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Kohal RJ, Riesterer E, Vach K, Patzelt SBM, Iveković A, Einfalt L, Kocjan A, Hillebrecht AL. Fracture Resistance of a Bone-Level Two-Piece Zirconia Oral Implant System-The Influence of Artificial Loading and Hydrothermal Aging. J Funct Biomater 2024; 15:122. [PMID: 38786633 PMCID: PMC11122605 DOI: 10.3390/jfb15050122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Preclinical and clinical research on two-piece zirconia implants are warranted. Therefore, we evaluated the in vitro fracture resistance of such a zirconia oral implant system. The present study comprised 32 two-piece zirconia implants and abutments attached to the implants using a titanium (n = 16) or a zirconia abutment screw (n = 16). Both groups were subdivided (n = 8): group T-0 comprised implants with a titanium abutment screw and no artificial loading; group T-HL was the titanium screw group exposed to hydro-thermomechanical loading in a chewing simulator; group Z-0 was the zirconia abutment screw group with no artificial loading; and group Z-HL comprised the zirconia screw group with hydro-thermomechanical loading. Groups T-HL and Z-HL were loaded with 98 N and aged in 85 °C hot water for 107 chewing cycles. All samples were loaded to fracture. Kruskal-Wallis tests were executed to assess the loading/bending moment group differences. The significance level was established at a probability of 0.05. During the artificial loading, there was a single occurrence of an implant fracture. The mean fracture resistances measured in a universal testing machine were 749 N for group T-0, 828 N for group Z-0, 652 N for group T-HL, and 826 N for group Z-HL. The corresponding bending moments were as follows: group T-0, 411 Ncm; group Z-0, 452 Ncm; group T-HL, 356 Ncm; and group Z-HL, 456 Ncm. There were no statistically significant differences found between the experimental groups. Therefore, the conclusion was that loading and aging did not diminish the fracture resistance of the evaluated implant system.
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Affiliation(s)
- Ralf J. Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (E.R.)
| | - Ellen Riesterer
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (E.R.)
| | - Kirstin Vach
- Medical Center—University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany;
| | - Sebastian B. M. Patzelt
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (E.R.)
- Private Dental Clinic, 78658 Zimmern ob Rottweil, Germany
| | - Aljaž Iveković
- Department for Nanostructured Materials, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (A.I.); (L.E.)
| | - Lara Einfalt
- Department for Nanostructured Materials, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (A.I.); (L.E.)
- Jožef Stefan International Postgraduate School, Jamova 39, 1000 Ljubljana, Slovenia
| | - Andraž Kocjan
- Department for Nanostructured Materials, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (A.I.); (L.E.)
| | - Anna-Lena Hillebrecht
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (E.R.)
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Taliercio MJ, Alnabulsi RK, Uppal PA, Shaw IM, Semenza KM, Pasha MA. Metal implant allergy: A retrospective cohort analysis at a university allergy practice. Allergy Asthma Proc 2024; 45:186-194. [PMID: 38755777 DOI: 10.2500/aap.2024.45.240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Concern of metal sensitization in pre- and postsurgical evaluation is growing, with the recent guidelines remaining the criterion standard for consideration of patch testing. Information remains scarce on surgical screening in the groups of patients who reported a history of metal sensitivity versus those with no reported history. Objective: The objective of this study was to assess the utility of patch testing in surgical candidates based on reported metal allergy history. The secondary objective was to evaluate the utility and outcomes in postsurgical patch testing. Methods: Nine hundred and thirty-one patient charts of patients with the diagnosis of "contact dermatitis" who underwent an evaluation at a single allergy clinic site between January 2013 and December 2022 were identified and reviewed as part of a retrospective chart review study. Patients were included in subgroups based on the time of patch testing and history of reported metal allergy. Results: In all, 67 patients underwent patch testing, 10 (14.9%) of whom were surgical candidates without a history of metal sensitivity, 31 (46.2%) of whom were surgical candidates with a history of metal sensitivity, and 26 (38.8%) of whom were postsurgical patients. Twenty-nine (43.3%) of patients had positive patch testing results, with only one (10%) in the presurgical group, 17 (54.8%) in the presurgical with a history of metal sensitivity, and 11 (42.3%) in the postsurgical group. Zero patients in our cohort without metal sensitivity who were undergoing the Nuss procedure had positive reactions on patch testing, whereas two of four (50%) with reported metal sensitivity who were undergoing the Nuss procedure had positive relevant metal reactions. Conclusion: Ambiguity in the utility of patch testing for surgical decision making remains, despite common utilization. Recent guidelines along with coordination of care among the surgeon, allergist, and patient remains the criterion standard of care.
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Affiliation(s)
- Mark J Taliercio
- From the Department of Internal Medicine, Albany Medical Center, Albany, New York
| | - Rawaa K Alnabulsi
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
| | | | - Ian M Shaw
- Department of Pediatrics, Albany Medical Collage, Albany, New York, and
| | - Kristy M Semenza
- Department of Allergy and Immunology, Bassett Medical Center, Cooperstown, New York
| | - Muhammad A Pasha
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
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Huang C, Chiang SYV, Gawkrodger DJ. The contribution of metal allergy to the failure of metal alloy implants, with special reference to titanium: Current knowledge and controversies. Contact Dermatitis 2024; 90:201-210. [PMID: 38148670 DOI: 10.1111/cod.14481] [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: 09/25/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023]
Abstract
After almost three-quarters of a century during which contact dermatologists have often struggled to comprehend the relationship between metal allergy and failure of metal-alloy containing implant, it is possible to say that a relationship does exist, particularly for cobalt and chromium, but also for nickel. There is still debate as to whether allergy develops as a consequent of failure but thenceforth contributes to it, or whether sensitisation starts first and induces failure secondarily-opinion probably favours the first. Metal-on-polypropylene articulations were associated with few metal allergic problems but now are less favoured by orthopaedists due to plastic wear products causing osteolysis and pseudotumour formation through local inflammation. New metal alloys are regularly being introduced such that interested dermatologists need to stay on top of the situation. The jury is still out as to whether the recent favouring of titanium-containing alloys will confirm them to be more inert allergenically. Case reports do show some clinical reactions to titanium-containing implants and patch test series have inferred sometimes quite a high background rate of allergy, but interpretation must be tempered by the awareness that titanium salts on patch testing have a tendency to cause irritant reactions. Blood monitoring of metal ion values is now recommended in certain situations after joint replacement and increasing levels may be an indication that allergy with joint failure can develop, in which case patch testing is indicated, and suggested series are available. Predictive patch testing, whilst generally not recommended in the past, has been introduced into some protocols often by non-dermatologists, such that it is now needed for temporo-mandibular joint and Nuss bar insertion, and it can be anticipated that this may become more commonplace in the future. One of the major current deficits for patch testers is standardised guidance on which preparation or preparations to use for suspected titanium allergy. One suggestion is 0.5% titanium sulphate in petrolatum, though experience in at least one centre suggests the use of a battery of titanium salts might be desirable.
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Affiliation(s)
- Chenghao Huang
- Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK
| | - Shu Yu Vanessa Chiang
- Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK
| | - David J Gawkrodger
- Department of Dermatology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
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Rahnama-Hezavah M, Mertowska P, Mertowski S, Skiba J, Krawiec K, Łobacz M, Grywalska E. How Can Imbalance in Oral Microbiota and Immune Response Lead to Dental Implant Problems? Int J Mol Sci 2023; 24:17620. [PMID: 38139449 PMCID: PMC10743591 DOI: 10.3390/ijms242417620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Dental implantology is one of the most dynamically developing fields of dentistry, which, despite developing clinical knowledge and new technologies, is still associated with many complications that may lead to the loss of the implant or the development of the disease, including peri-implantitis. One of the reasons for this condition may be the fact that dental implants cannot yield a proper osseointegration process due to the development of oral microbiota dysbiosis and the accompanying inflammation caused by immunological imbalance. This study aims to present current knowledge as to the impact of oral microflora dysbiosis and deregulation of the immune system on the course of failures observed in dental implantology. Evidence points to a strong correlation between these biological disturbances and implant complications, often stemming from improper osseointegration, pathogenic biofilms on implants, as well as an exacerbated inflammatory response. Technological enhancements in implant design may mitigate pathogen colonization and inflammation, underscoring implant success rates.
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Affiliation(s)
- Mansur Rahnama-Hezavah
- Chair and Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland; (M.R.-H.); (M.Ł.)
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
| | - Julia Skiba
- Student Research Group of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Karol Krawiec
- Student Research Group of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Michał Łobacz
- Chair and Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland; (M.R.-H.); (M.Ł.)
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
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Sadrolvaezin A, Pezhman A, Zare I, Nasab SZ, Chamani S, Naghizadeh A, Mostafavi E. Systemic allergic contact dermatitis to palladium, platinum, and titanium: mechanisms, clinical manifestations, prevalence, and therapeutic approaches. MedComm (Beijing) 2023; 4:e386. [PMID: 37873514 PMCID: PMC10590457 DOI: 10.1002/mco2.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 10/25/2023] Open
Abstract
Contact dermatitis (CD) is an inflammatory skin disease of eczema that is elicited by chemicals or metal ions that have toxic effects without eliciting a T-cell response (contact elicitation) or by small reactive chemicals that modify proteins and induce innate and adaptive immune responses (contact allergens). The clinical condition is characterized by localized skin rash, pruritus, redness, swelling, and lesions, which are mainly detected by patch tests and lymphocyte stimulation. Heavy metals such as palladium (Pd), platinum (Pt), and titanium (Ti) are ubiquitous in our environment. These heavy metals have shown CD effects as allergic agents. Immunological responses result from the interaction of cytokines and T cells. Occupational metal CD accounts for most cases of work-related cutaneous disorders. In this systematic review, the allergic effects of heavy metals, including Pd, Pt, and Ti, and the mechanisms, clinical manifestations, prevalence, and therapeutic approaches are discussed in detail. Furthermore, the therapeutic approaches introduced to treat CD, including corticosteroids, topical calcineurin inhibitors, systemic immunosuppressive agents, phototherapy, and antihistamines, can be effective in the treatment of these diseases in the future. Ultimately, the insights identified could lead to improved therapeutic and diagnostic pathways.
