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Khandelwal G, Alagarsamy R, Roychoudhury A, Bhutia O, Shariff A. Cross-Sectional Study of Serum Metal Ions in Patients With Metal Implants in the Maxillofacial Region. J Maxillofac Oral Surg 2023; 22:1034-1039. [PMID: 38105820 PMCID: PMC10719183 DOI: 10.1007/s12663-023-01988-3] [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: 02/14/2023] [Accepted: 08/03/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose The purpose of the present study was to measure the serum metal ion levels (titanium, cobalt, chromium) in patients who have metal implants in the maxillofacial region. Methods The investigators implemented a cross sectional study on patients treated with procedures requiring metal implants for management of maxillofacial trauma, fixation for orthognathic surgery, and total temporomandibular joint replacement (TJR). Inductively coupled plasma mass spectrometry was used as an analytical method to detect metal ions in serum samples. Results The study comprised of 50 patients who were divided into 4 groups- group I- total TJR (n = 18), group II- orthognathic (n = 8), group III- trauma (n = 8), and group IV- control (n = 16). The mean values of metal ions level were raised than the control group. Conclusion The present study's results suggest a rise in serum metal ion levels after the metal implantation in maxillofacial region. None of the patients had any abnormal signs and symptoms due to raised metal levels. Further studies are warranted to correlate the serum metal ion levels and their clinical relevance.
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Affiliation(s)
- Garima Khandelwal
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, Safdarjung Hospital, New Delhi, India
| | - Ajoy Roychoudhury
- Department of Oral and Maxillofacial Surgery, Centre of Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A. Shariff
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, 110029 India
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Sharma V, Agrawal S, Sharma D, Thorat R, Srichand R, Dalave P. Assessment of Metal Ions Levels in Blood of Dental Implant Patients. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S913-S915. [PMID: 37693986 PMCID: PMC10485422 DOI: 10.4103/jpbs.jpbs_47_23] [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: 01/19/2023] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 09/12/2023] Open
Abstract
Background Dental implants use has significantly increased and the concentration of metal ions into blood may have detrimental effect of human body. The present study aimed to determine metal ions levels in blood of dental implants patients. Materials and Methods 48 patients scheduled for dental implant surgery was assessed for measurement of titanium and aluminum pre-operatively and post-operatively at 6 weeks, 3 months, 6 months, and 1 year. Results Out of 48 patients, males were 22 (45.8%), and females were 26 (54.2%). The mean ± SD titanium metal levels in blood pre-operatively was 2.34 ± 0.47 mg/dl, at 6 weeks was 2.35 ± 0.48 mg/dl, at 3 months was 2.37 ± 0.52 mg/dl, at 6 months was 2.37 ± 0.42 mg/dl, and at 1 year was 2.38 ± 0.51 mg/dl. A non-significant difference was seen (P > 0.05). The mean ± SD aluminum metal levels in blood pre-operatively was 4.4 ± 0.12 mg/dl, at 6 weeks was 4.45 ± 0.14 mg/dl, at 3 months was 4.7 ± 0.13 mg/dl, at 6 months was 4.7 ± 0.21 mg/dl, and at 1 year was 4.8 ± 0.17 mg/dl. A non-significant difference was seen (P > 0.05). Conclusion A non- significant increase in titanium and aluminum ions level in blood of patients receiving dental implants was observed.
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Affiliation(s)
- Vivek Sharma
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Sneh Agrawal
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Deepak Sharma
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rohit Thorat
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Reema Srichand
- Department of Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Pranita Dalave
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances. Polymers (Basel) 2022; 14:polym14142782. [PMID: 35890557 PMCID: PMC9316877 DOI: 10.3390/polym14142782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 02/06/2023] Open
Abstract
Osteosynthesis systems are used to fixate bone segments in maxillofacial surgery. Titanium osteosynthesis systems are currently the gold standard. However, the disadvantages result in symptomatic removal in up to 40% of cases. Biodegradable osteosynthesis systems, composed of degradable polymers, could reduce the need for removal of osteosynthesis systems while avoiding the aforementioned disadvantages of titanium osteosyntheses. However, disadvantages of biodegradable systems include decreased mechanical properties and possible foreign body reactions. In this review, the literature that focused on the in vitro and in vivo performances of biodegradable and titanium osteosyntheses is discussed. The focus was on factors underlying the favorable clinical outcome of osteosyntheses, including the degradation characteristics of biodegradable osteosyntheses and the host response they elicit. Furthermore, recommendations for clinical usage and future research are given. Based on the available (clinical) evidence, biodegradable copolymeric osteosyntheses are a viable alternative to titanium osteosyntheses when applied to treat maxillofacial trauma, with similar efficacy and significantly lower symptomatic osteosynthesis removal. For orthognathic surgery, biodegradable copolymeric osteosyntheses are a valid alternative to titanium osteosyntheses, but a longer operation time is needed. An osteosynthesis system composed of an amorphous copolymer, preferably using ultrasound welding with well-contoured shapes and sufficient mechanical properties, has the greatest potential as a biocompatible biodegradable copolymeric osteosynthesis system. Future research should focus on surface modifications (e.g., nanogel coatings) and novel biodegradable materials (e.g., magnesium alloys and silk) to address the disadvantages of current osteosynthesis systems.
