Osteoblast responses to implant materials and the role of vitamin D in dental implant osseointegration: a narrative review

Purpose This narrative review aims to summarise current evidence on osteoblast responses to commonly used dental implant materials and to evaluate the potential role of vitamin D in modulating biological processes involved in dental implant osseointegration. Methods A narrative literature review was performed using PubMed/MEDLINE, Google Scholar, and reference lists of relevant articles and reviews. The literature was last updated in September 2026. The review focused on implant materials and surface characteristics, osteoblast adhesion, proliferation, differentiation, mineralised matrix formation, vitamin D biology, and clinical evidence related to vitamin D and dental implant osseointegration. Results Current evidence indicates that implant surface characteristics, including roughness, topography, surface chemistry, hydrophilicity, and coatings, influence osteoblast behaviour and the biological response at the bone-implant interface. Titanium remains the most established implant material, while zirconia and titanium-zirconium alloys have shown favourable biological and clinical performance in selected indications. Vitamin D is known to be biologically relevant for bone metabolism and osteoblast activity, and experimental studies suggest that it may support osteogenic differentiation and mineralised matrix formation. However, current human clinical evidence regarding vitamin D and implant outcomes remains limited and heterogeneous. Conclusions Osseointegration is influenced by a complex interaction between implant material characteristics, surface properties, osteoblast responses, systemic vitamin D status, and host-related biological factors. Although vitamin D is known to be biologically relevant and experimental findings are promising, there is currently insufficient evidence to show that vitamin D has variable effects on osseointegration around titanium, zirconia, or titanium-zirconium implants. Further in vitro, in vivo, and clinical studies are needed using clearly defined implant materials, surface characteristics, vitamin D status or supplementation protocols, and clinical outcomes.