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Affiliation(s)
- Ali Sadrolvaezin
- Medical Toxicology and Drug Abuse Research CenterBirjand University of Medical SciencesBirjandIran
| | - Arezou Pezhman
- School of MedicineZahedan Azad University of Medical SciencesZahedanIran
| | - Iman Zare
- Research and Development DepartmentSina Medical Biochemistry Technologies Co. Ltd.ShirazIran
| | - Shima Zahed Nasab
- Department of Life Science EngineeringFaculty of New Sciences and TechnologiesUniversity of TehranTehranIran
| | - Sajad Chamani
- Medical Toxicology and Drug Abuse Research CenterBirjand University of Medical SciencesBirjandIran
| | - Ali Naghizadeh
- Medical Toxicology and Drug Abuse Research CenterBirjand University of Medical SciencesBirjandIran
| | - Ebrahim Mostafavi
- Stanford Cardiovascular InstituteStanford University School of MedicineStanfordCaliforniaUSA
- Department of MedicineStanford University School of MedicineStanfordCaliforniaUSA
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Verma V, Hazari P, Verma P. Do implants made of polyetheretherketone and its composites have reduced stress shielding effects compared to other dental implant materials? A systematic review. Evid Based Dent 2023; 24:193-194. [PMID: 37749243 DOI: 10.1038/s41432-023-00935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The present systematic review was executed to evaluate the stress shielding effect of PEEK and its composite dental implants as compared to other implant (titanium and zirconia) materials in peri-implant bone. MATERIALS AND METHOD The comprehensive online literature search was conducted on PubMed, Google Scholar, and Web of Science from January 2011 to January 2023. A total of 43 in vitro studies were identified related to the raised question. In all, 34 studies were excluded as they included in vitro studies focusing on stress distribution in prosthesis framework, abutments, crown, and on biological properties such as cell adhesion, etc. Only eight studies after full-text screening were included in the present systematic review. RESULTS The data extracted from included studies showed that PEEK and its composite materials, have a less stress shielding effect due to their low modulus of elasticity resulting in higher stress concentration and strain in the peri-implant bone as compared to titanium and zirconia implant materials. CONCLUSION The PEEK and its composites can be used as an alternative material in the esthetic region and in those who have an allergy to metal implants. However, due to the low elastic modulus of PEEK, a homogenous stress distribution is not observed along the entire length of the implant. Further studies are required to improve the composition of PEEK material so that a homogenous reduction of stress shielding effect along the whole length of a dental implant can be achieved.
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Affiliation(s)
- Varsha Verma
- Department of Prosthodontics and Crown & Bridge, People's Dental Academy, Bhopal, Madhya Pradesh, India.
| | - Puja Hazari
- Department of Prosthodontics and Crown & Bridge, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Puja Verma
- School of Humanities and Engineering Sciences, MIT Academy of Engineering, Alandi, Pune, Maharashtra, India
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Gloc M, Przybysz S, Dulnik J, Kołbuk D, Wachowski M, Kosturek R, Ślęzak T, Krawczyńska A, Ciupiński Ł. A Comprehensive Study of a Novel Explosively Hardened Pure Titanium Alloy for Medical Applications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7188. [PMID: 38005116 PMCID: PMC10672667 DOI: 10.3390/ma16227188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
Pure titanium is gaining increasing interest due to its potential use in dental and orthopedic applications. Due to its relatively weak mechanical parameters, a limited number of components manufactured from pure titanium are available on the market. In order to improve the mechanical parameters of pure titanium, manufacturers use alloys containing cytotoxic vanadium and aluminum. This paper presents unique explosive hardening technology that can be used to strengthen pure titanium parameters. The analysis confirms that explosive induced α-ω martensitic transformation and crystallographic anisotropy occurred due to the explosive pressure. The mechanical properties related to residual stresses are very nonuniform. The corrosion properties of the explosive hardened pure titanium test do not change significantly compared to nonhardened titanium. The biocompatibility of all the analyzed samples was confirmed in several tests. The morphology of bone cells does not depend on the titanium surface phase composition and crystallographic orientation.
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Affiliation(s)
- Michał Gloc
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska St., 02-507 Warsaw, Poland; (A.K.); (Ł.C.)
| | - Sylwia Przybysz
- Institute of High Pressure Physics, Polish Academy of Sciences (Unipress), 29/37 Sokolowska St., 01-142 Warsaw, Poland;
| | - Judyta Dulnik
- Laboratory of Polymers and Biomaterials, Institute of Fundamental Technological Research, Polish Academy of Sciences, 4B Pawińskiego St., 02-106 Warsaw, Poland; (J.D.); (D.K.)
| | - Dorota Kołbuk
- Laboratory of Polymers and Biomaterials, Institute of Fundamental Technological Research, Polish Academy of Sciences, 4B Pawińskiego St., 02-106 Warsaw, Poland; (J.D.); (D.K.)
| | - Marcin Wachowski
- Faculty of Mechanical Engineering, Military University of Technology, 2 Gen. S. Kaliskiego St., 00-908 Warsaw, Poland; (M.W.); (R.K.); (T.Ś.)
| | - Robert Kosturek
- Faculty of Mechanical Engineering, Military University of Technology, 2 Gen. S. Kaliskiego St., 00-908 Warsaw, Poland; (M.W.); (R.K.); (T.Ś.)
| | - Tomasz Ślęzak
- Faculty of Mechanical Engineering, Military University of Technology, 2 Gen. S. Kaliskiego St., 00-908 Warsaw, Poland; (M.W.); (R.K.); (T.Ś.)
| | - Agnieszka Krawczyńska
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska St., 02-507 Warsaw, Poland; (A.K.); (Ł.C.)
| | - Łukasz Ciupiński
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska St., 02-507 Warsaw, Poland; (A.K.); (Ł.C.)
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Watanabe M, Liu L, Ichikawa T. Are Allergy-Induced Implant Failures Actually Hypersensitivity Reactions to Titanium? A Literature Review. Dent J (Basel) 2023; 11:263. [PMID: 37999027 PMCID: PMC10670842 DOI: 10.3390/dj11110263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE This literature review was performed to assess whether implant failures are associated with titanium allergy. MATERIALS AND METHODS An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed by two reviewers. Articles describing cases of implant failure in which the cause of implant failure was only identified as allergy were included. RESULTS Twelve studies were included. Eight studies identified Ti allergy by clinical examinations, of which four used patch tests, three used the lymphocyte transformation test (LTT)/memory lymphocyte immunostimulation assay (MELISA), and one used both tests. Nine studies reported cases of titanium hypersensitivity in combination with other systemic allergy-related disorders, with eight cases also showing positive results for Ni, Hg, Cr, and Co hypersensitivity. Ten papers reported the improvement of symptoms after the removal of the Ti implants and their replacement with zirconia implants, and two of these papers showed good results. CONCLUSION Cases of probable titanium allergy included those with true titanium allergies and those with a potentially different cause. However, the differentiation of these cases is difficult. Since no definitive method has been established for diagnosing titanium allergy, a comprehensive diagnosis based on the clinical course and clinical examination using a patch test/LTT/MELISA is necessary. Implant treatment should be performed with caution in patients with any preoperative allergies.
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Affiliation(s)
- Megumi Watanabe
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences, 3-18-15, Kuramoto, Tokushima 770-8504, Japan; (L.L.); (T.I.)
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Taleb A, Guigou C, Leclerc S, Lalande A, Bozorg Grayeli A. Image-to-Patient Registration in Computer-Assisted Surgery of Head and Neck: State-of-the-Art, Perspectives, and Challenges. J Clin Med 2023; 12:5398. [PMID: 37629441 PMCID: PMC10455300 DOI: 10.3390/jcm12165398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Today, image-guided systems play a significant role in improving the outcome of diagnostic and therapeutic interventions. They provide crucial anatomical information during the procedure to decrease the size and the extent of the approach, to reduce intraoperative complications, and to increase accuracy, repeatability, and safety. Image-to-patient registration is the first step in image-guided procedures. It establishes a correspondence between the patient's preoperative imaging and the intraoperative data. When it comes to the head-and-neck region, the presence of many sensitive structures such as the central nervous system or the neurosensory organs requires a millimetric precision. This review allows evaluating the characteristics and the performances of different registration methods in the head-and-neck region used in the operation room from the perspectives of accuracy, invasiveness, and processing times. Our work led to the conclusion that invasive marker-based methods are still considered as the gold standard of image-to-patient registration. The surface-based methods are recommended for faster procedures and applied on the surface tissues especially around the eyes. In the near future, computer vision technology is expected to enhance these systems by reducing human errors and cognitive load in the operating room.
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Affiliation(s)
- Ali Taleb
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
| | - Caroline Guigou
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Otolaryngology Department, University Hospital of Dijon, 21000 Dijon, France
| | - Sarah Leclerc
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
| | - Alain Lalande
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Medical Imaging Department, University Hospital of Dijon, 21000 Dijon, France
| | - Alexis Bozorg Grayeli
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Otolaryngology Department, University Hospital of Dijon, 21000 Dijon, France
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Byun SH, Park SY, Yi SM, Park IY, On SW, Jeong CK, Kim JC, Yang BE. Clinical Stability of Bespoke Snowman Plates for Fixation following Sagittal Split Ramus Osteotomy of the Mandible. Bioengineering (Basel) 2023; 10:914. [PMID: 37627799 PMCID: PMC10452001 DOI: 10.3390/bioengineering10080914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Maxillofacial skeletal surgery often involves the use of patient-specific implants. However, errors in obtaining patient data and designing and manufacturing patient-specific plates and guides can occur even with accurate virtual surgery. To address these errors, bespoke Snowman plates were designed to allow movement of the mandible. This study aimed to compare the stability of bespoke four-hole miniplates with that of a bespoke Snowman plate for bilateral sagittal split ramus osteotomy (SSRO), and to present a method to investigate joint cavity changes, as well as superimpose virtual and actual surgical images of the mandible. This retrospective study included 22 patients who met the inclusion criteria and underwent orthognathic surgery at a university hospital between 2015 and 2018. Two groups were formed on the basis of the plates used: a control group with four-hole bespoke plates and a study group with bespoke Snowman plates. Stability was assessed by measuring the condyle-fossa space and superimposing three-dimensional virtual surgery images on postoperative cone-beam computed tomography (CBCT) scans. No significant differences were observed in the condyle-fossa space preoperatively and 1 year postoperatively between the control and study groups. Superimposing virtual surgery and CBCT scans revealed minimal differences in the landmark points, with no variation between groups or timepoints. The use of bespoke Snowman plates for stabilizing the mandible following SSRO exhibited clinical stability and reliability similar to those with bespoke four-hole plates. Additionally, a novel method was introduced to evaluate skeletal stability by separately analyzing the condyle-fossa gap changes and assessing the mandibular position.
