IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 4 Ser.14 (April. 2021), PP 11-16 www.iosrjournals.org DOI: 10.9790/0853-2004141116 www.iosrjournal.org 11 | Page The Role and Importance of Lipoproteins, Vitamin D3, Vitamin K and Magnesium in the Osseointegration of Titanium Dental Implants Kreena Shah 1 , Juilee Mestry 1 , Sonali Rangnekar 1 , Saurabh Gupta 1 1 (Master Dental Science, Universitat Jaume I, Castellon de la plana, Spain) Abstract: Bone is a metabolically active tissue that renews itself throughout one’s life. Osseointegration is a vital process in which characteristics of the implant like the macro and micro geometry, surface properties, etc. play an important role in modulating cellular and molecular behavior. The process of osseointegration depends on many factors but systemic biological irregularity is seldom considered as a cause for failure in osseointegration of titanium implant. Various nutrients may significantly impact certain parameters of bone remodeling and in turn affect osseointegration. Certain factors in particular, such as levels of vitamin D3, vitamin K, blood sugar and cholesterol are some of the main systemic factors in the host that can contribute or interfere significantly in the process of effective bone tissue formation and growth over the implant surfaces. This review aims to comprehend the significance of vitamin D3, lipoproteins, magnesium and vitamin K levels in optimizing the process of osseointegration around titanium implants. Key Word: titanium implant, osseointegration, vitamin D, cholesterol, lipoproteins, magnesium, vitamin K, early failure, bone. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 16-04-2021 Date of Acceptance: 30-04-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Dental implants have proven to be a predictable modality for replacing, missing and failing teeth, with several types of removable and fixed prosthesis. It is crucial that the implant gets integrated to the bone during its initial stages, which ensures clinically asymptomatic fixation prior to functional loading. Osseointegration of implants rely on various factors including implant characteristics, surgical factors, loading factors and even patient related factors[1]. Despite of the constant efforts to increase the survival rate of implants, there are some factors that still need to be considered before planning implant placement. The most common problem encountered in modern implantology is early failure of implants due to lack of osseointegration. Identification of some additional systemic risk factors may help reduce the failure rate and increase the predictability of dental implant treatment[2]. Therefore, in order to obtain a timely and effective osseointegration, the implant recipient as well as the bone must be absolutely healthy and in required cases, the patients should be provided with the necessary nutrients to facilitate peri-implant hard and soft tissue healing. In the recent years, literature has been emphasizing the need for pre-surgical evaluation and optimization of vitamin D3, lipoproteins and vitamin K levels prior to implant surgery[3]. According to the studies, there is a close link between vitamin D3 and blood cholesterol levels. There are two major lipoproteins, HDL (also known as good cholesterol or high-density lipoprotein) and LDL (also known as the bad cholesterol or low-density lipoprotein). HDL facilitates bone synthesis; it also most likely has effects on reduced bone resorption. Particularly, decreased HDL levels result in enlarged adiposity of the bone marrow affecting the function of bone forming cells. Vitamin D3 plays an important role in the metabolism of bone and is considered to be linked to bone development hormones. Additionally, it decreases the potential effects of allergic and inflammatory reactions[3]. Whereas, vitamin K more precisely vitamin K2 beyond its role in the blood clotting cascade, plays a primary role in directing calcium to the bone. Vitamin K2 contributes to good bone health by maintaining calcium inside the bone thereby leading to better bone healing and osseointegration[4]. II. Bone Remodeling and Low Density Lipoproteins (LDL) A great number of studies have indicated that high cholesterol level has significant impact on bone causing low bone density, volume and strength. Today it is accepted that there is a strong connection between bone cartilage homeostasis and lipid metabolism. A high cholesterol level is linked not only with the pathophysiology of atherosclerosis and osteoporosis but it has been linked to periodontal disease as well[5,6,7].