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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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The Implications of Titanium Alloys Applied in Maxillofacial Osteosynthesis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Titanium alloys are known for their biological, mechanical and chemical properties, which have successfully expanded their use in the maxillofacial field. The internal fixation using titanium miniplates and screws offer a new perspective for the treatment of trauma and in orthognathic surgery and maxillofacial oncology. Although, titanium is highly recommended for its excellent biocompatibility, recent research has focused on identifying the potential local and general implications of the interactions between the human tissue and the metallic particles. This present review aims to outline the existing tissue changes, cellular alterations and future perspectives regarding the use of titanium-based alloys as osteosynthesis materials, taking into consideration the existing present debate whether the routinely removal of these materials should be an indication.
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Ferraro SA, Domingo MG, Etcheverrito A, Olmedo DG, Tasat DR. Neurotoxicity mediated by oxidative stress caused by titanium dioxide nanoparticles in human neuroblastoma (SH-SY5Y) cells. J Trace Elem Med Biol 2020; 57:126413. [PMID: 31606305 DOI: 10.1016/j.jtemb.2019.126413] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/17/2019] [Accepted: 09/24/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Titanium is widely used in biomedicine. Due to biotribocorrosion, titanium dioxide (TiO2) nanoparticles (NPs) can be released from the titanium implant surface, enter the systemic circulation, and migrate to various organs and tissues including the brain. A previous study showed that 5 nm TiO2 NPs reached the highest concentration in the brain. Even though TiO2 NPs are believed to possess low toxicity, little is known about their neurotoxic effects. The aim of the study was to evaluate in vitro the effects of 5 nm TiO2 NPs on a human neuroblastoma (SH-SY5Y) cell line. METHODS Cell cultures were divided into non-exposed and exposed to TiO2 NPs for 24 h. The following were evaluated: reactive oxygen species (ROS) generation, apoptosis, cellular antioxidant response, endoplasmic reticulum stress and autophagy. RESULTS Exposure to TiO2 NPs induced ROS generation in a dose dependent manner, with values reaching up to 10 fold those of controls (p < 0.001). Nrf2 nuclear localization and autophagy, also increased in a dose dependent manner. Apoptosis increased by 4- to 10-fold compared to the control group, depending on the dose employed. CONCLUSIONS Our results show that TiO2 NPs cause ROS increase, induction of ER stress, Nrf2 cytoplasmic translocation to the nucleus and apoptosis. Thus, neuroblastoma cell response to TiO2 NPs may be associated with an imbalance of the oxidative metabolism where endoplasmic reticulum-mediated signal pathway seems to be the main neurotoxic mechanism.
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Affiliation(s)
- Sebastián Ariel Ferraro
- Center of Studies in Health and Environment, School of Science and Technology, National University of San Martín, San Martín, Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Buenos Aires, Argentina.
| | - Mariela Gisele Domingo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina; Research Fellow of the University of Buenos Aires, Buenos Aires, Argentina.
| | - Analía Etcheverrito
- Center of Studies in Health and Environment, School of Science and Technology, National University of San Martín, San Martín, Buenos Aires, Argentina.
| | - Daniel Gustavo Olmedo
- National Council of Scientific and Technical Research (CONICET), Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina.
| | - Deborah Ruth Tasat
- Center of Studies in Health and Environment, School of Science and Technology, National University of San Martín, San Martín, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina.