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Affiliation(s)
- Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sang-Yoon Park
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sang-Min Yi
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - In-Young Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea
| | - Sung-Woon On
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
| | - Chun-Ki Jeong
- Department of Dental Science & Technology, Shingu College, Seongnam 13174, Republic of Korea;
| | - Jong-Cheol Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Mir Dental Hospital, Daegu 41940, Republic of Korea
| | - Byoung-Eun Yang
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
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11
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Marek R, Eichler J, Schwarze UY, Fischerauer S, Suljevic O, Berger L, Löffler JF, Uggowitzer PJ, Weinberg AM. Long-term in vivo degradation of Mg-Zn-Ca elastic stable intramedullary nails and their influence on the physis of juvenile sheep. BIOMATERIALS ADVANCES 2023; 150:213417. [PMID: 37087913 DOI: 10.1016/j.bioadv.2023.213417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/28/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
The use of bioresorbable magnesium (Mg)-based elastic stable intramedullary nails (ESIN) is highly promising for the treatment of pediatric long-bone fractures. Being fully resorbable, a removal surgery is not required, preventing repeated physical and psychological stress for the child. Further, the osteoconductive properties of the material support fracture healing. Nowadays, ESIN are exclusively implanted in a non-transphyseal manner to prevent growth discrepancies, although transphyseal implantation would often be required to guarantee optimized fracture stabilization. Here, we investigated the influence of trans-epiphyseally implanted Mg-Zinc (Zn)-Calcium (Ca) ESIN on the proximal tibial physis of juvenile sheep over a period of three years, until skeletal maturity was reached. We used the two alloying systems ZX10 (Mg-1Zn-0.3Ca, in wt%) and ZX00 (Mg-0.3Zn-0.4Ca, in wt%) for this study. To elaborate potential growth disturbances such as leg-length differences and axis deviations we used a combination of in vivo clinical computed tomography (cCT) and ex vivo micro CT (μCT), and also performed histology studies on the extracted bones to obtain information on the related tissue. Because there is a lack of long-term data regarding the degradation performance of magnesium-based implants, we used cCT and μCT data to evaluate the implant volume, gas volume and degradation rate of both alloying systems over a period of 148 weeks. We show that transepiphyseal implantation of Mg-Zn-Ca ESIN has no negative influence on the longitudinal bone growth in juvenile sheep, and that there is no axis deviation observed in all cases. We also illustrate that 95 % of the ESIN degraded over nearly three years, converging the time point of full resorption. We thus conclude that both, ZX10 and ZX00, constitute promising implant materials for the ESIN technique.
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Affiliation(s)
- R Marek
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria.
| | - J Eichler
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria
| | - U Y Schwarze
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria; Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - S Fischerauer
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria
| | - O Suljevic
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria
| | - L Berger
- Laboratory of Metal Physics and Technology, Department of Materials, ETH Zurich, 8093 Zurich, Switzerland
| | - J F Löffler
- Laboratory of Metal Physics and Technology, Department of Materials, ETH Zurich, 8093 Zurich, Switzerland
| | - P J Uggowitzer
- Laboratory of Metal Physics and Technology, Department of Materials, ETH Zurich, 8093 Zurich, Switzerland; Chair of Nonferrous Metallurgy, Montanuniversitaet Leoben, 8700 Leoben, Austria
| | - A-M Weinberg
- Department of Orthopaedics and Traumatology, Medical University of Graz, 8010 Graz, Austria
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12
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Stolzer C, Müller M, Gosau M, Henningsen A, Fuest S, Aavani F, Smeets R. Do Titanium Dioxide Particles Stimulate Macrophages to Release Proinflammatory Cytokines and Increase the Risk for Peri-implantitis? J Oral Maxillofac Surg 2023; 81:308-317. [PMID: 36442535 DOI: 10.1016/j.joms.2022.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/09/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Titanium dioxide (TiO2) particles detached from titanium dental implants by tribocorrosion can be phagocytosed by macrophages, releasing various proinflammatory cytokines at the implant sites that may trigger peri-implantitis. The study objective was to measure the association between peri-implantitis and the presence of non-allergy-related proinflammatory cytokines associated with TiO2 particles. METHODS The investigators implemented a retrospective cross-sectional study and enrolled a sample of 60 subjects from a dental practice. Subjects were excluded if the plaque index was grade 3 (Silness and Löe). The predictor variable was a positive or negative TiO2 stimulation test, an in vitro macrophage proinflammatory response test. The outcome variable was peri-implantitis status defined as present or absent. Three groups were considered: control group with 20 patients without dental implants (group 1), 2 groups of patients with titanium dental implants, one without peri-implantitis (group 2), and the other with peri-implantitis (group 3) (n = 20 each). For patients with implants, depth of the gingival pockets of the implants were measured, and existing bleeding and suppuration were determined to assess peri-implantitis. Radiographs were taken if one or more factors applied to confirm the diagnosis of peri-implantitis. Further covariates were age, sex, duration of implant wear, and number of implants which were analyzed descriptively. Inferential analyses were undertaken using χ2 test, Kruskal-Wallis-, Wilcoxon-two-sample tests, and logistic regressions. RESULTS The sample was composed of 35 female and 25 male patients with a mean age of 54.2 years (standard deviation = 14.76). The overall TiO2 stimulation test positivity frequency was 28.3% and were 30.0%, 5.0%, and 50.0% in the control, implants without peri-implantitis, and implants with peri-implantitis groups. No statistically significant differences could be seen in the frequencies of the TiO2 stimulation test results between control group and combined groups 2 and 3 (P-value = .84). The risk for positive TiO2 patients with a titanium implant of developing peri-implantitis was statistically significant and higher compared to negative TiO2 patients (odds ratio, 19.0 with 95% confidence interval [2.12,170.38]; P-value< .01). CONCLUSIONS The data in this study showed a statistically significant relationship between a positive TiO2 stimulation test and peri-implantitis. Further studies with larger numbers of subjects are recommended to confirm this result.
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Affiliation(s)
- Carolin Stolzer
- Consultant, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Martin Gosau
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anders Henningsen
- Assistant Professor, Consultant, Division of Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Fuest
- Research Assistant, Division of Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Farzaneh Aavani
- Research Assistant, Division of Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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13
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Kohal RJ, Burkhardt F, Chevalier J, Patzelt SBM, Butz F. One-Piece Zirconia Oral Implants for Single Tooth Replacement: Five-Year Results from a Prospective Cohort Study. J Funct Biomater 2023; 14:jfb14020116. [PMID: 36826915 PMCID: PMC9964460 DOI: 10.3390/jfb14020116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The intention of this 5-year prospective cohort investigation was to clinically and radiographically investigate the outcomes of a one-piece zirconia implant system for single tooth replacement. Sixty-five patients received a total of 66 single-tooth implants. All implants immediately received temporary restorations and were finally restored with all-ceramic crowns. Follow-ups were performed at the prosthetic delivery, after 1, 3, and 5 years. Peri-implant and dental soft-tissue parameters were evaluated and patient-reported outcomes recorded. To monitor peri-implant bone remodelling, standardised radiographs were taken at the implant insertion and at the 1-, 3-, and 5-year follow-ups. In the course of 5 years, 14 implants were lost, resulting in a cumulative implant survival rate of 78.2%. The mean marginal bone loss from the implant insertion to the 5-year follow-up amounted to 1.12 mm. Probing depth, clinical attachment level, bleeding, and plaque index increased over time. In 91.5% of the implants, the papilla index showed levels of 1 or 2, respectively. At the end of the study, the patient satisfaction was higher compared to the pre-treatment measurements. Due to the low survival rate after five years and the noticeably high frequency of advanced bone loss observed in this study, the implant has not met the launch criteria, as it would have not been recommended for routine clinical use.
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Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Felix Burkhardt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Jerome Chevalier
- INSA-Lyon, MATEIS Laboratory, University of Lyon, UMR CNRS 5510, 20 Avenue Albert Einstein, CEDEX, 69621 Villeurbanne, France
| | - Sebastian Berthold Maximilian Patzelt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Am Dorfplatz 3, 78658 Zimmern ob Rottweil, Germany
| | - Frank Butz
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Belchenstrasse 6a, 79189 Bad Krozingen, Germany
- Correspondence:
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14
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Mizukoshi K, Okazawa Y, Amemiya K, Tsuchiya Y, Motegi S, Tsukamoto R, Honjo K, Takahashi R, Yoshihara N, Kawano S, Kawai M, Munakata S, Ishiyama S, Sugimoto K, Takahashi M, Kojima Y, Ikeda S, Sakamoto K. Examination of colorectal cancer cases with metal allergy. Surg Today 2023:10.1007/s00595-023-02643-7. [PMID: 36757618 DOI: 10.1007/s00595-023-02643-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 09/30/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE To report our initiatives and treatment results for patients with colorectal cancer with metal allergy. METHODS A total of 27 patients (2.6%) with a history of metal contact dermatitis were identified among 1027 patients who underwent curative resection of colorectal cancer from 2014 to 2020. The results of the patch test, perioperative results, and postoperative colonoscopy findings were also investigated. RESULTS The patch test for metal allergens and staples was performed in 21 patients (77.8%), and 13 of them (61.9%) tested positive for at least one metal allergen. Ni (38.1%), Co (28.6%), and Pd (19.0%) showed higher positive rates than other metals, and 1 patient (4.8%) tested positive for staples. Stapled anastomosis/suturing was performed as planned in 15 of 27 patients. In 10 patients, the anastomosis method was changed from stapled to hand-sewn according to the no-patch test results (60%), positivity for multiple metals (20%), positivity for staples (10%), and surgeon's judgment (10%). No complications and abnormal colonoscopy findings were found to be associated with stapled anastomosis/suturing. CONCLUSION The patch test is useful for selecting an optimal anastomosis method for patients with suspected metal allergy.
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Affiliation(s)
- Kosuke Mizukoshi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. .,Department of Surgery, Kuwana City Medical Center, 3-11 Kotobuki-cho, Kuwana-shi, Mie, 511-0061, Japan.
| | - Yu Okazawa
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kota Amemiya
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yuki Tsuchiya
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shunsuke Motegi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Ryoichi Tsukamoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kumpei Honjo
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Rina Takahashi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Nagisa Yoshihara
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shingo Kawano
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masaya Kawai
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shinya Munakata
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shun Ishiyama
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kiichi Sugimoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Makoto Takahashi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yutaka Kojima
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kazuhiro Sakamoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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15
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Akashi Y, Shimoo Y, Hashiguchi H, Nakajima K, Kokubun K, Matsuzaka K. Effects of Excimer Laser Treatment of Zirconia Disks on the Adhesion of L929 Fibroblasts. MATERIALS (BASEL, SWITZERLAND) 2022; 16:115. [PMID: 36614454 PMCID: PMC9821666 DOI: 10.3390/ma16010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
The adhesion of zirconia and soft tissue is very important for the success of zirconia implants. The aim of this study was to characterize the effects of excimer laser treatment of zirconia on the adhesion of L929 fibroblasts. In this study, polished zirconia disks treated with an excimer laser were the experimental group and untreated zirconia disks were the control group. Surface roughness and contact angles of zirconia disks were measured. mRNA expression levels of integrin β1 and collagen type I α1 in L929 fibroblasts cultured on zirconia disks were measured using qRT-PCR. Cell morphology was evaluated using 3D laser microscopy and the expression of vinculin was characterized using confocal microscopy. There was no significant difference in the surface roughness of zirconia disks, but contact angles were significantly lower. mRNA expression of integrin β1 was significantly higher at 3, 6 and 24 h and of collagen type I α1 was significantly higher at 6 and 24 h. L929 fibroblasts tended to form elongated microspikes and vinculin colocalization in those microspikes. Furthermore, vinculin was strongly expressed in filopodia of L929 fibroblasts at 24 h. These results suggest that excimer laser treatment improves adhesion between zirconia disks and L929 fibroblasts.
