Challenges in vitamin D measurement and its role on bone regeneration

Vitamin D plays a crucial role in calcium homeostasis and is significantly involved in the maintenance of a strong mineralized skeleton, healthy teeth, and bone regeneration. Apart of this main function, the scientific evidence of vitamin D involvement in numerous physiological and pathological processes has been growing, linking deficiencies to systematic diseases, autoimmune diseases, and various infections. Over the last years, it has been made clear that modern lifestyle has been the major contributor to vitamin D deficiency globally and the extended awareness has led to an significant increase in vitamin D levels testing. There is a wide range of available testing methodologies, posing different limitations, such as cross-reactivity, low detection capacity, limited throughput, requirement of highly competent staff. Those result from not only due to assay limitations but also due to the complexity of vitamin D metabolisms and catabolism. With liquid chromatography in tandem with mass spectrometry (LC-MS/MS) still considered the gold standard to vitamin D blood level detection, novel point-of-care technologies emerge aiming to bypass the strong monitored variability between assays. The aim of this review is to discuss the crucial limitations of vitamin D measuring assays regarding accuracy and the important issues to consider when interpreting vitamin D results in the dental office.