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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Markowska-Szczupak A, Endo-Kimura M, Paszkiewicz O, Kowalska E. Are Titania Photocatalysts and Titanium Implants Safe? Review on the Toxicity of Titanium Compounds. NANOMATERIALS 2020; 10:nano10102065. [PMID: 33086609 PMCID: PMC7603142 DOI: 10.3390/nano10102065] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/11/2022]
Abstract
Titanium and its compounds are broadly used in both industrial and domestic products, including jet engines, missiles, prostheses, implants, pigments, cosmetics, food, and photocatalysts for environmental purification and solar energy conversion. Although titanium/titania-containing materials are usually safe for human, animals and environment, increasing concerns on their negative impacts have been postulated. Accordingly, this review covers current knowledge on the toxicity of titania and titanium, in which the behaviour, bioavailability, mechanisms of action, and environmental impacts have been discussed in detail, considering both light and dark conditions. Consequently, the following conclusions have been drawn: (i) titania photocatalysts rarely cause health and environmental problems; (ii) despite the lack of proof, the possible carcinogenicity of titania powders to humans is considered by some authorities; (iii) titanium alloys, commonly applied as implant materials, possess a relatively low health risk; (iv) titania microparticles are less toxic than nanoparticles, independent of the means of exposure; (v) excessive accumulation of titanium in the environment cannot be ignored; (vi) titanium/titania-containing products should be clearly marked with health warning labels, especially for pregnant women and young children; (vi) a key knowledge gap is the lack of comprehensive data about the environmental content and the influence of titania/titanium on biodiversity and the ecological functioning of terrestrial and aquatic ecosystems.
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Affiliation(s)
- Agata Markowska-Szczupak
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Al. Piastów 42, 71-065 Szczecin, Poland;
- Correspondence: (A.M.-S.); (E.K.)
| | - Maya Endo-Kimura
- Institute for Catalysis, Hokkaido University, N21, W10, Sapporo 001-0021, Japan;
| | - Oliwia Paszkiewicz
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Al. Piastów 42, 71-065 Szczecin, Poland;
| | - Ewa Kowalska
- Institute for Catalysis, Hokkaido University, N21, W10, Sapporo 001-0021, Japan;
- Correspondence: (A.M.-S.); (E.K.)
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Phosphatidylserine Metabolism in Human Lymphoblastic Cells Exposed to Chromium (VI). J Occup Environ Med 2011; 53:776-81. [DOI: 10.1097/jom.0b013e31821f2aaf] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cadosch D, Al-Mushaiqri MS, Gautschi OP, Meagher J, Simmen HP, Filgueira L. Biocorrosion and uptake of titanium by human osteoclasts. J Biomed Mater Res A 2010; 95:1004-10. [DOI: 10.1002/jbm.a.32914] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 05/06/2010] [Accepted: 06/07/2010] [Indexed: 01/15/2023]
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Ani A, Ani M, Moshtaghie AA, Ahmadvand H. Effect of titanium on lipoprotein lipase activity in vivo and in vitro. J Trace Elem Med Biol 2010; 24:95-8. [PMID: 20413066 DOI: 10.1016/j.jtemb.2009.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2007] [Revised: 07/12/2009] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Lipoprotein lipase (LPL) is a major lipolytic enzyme in the intravascular metabolism of postprandial triglyceride-rich lipoproteins. This enzyme is synthesized and secreted by tissues and transported to the capillary endothelial surface. Decreased activity of this enzyme is suggested to be involved in arterial sequestration of lipoproteins and thus in the progression of atherosclerosis. Titanium salts are widely used in industry, medicine, and pharmacy for tablet coating, pharmaceuticals and cosmetic products. In this study the effect of titanium on post-heparin LPL activity is reported in vivo and in vitro. METHODS Groups of Male Wistar rats were administered (i.p) with an acute dose of 2.5 mg/kg titanium chloride for 10 days and a chronic dose of 0.75 mg/kg for 30 and/or 60 days. Blood samples were then collected for LPL assay. For in vitro study, plasma aliquots were incubated in the presence of up to 50 mM titanium and the enzyme activity was measured. RESULTS Animals exposed to acute dose of titanium showed about 20% reduction in LPL activity, whereas 31% and 36% reductions were observed in animals chronically exposed for 30 and/or 60 days, respectively. Titanium in vitro also led to enzyme inhibition, so that a decrease of 28-53% was seen in the presence of 0.1-50 mM titanium. This inhibition by titanium was potentiated when citrate and/or bicarbonate was present. CONCLUSION Although the mechanism of titanium effect on LPL activity in vivo and in vitro demands more investigations, the inhibitory effect of titanium ion in vivo should be considered seriously in subjects exposed to this metal ion. Changes in LPL activity may affect whole body lipid metabolism, a condition favorable for development and progression of atherosclerosis.