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Affiliation(s)
- Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Yoshiaki Shimoo
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- MALO DENTAL and MEDICAL TOKYO, FUKUHARA GINZA 8F, 7-8-10 Ginza, Chuo-ku, Tokyo 104-0061, Japan
| | - Hayato Hashiguchi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
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16
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Popiolek I, Blasiak M, Kozak A, Pietak E, Bulanda M, Porebski G. Diagnostic Value of Oral Provocation Tests in Drug Hypersensitivity Reactions Induced by Nonsteroidal Anti-Inflammatory Drugs and Paracetamol. Diagnostics (Basel) 2022; 12:diagnostics12123074. [PMID: 36553081 PMCID: PMC9777020 DOI: 10.3390/diagnostics12123074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Oral drug provocation tests (DPT) are the basic diagnostic tool for the detection of hypersensitivity to non-opioid analgesics and for selecting a safe alternative for a patient. They are of great practical importance due to their common use, but the data on the follow-up of patients after negative DPT are still very scarce. We examined the further fate of 164 such adult patients after negative NSAID or paracetamol tests and analyzed which excipients in the studied drugs they could be exposed to after the diagnostic workup. A structured medical interview was performed 32.9 months (mean) after the provocation tests. Of the 164 patients, 131 (79.9%) retook the tested drug and 12 developed another hypersensitivity reaction, giving the estimated negative predictive value of 90.8%. These reactions were induced by acetylsalicylic acid, paracetamol, meloxicam, and diclofenac, and were clinically similar to the initial ones (most commonly urticaria and angioedema). There are 93 generics of these drugs on the local market, containing a total of 33 excipients for which hypersensitivity reactions have been reported. All available generics contain such excipients. Thirty-one patients (20.1%) did not take the previously tested drug again, most often because it was not needed or because they were afraid of another reaction. DPT with analgesics has a high diagnostic performance. A minority of patients had relapsed after reexposure. One of the underestimated reasons for this may be drug excipients provoking a reaction, so it is advisable to use exactly the same medical product that has been negatively tested. Many patients avoid reexposure to a given drug, despite negative tests, therefore very reliable patient education in connection with DPT is highly needed.
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Affiliation(s)
- Iwona Popiolek
- Department of Toxicology and Environmental Diseases, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Krakow, Poland
| | - Magdalena Blasiak
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, sw. Anny 12, 31-008 Krakow, Poland
| | - Aleksandra Kozak
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, sw. Anny 12, 31-008 Krakow, Poland
| | - Ewelina Pietak
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, sw. Anny 12, 31-008 Krakow, Poland
| | - Malgorzata Bulanda
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna 3, 31-503 Krakow, Poland
| | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna 3, 31-503 Krakow, Poland
- Correspondence: ; Tel.: +48-12-424-86-38
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17
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Madeira S, Buciumeanu M, Nobre D, Carvalho O, Silva FS. Development of a novel hybrid Ti6Al4V-ZrO 2 surface with high wear resistance by laser and hot pressing techniques for dental implants. J Mech Behav Biomed Mater 2022; 136:105508. [PMID: 36265278 DOI: 10.1016/j.jmbbm.2022.105508] [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: 07/12/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
The development of implant metal-free surfaces has gained attention since non-benefic results have been reported related to the metallic ions released from metal implants to the human body. Ceramic coatings have been proposed as a possible solution however, the detachment of these coatings, during implantation or even in function, can compromise its function. In order to overcome this problem, this work proposes a novel hybrid Ti6Al4V-ZrO2 surface, starting with laser texturing of the Ti6Al4V substrate by Laser Nd:YV04, followed by the allocation of the zirconia (ZrO2) powder and its subsequent sintering by hot pressing process. Results revealed that zirconia strongly adheres to titanium textured surfaces since no detachment was found under tribological and adhesion scratch tests. Moreover, the tribological results showed that the incorporation of zirconia into textured titanium surface reduces significantly the wear rate of titanium (≈93%), which is a good indicator of low metallic particles/ions released to the body. These results suggest that this novel surface with good aesthetic properties and improved wear resistance (given by zirconia) and mechanical resistance (from titanium) can be a promising solution for dental implants, especially for implant/abutment or abutment/ceramic contact zones, and thus have a huge impact on the long-term performance of implants.
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Affiliation(s)
- S Madeira
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal; LABBELS -Associate Laboratory, Braga, Guimarães, Portugal.
| | - M Buciumeanu
- Faculty of Engineering, "Dunărea de Jos" University of Galaţi, Domnească 47, 800008, Galati, Romania
| | - D Nobre
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - O Carvalho
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal; LABBELS -Associate Laboratory, Braga, Guimarães, Portugal
| | - F S Silva
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal; LABBELS -Associate Laboratory, Braga, Guimarães, Portugal
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18
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Martinez JS, Peterson S, Hoel CA, Erno DJ, Murray T, Boyd L, Her JH, Mclean N, Davis R, Ginty F, Duclos SJ, Davis BM, Parthasarathy G. High resolution DLP stereolithography to fabricate biocompatible hydroxyapatite structures that support osteogenesis. PLoS One 2022; 17:e0272283. [PMID: 35939440 PMCID: PMC9359536 DOI: 10.1371/journal.pone.0272283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/16/2022] [Indexed: 11/29/2022] Open
Abstract
Lithography based additive manufacturing techniques, specifically digital light processing (DLP), are considered innovative manufacturing techniques for orthopaedic implants because of their potential for construction of complex geometries using polymers, metals, and ceramics. Hydroxyapatite (HA) coupons, printed using DLP, were evaluated for biological performance in supporting viability, proliferation, and osteogenic differentiation of the human cell line U2OS and human mesenchymal stem cells (MSCs) up to 35 days in culture to determine feasibility for future use in development of complex scaffold geometries. Contact angle, profilometry, and scanning electron microscopy (SEM) measurements showed the HA coupons to be hydrophilic, porous, and having micro size surface roughness, all within favourable cell culture ranges. The study found no impact of leachable and extractables form the DLP printing process. Cells seeded on coupons exhibited morphologies comparable to conventional tissue culture polystyrene plates. Cell proliferation rates, as determined by direct cell count and the RealTime-GloTM MT Cell Viability Assay, were similar on HA coupons and standard tissue culture polystyrene plates). Osteogenic differentiation of human MSCs on HA coupons was confirmed using alkaline phosphatase, Alizarin Red S and von Kossa staining. The morphology of MSCs cultured in osteogenic medium for 14 to 35 days was similar on HA coupons and tissue culture polystyrene plates, with osteogenic (geometric, cuboidal morphology with dark nodules) and adipogenic (lipid vesicles and deposits) features. We conclude that the DLP process and LithaBone HA400 slurry are biocompatible and are suitable for osteogenic applications. Coupons served as an effective evaluation design in the characterization and visualization of cell responses on DLP printed HA material. Results support the feasibility of future technical development for 3D printing of sophisticated scaffold designs, which can be constructed to meet the mechanical, chemical, and porosity requirements of an artificial bone scaffold.
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Affiliation(s)
| | - Sara Peterson
- GE Research, Niskayuna, New York, United States of America
| | | | - Daniel J. Erno
- GE Research, Niskayuna, New York, United States of America
| | - Tony Murray
- GE Research, Niskayuna, New York, United States of America
| | - Linda Boyd
- GE Research, Niskayuna, New York, United States of America
| | - Jae-Hyuk Her
- GE Research, Niskayuna, New York, United States of America
| | - Nathan Mclean
- GE Research, Niskayuna, New York, United States of America
| | - Robert Davis
- GE Research, Niskayuna, New York, United States of America
| | - Fiona Ginty
- GE Research, Niskayuna, New York, United States of America
| | | | - Brian M. Davis
- GE Research, Niskayuna, New York, United States of America
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Diagnostic tests for titanium hypersensitivity in implant dentistry: a systematic review of the literature. Int J Implant Dent 2022; 8:29. [PMID: 35819566 PMCID: PMC9276909 DOI: 10.1186/s40729-022-00428-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/30/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE There are rising concerns about titanium hypersensitivity reaction regarding dental endosseous implants. This review aims to summarize and compare the validity and reliability of the available dermatological and laboratory diagnostic tests regarding titanium hypersensitivity. The following PICO design was used: In Patients with titanium dental implants (P) does epicutaneous testing (ECT) (I), compared to lymphocyte transformation test (LTT) or Memory Lymphocyte Immunostimulation Assay (MELISA) (C) detect hypersensitivity reactions (O)? A literature search was performed including all studies dealing with this topic. Studies regarding orthopedic implants were excluded. METHODS Three databases (MEDLINE PubMed, Cochrane Library, SciELO) were screened for suitable studies and an additional manual search was also performed. Literature regarding hypersensitivity reactions in orthopedic implants, hypersensitivity reactions regarding implants not related to dental or maxillofacial surgery, animal studies and in vitro studies were excluded. A quality assessment of all selected full-text articles was performed. Randomized, controlled trials were evaluated with the Cochrane Risk of Bias Tool I. Cohort studies were assessed according to the New Castle-Ottawa Scale and case series according to Moga et al. (Development of a quality appraisal tool for case series studies using a modified Delphi technique. 2012). RESULTS 10 studies were included in the quantitative synthesis and available for the endpoint diagnostics of intolerance reactions to titanium dental implants: 2 clinical studies, 7 cohort studies and 1 case series. The potential for bias (internal validity) for these studies was overall rated as high. CONCLUSIONS The study of the available literature regarding ECT and MELISA or LTT in patients with suspected titanium hypersensitivity showed inconsistent results in terms of reliability and validity and thus, those tests should be regarded cautiously. There is strong evidence that titanium hypersensitivity in dental implants is associated with innate immunity: unspecific pro-inflammatory responses due to particle induced hyperreactivity of macrophages or toxicological responses especially towards nanoparticles rather than activation of the adaptive immune system. Therefore, tests detecting allergies do not seem expedient and inflammatory clinical signs should be regarded as leading parameters.
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Yabit F, Hughes L, Sylvester B, Tiesenga F. Hypersensitivity Reaction Post Laparoscopic Cholecystectomy Due to Retained Titanium Clips. Cureus 2022; 14:e26167. [PMID: 35891858 PMCID: PMC9302919 DOI: 10.7759/cureus.26167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Titanium is an inert metal that has many medical uses and applications because of its biocompatibility. However, titanium is not completely devoid of adverse reactions. This was the case of a 55-year-old female who presented following a laparoscopic cholecystectomy with right upper quadrant pain, diarrhea, nausea and eventual neuralgia in the right lower extremity. This led to a series of diagnostic procedures including an esophagogastroduodenoscopy (EGD), a colonoscopy, a CT scan, and an abdominal ultrasound, all of which proved to be futile. The patient was eventually formally diagnosed with hypersensitivity reaction due to titanium clips and underwent a diagnostic laparoscopy, adhesiolysis, and removal of foreign body under fluoroscopy. A total of four clips were identified and removed during the procedure. Repeat x-ray showed no evidence of further clips in the right upper quadrant nor throughout the abdomen. The patient was discharged the same day and showed improvement of symptoms one week later during the post-operative follow-up visit.
