinical attachment loss, alveolar bone loss, and impaired oral tissue healing. However, the relationship between vitamin D deficiency and failure of fixed dental prostheses remains less clearly established, especially when prosthetic failure is linked to periodontal deterioration around abutment teeth. This systematic literature review aimed to evaluate the available evidence on the association between vitamin D deficiency, periodontal disease, and fixed dental prosthesis failure. A structured literature search was conducted in PubMed, Scopus, Web of Science, ScienceDirect, Cochrane Library, and Google Scholar for studies published between 2020 and 2026. The search used combinations of terms related to vitamin D deficiency, serum 25-hydroxyvitamin D, periodontal disease, periodontitis, alveolar bone loss, fixed dental prosthesis, crowns, bridges, abutment teeth, and prosthetic complications. Studies were selected according to predefined inclusion and exclusion criteria. Data were extracted regarding study design, vitamin D assessment, periodontal outcomes, prosthetic outcomes, and main findings. The methodological quality of the included evidence was assessed according to study design, and the findings were summarized narratively because of differences in study methods and outcomes. The reviewed evidence showed a consistent association between low serum vitamin D levels and poorer periodontal outcomes, including increased gingival inflammation, deeper periodontal pockets, clinical attachment loss, and alveolar bone loss. The direct evidence linking vitamin D deficiency to fixed dental prosthesis failure was limited. However, available periodontal, prosthodontic, and implant-related studies suggest that vitamin D deficiency may contribute indirectly to fixed prosthesis complications through periodontal inflammation, reduced alveolar bone support, impaired healing, and compromised abutment tooth stability. Vitamin D deficiency may be considered a potential systemic risk indicator for periodontal disease. Its relationship with fixed dental prosthesis failure appears to be indirect rather than direct, mainly through periodontal breakdown, alveolar bone loss, and abutment tooth compromise. Further longitudinal clinical studies are needed to clarify whether correction of vitamin D deficiency can improve periodontal stability and reduce biological complications around fixed dental prostheses.