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Affiliation(s)
- Alireza Ani
- Department of Clinical Biochemistry, School of pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.
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Cadosch D, Sutanto M, Chan E, Mhawi A, Gautschi OP, von Katterfeld B, Simmen HP, Filgueira L. Titanium uptake, induction of RANK-L expression, and enhanced proliferation of human T-lymphocytes. J Orthop Res 2010; 28:341-7. [PMID: 19810098 DOI: 10.1002/jor.21013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There is increasing evidence that titanium ions are released from orthopedic implants by biocorrosion. The aim of this study was to investigate titanium uptake by human T-lymphocytes and its effects on phenotype and proliferation. Freshly isolated human nonadherent peripheral blood mononuclear cells (NA-PBMC), were exposed to TiCl4 [Ti(IV)]. Bioavailability and distribution of Ti(IV) in T-lymphocytes was determined by energy-filtered electron microscopy (EFTEM). The effects of Ti(IV) challenge on nonactivated and PHA-activated cells were assessed by flow cytometric analysis of surface markers, RANK-L production, and proliferation assays. EFTEM colocalized Ti(IV) with phosphorus in the nucleus, ribosomes, cytoplasmic membranes, and the surface membrane of T-lymphocytes. Ti(IV) increased significantly the expression of CD69, CCR4, and RANK-L in a concentration-dependent manner. Titanium enters T-lymphocytes through a currently unknown mechanism and binds to phosphorus-rich cell structures. Titanium influences phenotype and function of T-lymphocytes, resulting in activation of a CD69+ and CCR4+ T-lymphocyte population and secretion of RANK-L. These results strongly suggest the involvement of titanium ions challenged T-lymphocytes in the complex pathophysiological mechanisms of aseptic loosening of orthopedic implants.
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Affiliation(s)
- Dieter Cadosch
- School of Anatomy and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, Australia 6009.
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Chan EP, Mhawi A, Clode P, Saunders M, Filgueira L. Effects of titanium(iv) ions on human monocyte-derived dendritic cells. Metallomics 2009; 1:166-74. [PMID: 21305110 DOI: 10.1039/b820871a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Orthopaedic metal implants composed of titanium are routinely used in bone fracture repair and for joint replacement therapies. A considerable fraction of implant recipients are unable to benefit due to implant failure resulting from aseptic loosening, while others may experience cutaneous sensitivity to titanium after implantation. An adaptive immune reactivity towards titanium ions, originating from the biocorrosion of the implants, could play a role. As an initiator of the adaptive immune response, dendritic cells (DC) were studied for uptake and characteristics after titanium exposure. Energy filtered transmission electron microscopy showed uptake of titanium(iv) (Ti(iv)) ions by DCs in vitro and co-localisation with phosphorus-rich cell structures of the DC membranes (phospholipids), cytoplasm (ribosomes and phosphorylated proteins) and the nucleus (DNA). DC maturation and function were investigated by measuring cell surface marker expression by flow cytometry. After exposure, DCs showed a decrease in MHC class II (HLA-DR), co-stimulatory molecules (CD40, CD80 & CD86) and chemokine receptors (CCR) 6 and CCR7 but an increase in CCR4 after Ti(iv) treatment. However, Ti(iv) treated DCs had an increased stimulatory capacity towards allogenic lymphocytes. A Ti(iv) concentration dependant increase of IL-12p70 was observed amidst decrease of the other measured cytokines (TGF-β1 and TGF-β2). Hence, Ti(iv) alters DC properties, resulting in an enhanced T lymphocyte reactivity and deviation towards a Th1 type immune response. This effect may be responsible for the inflammatory side effects of titanium implants seen in patients.