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21
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Ion Release and Surface Changes of Nickel-Titanium Archwires Induced by Changes in the pH Value of the Saliva-Significance for Human Health Risk Assessment. MATERIALS 2022; 15:ma15061994. [PMID: 35329446 PMCID: PMC8954586 DOI: 10.3390/ma15061994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023]
Abstract
The aim of this study was to explore whether changes in the salivary pH influence mechanical properties, surface roughness, and ion release from NiTi archwires with various surface coatings, and discuss the clinical significance of the findings. The uncoated, rhodium-coated, and nitrified NiTi wires were immersed into artificial saliva of different pH values (4.8, 5.1, 5.5, and 6.6). Released nickel and titanium ions were measured with inductively coupled plasma-optical emission spectroscopy at the end of 28 days. Atomic force microscopy was used to measure the arithmetic average surface roughness Ra, the root-mean-square roughness Rq, and the maximum height of the asperities RZ. The nanoindentation hardness (HIT) and Young's modulus (EIT) measurements were performed. The change in the pH of artificial saliva is inversely proportional to the release of titanium from both coated and uncoated wires, and the release of nickel from uncoated wires. The surface roughness parameters of both coated and uncoated wires are unaffected by the change in the pH of artificial saliva. The change in the pH of saliva has minor influence on the hardness and Young's modulus of elasticity of both coated and uncoated wires. The concentration of released metal ions measured was below the recommended upper limit for daily intake; nevertheless, hypersensitivity effects cannot be excluded, even at lower concentrations and at low pH.
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22
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Is Allergy to Titanium Bone Fixation Plates a Problem? COATINGS 2022. [DOI: 10.3390/coatings12020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Open reduction and internal fixation (ORIF) with titanium fixation plates is the gold standard for maxillofacial fracture treatment. Titanium is considered a fully compatible material. However, reports of allergic reactions to titanium implants do occur. The aim of this work is to answer the question whether titanium devices used in the treatment of fractures in the craniofacial region can cause allergic reactions. The study comprised 50 subjects treated surgically for maxillofacial injuries with the use of titanium composite devices. Allergic tests were performed by the patch method. The control group consisted of 20 healthy people who did not have any titanium elements. There were no skin changes to titanium and its compounds in both the test and control groups. Only one patient had a positive skin test which showed an allergic reaction to silver nitrate. Titanium fixing elements, as well as titanium dental implants, according to our research, do not show allergic skin reactions.
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Moreira A, Madeira S, Buciumeanu M, Fialho J, Carvalho A, Silva F, Monteiro FJ, Caramês J. Design and surface characterization of micropatterned silica coatings for zirconia dental implants. J Mech Behav Biomed Mater 2022; 126:105060. [PMID: 34974323 DOI: 10.1016/j.jmbbm.2021.105060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
The use of zirconia as an alternative biomaterial for titanium implants has been increasing due to its biocompatibility, favorable aesthetic features, less potential for early plaque accumulation and mechanical properties. Despite the developed efforts, strategies to promote an effective osseointegration are still enough. In this sense and combining the silica properties to improve bone formation with the micropatterning guidance characteristics, silica coatings with micropatterns were designed and evaluated regarding their hydrophilicity and integrity through resistance to scratch and friction tests against femoral bone plates (simulating implant insertion). A combined sol-gel and soft-lithography techniques were used to produce silica coatings onto zirconia substrates and different techniques were used to characterize the micropatterned silica coatings. The results revealed that the production of lines and pillars micropatterns increases the surface roughness (Ra values) and improves the surface strength adhesion. Through the scratch test, it was possible to verify that the integrity and topography characteristics of all micropatterned coatings were not significantly affected after the friction test meaning that their function is not compromised after implant insertion. Additionally, the lines micropattern was the one that presented the highest hydrophilicity for distilled water, thus being a promising surface to promote improved osseointegration. The combined use of different surface micropatterns could potentially be used to guide bone apposition and avoiding peri-implantitis.
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Affiliation(s)
- André Moreira
- Department of Oral Surgery and Implant Dentistry, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277, Lisboa, Portugal.
| | - Sara Madeira
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), Universidade do Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Mihaela Buciumeanu
- Faculty of Engineering, "Dunărea de Jos" University of Galaţi, Domnească 47, 800008, Galati, Romania
| | - Joana Fialho
- Escola Superior de Tecnologia e Gestão de Viseu, CI&DEI, Instituto Politécnico de Viseu, 3504-510 Viseu, Portugal
| | - Angela Carvalho
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal; INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Filipe Silva
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), Universidade do Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Fernando J Monteiro
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal; INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal; Faculdade de Engenharia, Departamento de Engenharia Metalúrgica e Materiais, Universidade do Porto, Rua Dr Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - João Caramês
- Department of Oral Surgery and Implant Dentistry, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277, Lisboa, Portugal
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Buciumeanu M, Bagheri A, Silva FS, Henriques B, Lasagni AF, Shamsaei N. Tribocorrosion Behavior of NiTi Biomedical Alloy Processed by an Additive Manufacturing Laser Beam Directed Energy Deposition Technique. MATERIALS 2022; 15:ma15020691. [PMID: 35057411 PMCID: PMC8780431 DOI: 10.3390/ma15020691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
The purpose of the present study was to experimentally assess the synergistic effects of wear and corrosion on NiTi alloy in comparison with Ti-6Al-4V alloy, the most extensively used titanium alloy in biomedical applications. Both alloys were processed by an additive manufacturing laser beam directed energy deposition (LB-DED) technique, namely laser engineered net shaping (LENS), and analyzed via tribocorrosion tests by using the ball-on-plate configuration. The tests were carried out in phosphate buffered saline solution at 37 °C under open circuit potential (OCP) to simulate the body environment and temperature. The synergistic effect of wear and corrosion was found to result in an improved wear resistance in both materials. It was also observed that, for the process parameters used, the LB-DED NiTi alloy exhibits a lower tendency to corrosion as compared to the LB-DED Ti-6Al-4V alloy. It is expected that, during the service life as an implant, the NiTi alloy is less susceptible to the metallic ions release when compared with the Ti-6Al-4V alloy.
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Affiliation(s)
- Mihaela Buciumeanu
- Department of Mechanical Engineering, Faculty of Engineering, “Dunărea de Jos” University of Galaţi, Domnească 47, 800008 Galati, Romania
- Correspondence: (M.B.); (F.S.S.)
| | - Allen Bagheri
- Center for Advanced Vehicular Systems (CAVS), Mississippi State University, Starkville, MS 39762, USA;
| | - Filipe Samuel Silva
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), Campus de Azurém, University of Minho, 4800-058 Guimarães, Portugal;
- Correspondence: (M.B.); (F.S.S.)
| | - Bruno Henriques
- Center for Micro-Electro Mechanical Systems (CMEMS-UMinho), Campus de Azurém, University of Minho, 4800-058 Guimarães, Portugal;
- Laboratory of Ceramic and Composite Materials (CERMAT), Campus Trindade, Federal University of Santa Catarina (UFSC), Florianópolis 88040-900, SC, Brazil
| | - Andrés F. Lasagni
- Institute for Manufacturing Technology, Technische Universität Dresden, 01062 Dresden, Germany;
- Fraunhofer-Institut für Werkstoff- und Strahltechnik IWS, Winterbergstr. 28, 01277 Dresden, Germany
| | - Nima Shamsaei
- Department of Mechanical Engineering, Auburn University, Auburn, AL 36849, USA;
- National Center for Additive Manufacturing Excellence (NCAME), Auburn University, Auburn, AL 36849, USA
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An Assessment of the Components of Dental Implant Materials. Dermatitis 2021; 32:e151-e153. [PMID: 34807544 DOI: 10.1097/der.0000000000000744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Poli PP, de Miranda FV, Polo TOB, Santiago Júnior JF, Lima Neto TJ, Rios BR, Assunção WG, Ervolino E, Maiorana C, Faverani LP. Titanium Allergy Caused by Dental Implants: A Systematic Literature Review and Case Report. MATERIALS 2021; 14:ma14185239. [PMID: 34576463 PMCID: PMC8465040 DOI: 10.3390/ma14185239] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022]
Abstract
(1) Background: Hypersensitivity reactions to metals may arise in predisposed patients chronically exposed to metallic materials, including dental implants made of titanium alloys. The purpose of this article was to systematically review titanium allergy manifestations in patients treated with dental implants and report a clinical case; (2) Methods: A systematic electronic search was performed for articles published in the English language until July 2021. The following eligibility criteria were adopted: (1) Population: individuals undergoing titanium and/or titanium alloy implant-supported rehabilitations; (2) Exposure: peri-implant soft tissue reactions attributable to implant insertion; (3) Outcome: evidence of titanium allergy, diagnostic methods, and forms of resolution; (3) Results: The included studies, in summary, presented evidence that titanium should not be considered an inert material, being able to trigger allergic reactions, and may be responsible for implant failure. A 55-year-old male patient received 3 implants in the posterior region of the left mandible and presented an epulis-like lesion developed from the peri-implant mucosa. The immunohistochemical analysis of the biopsy specimen confirmed the initial diagnosis of allergic reaction to titanium; (4) Conclusions: Although the evidence is weak, and titanium allergy has a low incidence, hypersensitivity reactions should not be underestimated. A rapid and conclusive diagnosis is mandatory to prevent further complications.
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Affiliation(s)
- Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Fábio Vieira de Miranda
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Tárik Ocon Braga Polo
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | | | - Tiburtino José Lima Neto
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Bárbara Ribeiro Rios
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Wirley Gonçalves Assunção
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
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Pan Z, Yang Y, Zhang L, Zhou X, Zeng Y, Tang R, Chang C, Sun J, Zhang J. Systemic Contact Dermatitis: The Routes of Allergen Entry. Clin Rev Allergy Immunol 2021; 61:339-350. [PMID: 34338976 DOI: 10.1007/s12016-021-08873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/19/2023]
Abstract
Systemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis of SCD may be delayed. In this work, we summarized all of the routes through which allergens can enter the body and cause SCD, including oral intake, local contact (through skin, inhalation, nasal spray and anal application), implants, and other iatrogenic or invasive routes (intravenous, intramuscular, intraarticular, and intravesicular). This will provide a comprehensive reference for the clinicians to identify the culprit of SCD.
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Affiliation(s)
- Zhouxian Pan
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yongshi Yang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Lishan Zhang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Xianjie Zhou
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yueping Zeng
- Dermatology Department, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, PekingBeijing, 100730, China
| | - Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA. .,Division of Pediatric Immunology and Allergy, Joe DiMaggio Children's Hospital, Hollywood, FL, USA.
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Jing Zhang
- Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
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Titanium and Other Metal Hypersensitivity Diagnosed by MELISA® Test: Follow-Up Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5512091. [PMID: 34124241 PMCID: PMC8192180 DOI: 10.1155/2021/5512091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022]
Abstract
This study is aimed at proving the clinical benefit of the MELISA® test in the minimization or complete elimination of health problems in patients with confirmed hypersensitivity to metals used for tissue replacements. A group of 305 patients aged 20-75 years with previously proven metal hypersensitivity (initial MELISA® test), mainly to titanium and then to another fifteen metals, was chosen from the database at the Institute of Dental Medicine. From these patients, a final group of 42 patients agreed to participate in the study, 35 of which were female and 7 were male. The patients completed a special questionnaire aimed at information regarding change of health status from their last visit and determining whether the results of the initial MELISA® test and recommendations based on it were beneficial for patients or not. They were clinically examined, and peripheral blood samples were taken to perform follow-up MELISA® tests. Questionnaire data was processed, and the follow-up MELISA® test results were compared with the results of the initial MELISA® tests. For statistical analysis, the Fisher's exact test and paired T-test were used. Thirty-two patients reported that they followed the recommendations based on the results of the initial MELISA® tests, and of these, 30 patients (94%) confirmed significant health improvement. Six patients did not follow the recommendation, and from these, only one patient reported an improvement in his health problems. By comparison of the initial and follow-up MELISA® test results, it can be stated that the hypersensitivity to the given metal decreased or disappeared after the therapeutic interventions performed based on the initial MELISA® test results. The evaluation of the data obtained from patients in this study confirmed a significant clinical benefit of MELISA® test.
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Zwolak I. Epigallocatechin Gallate for Management of Heavy Metal-Induced Oxidative Stress: Mechanisms of Action, Efficacy, and Concerns. Int J Mol Sci 2021; 22:4027. [PMID: 33919748 PMCID: PMC8070748 DOI: 10.3390/ijms22084027] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
In this review, we highlight the effects of epigallocatechin gallate (EGCG) against toxicities induced by heavy metals (HMs). This most active green tea polyphenol was demonstrated to reduce HM toxicity in such cells and tissues as testis, liver, kidney, and neural cells. Several protective mechanisms that seem to play a pivotal role in EGCG-induced effects, including reactive oxygen species scavenging, HM chelation, activation of nuclear factor erythroid 2-related factor 2 (Nrf2), anti-inflammatory effects, and protection of mitochondria, are described. However, some studies, especially in vitro experiments, reported potentiation of harmful HM actions in the presence of EGCG. The adverse impact of EGCG on HM toxicity may be explained by such events as autooxidation of EGCG, EGCG-mediated iron (Fe3+) reduction, depletion of intracellular glutathione (GSH) levels, and disruption of mitochondrial functions. Furthermore, challenges hampering the potential EGCG application related to its low bioavailability and proper dosing are also discussed. Overall, in this review, we point out insights into mechanisms that might account for both the beneficial and adverse effects of EGCG in HM poisoning, which may have a bearing on the design of new therapeutics for HM intoxication therapy.
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Affiliation(s)
- Iwona Zwolak
- Centre for Interdisciplinary Research, Laboratory of Oxidative Stress, The John Paul II Catholic University of Lublin, Konstantynów Ave. 1J, 20-708 Lublin, Poland
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A Clinical Case Report of a Potential Acute Allergic Reaction with Titanium Dental Implant. Case Rep Dent 2021; 2021:5592934. [PMID: 33953988 PMCID: PMC8057912 DOI: 10.1155/2021/5592934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/20/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022] Open
Abstract
Titanium hypersensitivity is rare, but it may exist among patients who need dental implant treatment. It could contribute to mild or severe peri-implant tissue hypersensitivity reactions and affect patients' oral and general health according to some clinical reports. In extreme cases, it may lead to implant failure or extraction. In this case report, a 64-year-old Caucasian female patient received a titanium implant placement on #5. Right after the implant placement, she reported the symptoms of pain, eczema, and slight extraoral swelling, along with significant burning sensation occurring intra- and extraorally. The symptoms were not released after the systemic intervention of antibiotics for six days. On retrieving her medical history, the patient reported a previous allergic reaction to jewelry-like earrings in her childhood. The diagnosis of titanium hypersensitivity was made based on the rapid onset of symptoms and her metal allergy history. Therefore, the dental implant was removed after diagnosis, and a bone allograft was used to preserve the alveolar bone volume. Immediately after implant extraction, the swelling and burning sensation were receded. A complete recovery was achieved three weeks later. The dimension of the alveolar ridge bone was found well maintained in 10 weeks follow-up visit. Conclusion. Rapid onset of peri-implant gingival swelling may indicate a hypersensitivity to titanium implant in the clinic. For patients with a history of allergy to jewelry, the hypersensitivity tests to titanium alloy such as patch test or lymphocyte transformation test should be recommended as part of the dental implant treatment plan.
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Razali M, Ngeow WC, Omar RA, Chai WL. An In-Vitro Analysis of Peri-Implant Mucosal Seal Following Photofunctionalization of Zirconia Abutment Materials. Biomedicines 2021; 9:biomedicines9010078. [PMID: 33467486 PMCID: PMC7830892 DOI: 10.3390/biomedicines9010078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/17/2022] Open
Abstract
The presence of epithelial and connective tissue attachment at the peri-implant-soft tissue region has been demonstrated to provide a biological barrier of the alveolar bone from the oral environment. This barrier can be improved via surface modification of implant abutment materials. The effect of photofunctionalization on creating a bioactive surface for the enhancement of the epithelial and connective tissue attachment of zirconia implant abutment's peri-implant mucosal interface using organotypic model has not been investigated. Therefore, this study aimed to evaluate the soft tissue seal around peri-implant mucosa and to understand the effect of photofunctionalization on the abutment materials. Three types of abutment materials were used in this study; yttria-stabilized zirconia (YSZ), alumina-toughened zirconia, and grade 2 commercially pure titanium (CPTi) which were divided into nontreated (N-Tx) and photofunctionalized group (UV-Tx). The three-dimensional peri-implant mucosal model was constructed using primary human gingival keratinocytes and fibroblasts co-cultured on the acellular dermal membrane. The biological seal was determined through the concentration of tritiated water permeating the material-soft tissue interface. The biological seal formed by the soft tissue in the N-Tx group was significantly reduced compared to the UV-treated group (p < 0.001), with YSZ exhibiting the lowest permeability among all materials. Photofunctionalization of implant abutment materials improved the biological seal of the surrounding soft tissue peri-implant interface.
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Affiliation(s)
- Masfueh Razali
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (M.R.); (W.L.C.); Tel.: +603-92897745 (M.R.); +603-79674548 (W.L.C.)
| | - Wei Cheong Ngeow
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Ros Anita Omar
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (M.R.); (W.L.C.); Tel.: +603-92897745 (M.R.); +603-79674548 (W.L.C.)
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de Lima-Souza RA, Vallarelli AFA, Viviane Mariano F, Cintra ML. Multiple cutaneous fistula after titanium dental implant: A case report. Clin Implant Dent Relat Res 2021; 23:270-274. [PMID: 33393197 DOI: 10.1111/cid.12972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dental implants allow functional and aesthetic reestablishment. Titanium (Ti) implants emerge as the preferred choice because Ti is considered an inert material, highly resistant to corrosion. However, virtually no material can be considered universally biocompatible and this includes titanium. PURPOSE To report an unusual presentation of inflammatory reaction after a Ti dental implant. MATERIALS AND METHODS The patient presented to a dermatology clinic to evaluate lesions on her face. She reported the placement of dental implants 2 years earlier, one of which evolved with inflammatory signs and instability a few days after the procedure. As anti-inflammatory and antibiotic therapy were fruitless, after 3 months the implant was removed, but the inflammation persisted. On physical examination, painful erythematous-papule-nodular lesions were found on the left mandibular and submandibular region. RESULTS Culture tests for microorganisms were negative and histopathological examination revealed a chronic fistula with a foreign body reaction. Using X-ray fluorescence, Ti particles were found along the fistula wall. CONCLUSIONS Professionals should be aware of complications arising from dental implants, including Ti implants. Detailed anamnesis and laboratory investigation can assure diagnosis for specific therapeutic approaches.
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Affiliation(s)
| | | | - Fernanda Viviane Mariano
- Department of Pathology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Maria Letícia Cintra
- Department of Pathology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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Afradh KM, Gopi G, Shanmugasundaram S, Krishnakumar Raja VB. Evaluation of serum metal ion levels in dental implant patients: A prospective study. Ann Maxillofac Surg 2021; 11:261-265. [PMID: 35265495 PMCID: PMC8848711 DOI: 10.4103/ams.ams_70_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/03/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction: Titanium is the most commonly used bio-inert implant material. Nevertheless, there is a possibility of systemic release of metal ions, which could have clinical implications like implant failure and toxicity. This prospective study focuses on the evaluation of serum metal ion levels in patients receiving dental implants. The aim of the study is to evaluate the release of titanium, aluminium, and vanadium from dental implants by comparing the preoperative and postoperative serum levels of these ions. Methodology: Serum samples were collected from 30 patients undergoing dental implant placement preoperatively and postoperatively at intervals of 6 weeks, 3, 6, and 12 months. These samples were analyzed for titanium, aluminium, and vanadium levels using Inductively Coupled Plasma Optical Emission Spectrometry. The difference in preoperative and postoperative serum levels was measured and statistically analyzed using the paired t-test. Results: There was a slight difference in the postoperative levels of titanium and aluminium (2.30 and 4.07 mg/dl) as compared to the preoperative levels (2.28 and 2.30 mg/dl), which was statistically insignificant (P > 0.5). The serum levels of vanadium were too insignificant to be detected by the instrument (<0.0088 mg/dl). Discussion: Mild increase in the titanium and aluminium levels in blood serum was noted. These metallic ion levels might increase significantly due to which further clinical research with larger sample sizes and a long-term follow-up period is required to evaluate the clinical effects of metallic ion release from dental implants. There is no significant difference in the serum metal ion levels before and after the implant placement, although a little increase is observed in the aluminium ion levels after the implant placement.
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Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Comino-Garayoa R, Cortés-Bretón Brinkmann J, Peláez J, López-Suárez C, Martínez-González JM, Suárez MJ. Allergies to Titanium Dental Implants: What Do We Really Know about Them? A Scoping Review. BIOLOGY 2020; 9:biology9110404. [PMID: 33217944 PMCID: PMC7698636 DOI: 10.3390/biology9110404] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Abstract
Simple Summary The scientific literature repeatedly insists on the success of titanium implants. Nevertheless, the so-called tribocorrosion process releases titanium ions into the surrounding tissues, which can trigger a cascade of reactions, localized or at a distance, or even systemic reactions. Consequently, guidelines should be drawn up before starting treatment; when a hypersensitivity reaction following titanium dental implant placement occurs, a range of treatment alternatives should be clearly established and made available. Abstract The purpose of this scoping review was to describe the current state of knowledge and understanding of allergies to titanium dental implants. A scoping review was conducted following the Prisma Extension for Scoping Reviews checklist. An electronic search was performed in five databases complemented by manual and grey literature searches. Fifty-two relevant papers were included for final review. Titanium particles can be released from the surfaces of dental implants in a process called tribocorrosion, which may contribute to bone loss due to inflammatory reaction. Diverse mechanisms have been described that may trigger allergy to titanium, as well as the clinical signs that manifest as the allergy develops. Allergies to titanium are uncommon but represent a real possibility that should not be overlooked in patients requiring prosthodontic rehabilitation with dental implants. Allergy can trigger a range of symptoms. Patients who have already been diagnosed with allergies to other metals will be more predisposed to suffering an allergy to titanium. Further investigation is needed in order to measure the true scope of these allergies.