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Affiliation(s)
- Erwin Ph Chan
- School of Anatomy & Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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Nguea HD, de Reydellet A, Le Faou A, Zaiou M, Rihn B. Macrophage culture as a suitable paradigm for evaluation of synthetic vitreous fibers. Crit Rev Toxicol 2008; 38:675-95. [PMID: 18686077 DOI: 10.1080/10408440802194915] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The ultimate goal of toxicologic investigation of synthetic vitreous fibers (SVFs) is to provide essential input for the assessment of human risk to their exposure. Toxicity of mineral fibers is usually evaluated by testing biopersistence in rodent model. However, a cellular model would be much appreciated in order to reduce, refine, and replace animal models. Pulmonary disorders triggered by inhalation of occupational or environmental mineral particulates can be the endpoints of a chronic inflammatory process in which alveolar macrophages (AMs) play a crucial role. Depending on the type of SVF involved, phagocytosis of fiber leads to activation of macrophages, resulting in release of fiber components and potent mediators, such as reactive oxygen or nitrogen species and cytokines. As a matter of fact, macrophages should be the cells of choice since SVF toxicity is the consequence of fibers and alveolar macrophages interaction. Today, monocytes and macrophages culture are firmly established as a paradigm in toxicology when several endpoints are assayed in macrophages: (1) fiber durability, (2) fiber surface changes, (3) oxidative stress and genotoxicity in macrophage, and (4) macrophage cell viability and apoptosis. This article is a review of up-to-date knowledge of in vitro studies involving macrophages, and assesses endpoints of macrophage toxicity with an emphasis on (1) dissolution, (2) scanning electron microscopy analysis, (3) cytotoxicity, and (4) gene expression.
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Affiliation(s)
- Hermine Dika Nguea
- Laboratoire de Bactériologie Virologie, Faculté de Medecine, Nancy University, Vandoeuvre-lès-Nancy, France
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Michiardi A, Engel E, Aparicio C, Planell JA, Gil FJ. Oxidized NiTi surfaces enhance differentiation of osteoblast-like cells. J Biomed Mater Res A 2008; 85:108-14. [PMID: 17688278 DOI: 10.1002/jbm.a.31486] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A new oxidation treatment (OT) on NiTi shape memory alloys was developed in a previous work. This OT treatment significantly decreases Ni ion release into the exterior medium, and therefore is thought to be beneficial for NiTi cytocompatibility. As to confirm this expectation, the in vitro response of MG63 osteoblast-like cells cultured on untreated and oxidized NiTi surfaces was studied. An adhesion test at 1, 4, and 8 h of incubation was performed. Statistical differences were evidenced at 1 h of adhesion depending on the surface treatment and chemical composition of the substrate. However, at larger times of study, there were no statistically significant differences between untreated and oxidized surfaces. The proliferation test (until 9 days) showed that untreated and oxidized NiTi surfaces are not cytotoxic for MG63 cells. The differences of adhesion at short times did not affect the proliferation of MG63 cells. However, after 48 h of stimulation with ascorbic acid and dexamethasone, the MG63 cells cultured on oxidized surfaces showed higher alkaline phosphatase activity and osteocalcin levels. The improvement of osteoblast differentiation due to OT treatment could accelerate bone formation, and, therefore, could allow earlier loading of NiTi devices used in dental and orthopedic applications.
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Affiliation(s)
- A Michiardi
- Centre of Reference for Bioengineering of Catalonia, Biomaterials and Biomechanics Division, Department of Materials Science and Metallurgy, Technical University of Catalonia (UPC), Avda. Diagonal 647, Barcelona, 08028, Spain
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Nicoloff G, Angelova M, Christova I, Nikolov A, Alexiev A. Serum cobalt in children with essential hypertension. Am J Hum Biol 2006; 18:798-805. [PMID: 17039479 DOI: 10.1002/ajhb.20554] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The effect of cobalt on the cardiovascular system is one of many aspects of cobalt metabolism in humans. Elastin and collagen are the main proteins of the vascular wall. The aims of this study were: 1) to determine serum cobalt concentrations in children with hypertension; and 2) to study the correlation between serum cobalt and some biological markers of the extracellular matrix of the vascular wall, i.e., anti-elastin and anti-collagen type IV antibodies. Patients showed statistically significant higher levels of systolic and diastolic blood pressure, and significantly lower serum cobalt concentrations, than controls. Children with hypertension showed significantly higher levels of total cholesterol (P = 0.0003) and collagen type IV IgM (P = 0.04). Collagen type IV IgG levels (P = 0.027) were lower than in controls. Serum cobalt in patients showed a correlation with systolic blood pressure (r = -0.44, P = 0.05), elastin IgM (r = 0.60, P = 0.007), and collagen type IV IgG (r = -0.46, P = 0.04). Our data suggest the existence of a correlation between changes in levels of serum cobalt, total cholesterol, anti-collagen type IV antibodies, and essential hypertension in children. This is the first study of serum cobalt in children with essential hypertension.
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Affiliation(s)
- G Nicoloff
- Department of Biology and Pathological Physiology, University School of Medicine, 5800 Pleven, Bulgaria.
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