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Affiliation(s)
- Rubén Comino-Garayoa
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain; (R.C.-G.); (J.P.); (C.L.-S.); (M.J.S.)
| | - Jorge Cortés-Bretón Brinkmann
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain;
- Correspondence:
| | - Jesús Peláez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain; (R.C.-G.); (J.P.); (C.L.-S.); (M.J.S.)
| | - Carlos López-Suárez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain; (R.C.-G.); (J.P.); (C.L.-S.); (M.J.S.)
| | - Jose María Martínez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain;
| | - María Jesús Suárez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28001 Madrid, Spain; (R.C.-G.); (J.P.); (C.L.-S.); (M.J.S.)
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Gurau C, Gurau G, Mitran V, Dan A, Cimpean A. The Influence of Severe Plastic Deformation on Microstructure and In Vitro Biocompatibility of the New Ti-Nb-Zr-Ta-Fe-O Alloy Composition. MATERIALS 2020; 13:ma13214853. [PMID: 33138165 PMCID: PMC7663053 DOI: 10.3390/ma13214853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/15/2022]
Abstract
In this work, severe plastic deformation (SPD) of the newly designed Ti-Nb-Zr-Ta-Fe-O GUM metal was successfully conducted at room temperature using high speed high pressure torsion (HSHPT) followed by cold rolling (CR) to exploit the suitability of the processed alloy for bone staples. The Ti-31.5Nb-3.1Zr-3.1Ta-0.9Fe-0.16O GUM alloy was fabricated in a levitation melting furnace using a cold crucible and argon protective atmosphere. The as-cast specimens were subjected to SPD, specifically HSHPT, and then processed by the CR method to take the advantages of both grain refinement and larger dimensions. This approach creates the opportunity to obtain temporary orthopedic implants nanostructured by SPD. The changes induced by HSHPT technology from the coarse dendrite directly into the ultrafine grained structure were examined by optical microscopy, scanning electron microscopy and X-ray diffraction. The structural investigations showed that by increasing the deformation, a high density of grain boundaries is accumulated, leading gradually to fine grain size. In addition, the in vitro biocompatibility studies were conducted in parallel on the GUM alloy specimens in the as-cast state, and after HSHPT- and HSHPT+CR- processing. For comparative purposes, in vitro behavior of the bone-derived MC3T3-E1 cells on the commercially pure titanium has also been investigated regarding the viability and proliferation, morphology and osteogenic differentiation. The results obtained support the appropriateness of the HSHPT technology for developing compression staples able to ensure a better fixation of bone fragments.
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Affiliation(s)
- Carmela Gurau
- Faculty of Engineering, “Dunărea de Jos” University of Galati, Domnească Street 47, 800008 Galati, Romania; (C.G.); (G.G.)
| | - Gheorghe Gurau
- Faculty of Engineering, “Dunărea de Jos” University of Galati, Domnească Street 47, 800008 Galati, Romania; (C.G.); (G.G.)
| | - Valentina Mitran
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania;
| | - Alexandru Dan
- R&D Consultanta si Servicii, 45 Maria Ghiculeasa, 020943 Bucharest, Romania;
| | - Anisoara Cimpean
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania;
- Correspondence: ; Tel.: +40-21-318-1575 (ext. 106)
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Zigante M, Rincic Mlinaric M, Kastelan M, Perkovic V, Trinajstic Zrinski M, Spalj S. Symptoms of titanium and nickel allergic sensitization in orthodontic treatment. Prog Orthod 2020; 21:17. [PMID: 32607604 PMCID: PMC7326753 DOI: 10.1186/s40510-020-00318-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/06/2020] [Indexed: 01/26/2023] Open
Abstract
Aim The study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic appliances. Methods The study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used. Results Prevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%; p = 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6; p = 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1; p = 0.022). None of the symptoms were significant predictors of titanium sensitization. Conclusion Allergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.
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Affiliation(s)
- Martina Zigante
- Department of Orthodontics, University of Rijeka, Faculty of Dental Medicine, Kresimirova 40, 51000, Rijeka, Croatia.
| | | | - Marija Kastelan
- Department of Dermatovenereology, University of Rijeka, Faculty of Medicine, Brace Branchetta 20, 51000, Rijeka, Croatia
| | - Vjera Perkovic
- Department of Orthodontics, University of Rijeka, Faculty of Dental Medicine, Kresimirova 40, 51000, Rijeka, Croatia
| | - Magda Trinajstic Zrinski
- Department of Orthodontics, University of Rijeka, Faculty of Dental Medicine, Kresimirova 40, 51000, Rijeka, Croatia
| | - Stjepan Spalj
- Department of Orthodontics, University of Rijeka, Faculty of Dental Medicine, Kresimirova 40, 51000, Rijeka, Croatia.,Department of Dental Medicine 1, J.J. Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Crkvena 21, 31000, Osijek, Croatia
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Wang Q, Zhou P, Liu S, Attarilar S, Ma RLW, Zhong Y, Wang L. Multi-Scale Surface Treatments of Titanium Implants for Rapid Osseointegration: A Review. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1244. [PMID: 32604854 PMCID: PMC7353126 DOI: 10.3390/nano10061244] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/30/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
The propose of this review was to summarize the advances in multi-scale surface technology of titanium implants to accelerate the osseointegration process. The several multi-scaled methods used for improving wettability, roughness, and bioactivity of implant surfaces are reviewed. In addition, macro-scale methods (e.g., 3D printing (3DP) and laser surface texturing (LST)), micro-scale (e.g., grit-blasting, acid-etching, and Sand-blasted, Large-grit, and Acid-etching (SLA)) and nano-scale methods (e.g., plasma-spraying and anodization) are also discussed, and these surfaces are known to have favorable properties in clinical applications. Functionalized coatings with organic and non-organic loadings suggest good prospects for the future of modern biotechnology. Nevertheless, because of high cost and low clinical validation, these partial coatings have not been commercially available so far. A large number of in vitro and in vivo investigations are necessary in order to obtain in-depth exploration about the efficiency of functional implant surfaces. The prospective titanium implants should possess the optimum chemistry, bionic characteristics, and standardized modern topographies to achieve rapid osseointegration.
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Affiliation(s)
- Qingge Wang
- School of Metallurgical Engineering, Xi’an University of Architecture and Technology, No.13 Yanta Road, Xi’an 710055, China;
| | - Peng Zhou
- School of Aeronautical Materials Engineering, Xi’an Aeronautical Polytechnic Institute, Xi’an 710089, China;
| | - Shifeng Liu
- School of Metallurgical Engineering, Xi’an University of Architecture and Technology, No.13 Yanta Road, Xi’an 710055, China;
| | - Shokouh Attarilar
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Robin Lok-Wang Ma
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong 999077, China; (R.L.-W.M.); (Y.Z.)
| | - Yinsheng Zhong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong 999077, China; (R.L.-W.M.); (Y.Z.)
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China;
- National Engineering Research Center for Nanotechnology (NERCN), 28 East JiangChuan Road, Shanghai 200241, China
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Shi C, Xi Y, Sun B, He H, Wen J, Ruan Y, Ye X. Suspected allergy to titanium after anterior cervical discectomy and fusion using a Zero-P device: a case report. Br J Neurosurg 2020:1-5. [PMID: 32003246 DOI: 10.1080/02688697.2020.1718605] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Cases of allergy to large surgical implants have been reported. However, few studies have reported allergy to small titanium-containing implants (e.g. Zero-P device).Methods: We reported the case of a 51-year old male patient who underwent the anterior cervical discectomy and fusion (ACDF) procedure using a Zero-P device and exhibited allergic symptoms 1 month after the surgery.Results: The allergic symptoms included intermittent tingling and itches in the throat induced by speaking. Systemic rashes over the skin surface and congestion of the eyeball, and dysphagia were also present. Anti-allergic treatment did not resolve the symptoms. Patch tests revealed negative reactions to the rested reagents including titanium. Radiographic results showed solid bone fusion and no signs of chronic inflammation or hypotoxic infection in the surrounding tissues. Upon the patient's request, we removed the titanium screws and plate of the Zero-P device. No allergic reactions were observed after the surgery and at a 6-month follow-up.Conclusions: Even with a small implant such as the Zero-P device, allergy to titanium may still occur. This case demonstrated the need to screen for the presence of allergy to metals including titanium before the surgery.
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Affiliation(s)
- Changgui Shi
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yanhai Xi
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Bin Sun
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hailong He
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jiankun Wen
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yushan Ruan
- Department of Spine Surgery, The First Affiliated Hospital of Dali University, Yunnan, China
| | - Xiaojian Ye
- Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Koller M, Steyer E, Theisen K, Stagnell S, Jakse N, Payer M. Two-piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial. Clin Oral Implants Res 2020; 31:388-396. [PMID: 31944420 DOI: 10.1111/clr.13576] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two-piece zirconia implants in comparison with titanium implants 80 months after delivery of all-ceramic (lithium disilicate) single-tooth restorations. MATERIAL AND METHODS The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann-Whitney U test. RESULTS Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL. CONCLUSIONS No significant differences were found between the clinical outcomes of two-piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.
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Affiliation(s)
- Martin Koller
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Elisabeth Steyer
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Kerstin Theisen
- Division of Preventive and Operative Dentistry, Endodontics, Periodontology, Prosthodontics, Restorative Dentistry and Implantology, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Sami Stagnell
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Norbert Jakse
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
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Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Has zirconia made a material difference in implant prosthodontics? A review. Dent Mater 2020; 36:1-8. [DOI: 10.1016/j.dental.2019.08.100] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 12/17/2022]
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Knaus J, Schaffarczyk D, Cölfen H. On the Future Design of Bio-Inspired Polyetheretherketone Dental Implants. Macromol Biosci 2019; 20:e1900239. [PMID: 31802617 DOI: 10.1002/mabi.201900239] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/10/2019] [Indexed: 11/09/2022]
Abstract
Polyetheretherketone (PEEK) is a promising implant material because of its excellent mechanical characteristics. Although this polymer is a standard material in spinal applications, PEEK is not in use in the manufacturing of dental implants, where titanium is still the most-used material. This may be caused by its relative bio-inertness. By the use of various surface modification techniques, efforts have been made to enhance its osseointegrative characteristics to enable the polymer to be used in dentistry. In this feature paper, the state-of-the-art for dental implants is given and different surface modification techniques of PEEK are discussed. The focus will lie on a covalently attached surface layer mimicking natural bone. The usage of such covalently anchored biomimetic composite materials combines many advantageous properties: A biocompatible organic matrix and a mineral component provide the cells with a surrounding close to natural bone. Bone-related cells may not recognize the implant as a foreign body and therefore, may heal and integrate faster and more firmly. Because neither metal-based nor ceramics are ideal material candidates for a dental implant, the combination of PEEK and a covalently anchored mineralized biopolymer layer may be the start of the desired evolution in dental surgery.
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Affiliation(s)
- Jennifer Knaus
- Department of Chemistry, Physical Chemistry, University of Konstanz, Universitätsstraße 10, 78457, Konstanz, Germany.,stimOS GmbH, Byk-Gulden-Straße 2, 78467, Konstanz, Germany
| | | | - Helmut Cölfen
- Department of Chemistry, Physical Chemistry, University of Konstanz, Universitätsstraße 10, 78457, Konstanz, Germany
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Magrone T, Russo MA, Jirillo E. Impact of Heavy Metals on Host Cells: Special Focus on Nickel-Mediated Pathologies and Novel Interventional Approaches. Endocr Metab Immune Disord Drug Targets 2019; 20:1041-1058. [PMID: 31782370 DOI: 10.2174/1871530319666191129120253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/13/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Heavy metals [arsenic, aluminium, cadmium, chromium, cobalt, lead, nickel (Ni), palladium and titanium] are environmental contaminants able to impact with host human cells, thus, leading to severe damage. OBJECTIVE In this review, the detrimental effects of several heavy metals on human organs will be discussed and special emphasis will be placed on Ni. In particular, Ni is able to interact with Toll-like receptor-4 on immune and non-immune cells, thus, triggering the cascade of pro-inflammatory cytokines. Then, inflammatory and allergic reactions mediated by Ni will be illustrated within different organs, even including the central nervous system, airways and the gastrointestinal system. DISCUSSION Different therapeutic strategies have been adopted to mitigate Ni-induced inflammatoryallergic reactions. In this context, the ability of polyphenols to counteract the inflammatory pathway induced by Ni on peripheral blood leukocytes from Ni-sensitized patients will be outlined. In particular, polyphenols are able to decrease serum levels of interleukin (IL)-17, while increasing levels of IL- 10. These data suggest that the equilibrium between T regulatory cells and T helper 17 cells is recovered with IL-10 acting as an anti-inflammatory cytokine. In the same context, polyphenols reduced elevated serum levels of nitric oxide, thus, expressing their anti-oxidant potential. Finally, the carcinogenic potential of heavy metals, even including Ni, will be highlighted. CONCLUSION Heavy metals, particularly Ni, are spread in the environment. Nutritional approaches seem to represent a novel option in the treatment of Ni-induced damage and, among them, polyphenols should be taken into consideration for their anti-oxidant and anti-inflammatory activities.
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Affiliation(s)
- Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, School of Medicine, University of Bari, Bari, Italy
| | - Matteo A Russo
- MEBIC Consortium, San Raffaele Open University of Rome and IRCCS San Raffaele Pisana of Rome, Rome, Italy
| | - Emilio Jirillo
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, School of Medicine, University of Bari, Bari, Italy
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Ozan S, Lin J, Weng W, Zhang Y, Li Y, Wen C. Effect of thermomechanical treatment on the mechanical and microstructural evolution of a β-type Ti-40.7Zr-24.8Nb alloy. Bioact Mater 2019; 4:303-311. [PMID: 31709313 PMCID: PMC6829099 DOI: 10.1016/j.bioactmat.2019.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/11/2022] Open
Abstract
In this study, the microstructural evolution and mechanical properties of a newly developed Ti-40.7Zr–24.8Nb (TZN) alloy after different thermomechanical processes were examined. As-cast TZN alloy plates were solution-treated at 890 °C for 1 h, after which the thickness of the alloy plates was reduced by cold rolling at reduction ratios of 20%, 56%, 76%, and 86%. Stress-induced α” formation, {332} <113> β mechanical twinning, and kink band formation were observed in the cold-rolled TZN alloy samples. In the TZN sample after cold rolling at the 86% reduction ratio plus a recrystallization annealing at 890 °C for 1 h, the deformation products of a stress-induced α” phase, {332}<113> β mechanical twinning, and kink bands disappeared, resulting in a fine, equiaxed single β phase. The alloy samples exhibited elongation at rupture ranging from 7% to 20%, Young's modulus ranging from 63 to 72 GPa and tensile strength ranging from 753 to 1158 MPa. The TZN alloy sample after cold rolling and recrystallization annealing showed a yield strength of 803 MPa, a tensile strength of 848 MPa, an elongation at rupture of 20%, and an elastic admissible strain of 1.22%, along with the most ductile fractures during tensile testing. A newly developed Ti-40.7Zr–24.8Nb (TZN) alloy was thermomechanically processed. Deformation occurred via kink bands, mechanical twinning, and stress-induced α”. Cold rolling resulted in an increase in the tensile strength. Deformation products were disappeared after recrystallization annealing. TZN alloy can be considered as a promising candidate biomedical material.
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Affiliation(s)
- Sertan Ozan
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
- Department of Mechanical Engineering, Yozgat Bozok University, 66100, Yozgat, Turkey
- Corresponding author. School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia.
| | - Jixing Lin
- Advanced Material Research and Development Center, Zhejiang Industry & Trade Vocational College, Wenzhou, Zhejiang, 325003, China
| | - Weijie Weng
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Yaowu Zhang
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Yuncang Li
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Cuie Wen
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
- Corresponding author.
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Ceramic implant fracture: A clinical report. J Prosthet Dent 2019; 122:425-429. [DOI: 10.1016/j.prosdent.2019.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 01/15/2023]
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Chaubey AK, Mishra SK, Chowdhary R. Positive Material Identification testing of dental implant to correlate their compositions with allergic conditions. J Oral Biol Craniofac Res 2019; 9:294-298. [PMID: 31289719 PMCID: PMC6593213 DOI: 10.1016/j.jobcr.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Rapid increase of products containing titanium leads to the increases in percutaneous and permucosal exposure of populations to the titanium. PURPOSE Evaluate the various material compositions in five commercially available dental implant systems and correlate the obtained material contents with allergic conditions seen with implants. MATERIAL AND METHODS A total of 25 implant, with 5 samples each in 5 groups of commercially available dental implants (MKIII, Myriad, Nobel Replace, MIS and Alpha Dent) were used in the study. Positive Material Identification (PMI) testing was done to analyse the amount of different metals (percentage by mass) present in the dental implants. RESULTS Highest titanium content, 99.47% by mass was found in sample 2 (Myriad) and least, 89.04% by mass in sample 5(Alpha dent). Nickel was found only in sample 5 (Alpha dent) in 0.079% by mass and zinc in sample 4 (MIS) in0.084% by mass, chromium was found in sample 1 (MK III) in 0.263% by mass and in sample 2 in0.273% by mass. CONCLUSIONS Implant composition should be made mandatory to be disclosed on the implant packet and before implant placement patch test for the allergen present in the particular implant can be done for the patient's health benefit and long term clinical success of dental implants.
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Affiliation(s)
- Avadhesh Kumar Chaubey
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, 560074, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Peoples College of Dental Sciences & Research Centre, Bhopal, 462037, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, 560074, India
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Kim KT, Eo MY, Nguyen TTH, Kim SM. General review of titanium toxicity. Int J Implant Dent 2019; 5:10. [PMID: 30854575 PMCID: PMC6409289 DOI: 10.1186/s40729-019-0162-x] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/21/2019] [Indexed: 12/16/2022] Open
Abstract
Background Titanium is a commonly used inert bio-implant material within the medical and dental fields. Although the use of titanium is thought to be safe with a high success rate, in some cases, there are rare reports of problems caused by titanium. In most of these problematic reports, only individual reports are dominant and comprehensive reporting has not been performed. This comprehensive article has been prepared to review the toxicity of titanium materials within the medical and dental fields. Methods We used online searching tools including MEDLINE (PubMed), Embase, Cochrane Library, and Google Scholar by combining keywords such as “titanium implant toxicity,” “titanium implant corrosion,” “titanium implant allergy,” and “yellow nail syndrome.” Recently updated data has been collected and compiled into one of four categories: “the toxicity of titanium,” “the toxicity of titanium alloys,” “the toxicity of titanium implants,” and “diseases related to titanium.” Results Recent studies with regard to titanium toxicity have been increasing and have now expanded to the medical field in addition to the fields of environmental research and basic science. Problems that may arise in titanium-based dental implants include the generation of titanium and titanium alloy particles and ions deposited into surrounding tissues due to the corrosion and wear of implants, resulting in bone loss due to inflammatory reactions, which may lead to osseointegration failure of the dental implant. These titanium ions and particles are systemically deposited and can lead to toxic reactions in other tissues such as yellow nail syndrome. Additionally, implant failure and allergic reactions can occur due to hypersensitivity reactions. Zirconia implants can be considered as an alternative; however, limitations still exist due to a lack of long-term clinical data. Conclusions Clinicians should pay attention to the use of titanium dental implants and need to be aware of the problems that may arise from the use of titanium implants and should be able to diagnose them, in spite of very rare occurrence. Within the limitation of this study, it was suggested that we should be aware the rare problems of titanium toxicity.
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Affiliation(s)
- Kyeong Tae Kim
- Department of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Truc Thi Hoang Nguyen
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Soung Min Kim
- Department of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea. .,Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea. .,Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana.
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Kitagawa M, Murakami S, Akashi Y, Oka H, Shintani T, Ogawa I, Inoue T, Kurihara H. Current status of dental metal allergy in Japan. J Prosthodont Res 2019; 63:309-312. [PMID: 30738702 DOI: 10.1016/j.jpor.2019.01.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/27/2018] [Accepted: 01/08/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the current status of patients with dental metal allergies in Japan. METHODS This study analyzed dental metal allergy in 1225 patients (1:3 male to female ratio; average age 53.0 ±16.5 years), including 300 who were scheduled to undergo dental implant surgery, between 2006 and 2016. For diagnosis of metal allergy, patch tests using metal allergens were performed. Additionally, when necessary, metal element analysis of dental alloys was performed in the mouths of some patients using an X-ray fluorescence analyzer for those who exhibited positive reactions. RESULTS Among 925 patients (i.e., excluding those scheduled to undergo dental implant surgery [n=300]), nearly one-half (44.0%) exhibited a positive response to any metal element in the patch test. The positivity rates were as follows: nickel (22.5%); palladium (14.8%); and zinc (11.5%). Almost one-half (42.3%) of the patients had diseases associated with metal allergy. Among patients who exhibited a positive reaction to any metal element in the patch test, more than two-thirds (67.9%) had dental alloys containing the positive metal element(s). One-half (55.6%) of the patients who underwent treatment to remove the metal experienced improvement in symptoms. In patients who underwent patch testing as an implant preoperative examination, several (2.7%) exhibited a positive reaction to titanium. CONCLUSIONS Dental metals, including nickel, palladium and zinc, which are indispensable to dental treatment in Japan, had high positivity rates in patch testing, and one-half of the patients improved following removal of the metal. Additionally, there were several patients with allergy to titanium.
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Affiliation(s)
- Masae Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.
| | - Satoshi Murakami
- Department of Clinical Pathophysiology, Tokyo Dental College, Tokyo, Japan
| | - Yoshihiko Akashi
- Department of Clinical Pathophysiology, Tokyo Dental College, Tokyo, Japan
| | - Hiroko Oka
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan; Department of Global Dental Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoaki Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Takashi Inoue
- Department of Clinical Pathophysiology, Tokyo Dental College, Tokyo, Japan
| | - Hidemi Kurihara
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan; Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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