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Vatani M, Beigi MH, Ejeian F, Mottaghi A, Yadegari-Naeini A, Nasr-Esfahani MH. Cytotoxicity Evaluation of The Bioresorbable and Titanium Plates/Screws Used in Maxillofacial Surgery on Gingival Fibroblasts and Human Mesenchymal Bone Marrow Stem Cells. CELL JOURNAL 2019; 22:310-318. [PMID: 31863656 PMCID: PMC6947002 DOI: 10.22074/cellj.2020.6409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/08/2019] [Indexed: 12/02/2022]
Abstract
Objective Bioresorbable and titanium plates/screws are considered as a standard treatment for fixation of the bone
segments of craniofacial area and paying attention to their biocompatibility is an important issue along with other
aspects of application. The purpose of the study was to evaluate the cell viability of two types of plate and screw used
in maxillofacial surgeries in contact with gingival fibroblasts and bone marrow stem cells.
Materials and Methods In this experimental study after extraction and cultivation of cells from healthy human gingival
tissue and alveolar bone of jaw, cytotoxicity of device was evaluated. In direct contact method, samples had near
vicinity contact with the both cell lines and in indirect contact method, by-products released, like ions, from samples
after 8 weeks were used to assess cytotoxicity. Then cytotoxicity was evaluated on the 2nd, 4th and 6th day with MTS
tests and microscopy. The data were analyzed by one-way ANOVA and independent t tests.
Results There was a statistically significant difference between the German plate and screw and all the samples
studied on day 6 (P<0.05). Furthermore, a statistically significant difference was observed between both metal samples
and both bio-absorbable samples on day 6 and both cell lines (P<0.05). Comparisons between the two groups with
each other for both cell lines on the 6th day were statistically significant (P<0.05).
Conclusion Our results suggest that that cytotoxicity of biomaterial, from different brands, were not similar and some
of the biomaterial showed lower degree of toxicity compared to others and specialist using these products showed
be aware of this differences. Our investigation indicates more biocompatibility of bioresorbable plates and screws
compared to titanium. In addition our results suggest that biomaterials were not completely neutral.
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Affiliation(s)
- Masoud Vatani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Beigi
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Fatemeh Ejeian
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Ahmad Mottaghi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Electronic Address:
| | - Afshin Yadegari-Naeini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. Electronic Address:
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Cabaña-Muñoz ME, Parmigiani-Izquierdo JM, Camacho Alonso F, Merino JJ. Increased Systemic Malondialdehyde Levels and Decreased Mo/Co, Co/Fe 2+ Ratios in Patients with Long-Term Dental Titanium Implants and Amalgams. J Clin Med 2019; 8:jcm8010086. [PMID: 30642082 PMCID: PMC6352171 DOI: 10.3390/jcm8010086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/19/2018] [Accepted: 01/02/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION the biological safety of dental biomaterials has been questioned in human studies. MATERIAL AND METHODS Several heavy metals/oligoelements were compared by Inductive Coupled Mass Spectrometry (ICP-MS) in hair samples from 130 patients (n = 54 patients with long-term titanium dental implants and amalgams (A + I group), 51 patients with long-term dental amalgam alone (A group), as well as controls (n = 25: without dental materials) of similar age. All patients (except controls) had had titanium dental implants and/or dental amalgams for at least 10 years (average: 17). We evaluated whether A + I patients could present higher systemic malondialdehyde levels (MDA) as compared to the A group. RESULTS The A + I group have lower molybdenum levels (A + I) and reduced Mo/Co and Mo/Fe2+ ratios, which could predispose them to oxidative stress by raising MDA levels as compared to the A group alone; our findings suggest that higher Co levels could enhance oxidative stress in the A + I group. However, there were no differences on metals from titanium alloy (Ti-6Al), Cr from crowns or Hg2+, Sn, Zn2+, Cu2+ levels between the A + I and A groups. CONCLUSION patients with long-term dental titanium and amalgams have systemic oxidative stress due to rising MDA levels and lower Mo/Co and Mo/Fe2+ ratios than those with amalgams alone.
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Affiliation(s)
| | | | - Fabio Camacho Alonso
- Full Proffesor of Oral Surgery, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain.
- Hospital General Universitario Morales Meseguer, University of Murcia, 30100 Murcia, Spain.
| | - José Joaquín Merino
- Centro CIROM, Centro de Implantología y Rehabilitación Oral Multidisciplinaria, 30001 Murcia, Spain.
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Mercuri LG, Miloro M, Skipor AK, Bijukumar D, Sukotjo C, Mathew MT. Serum Metal Levels in Maxillofacial Reconstructive Surgery Patients: A Pilot Study. J Oral Maxillofac Surg 2018; 76:2074-2080. [DOI: 10.1016/j.joms.2018.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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Revathi A, Borrás AD, Muñoz AI, Richard C, Manivasagam G. Degradation mechanisms and future challenges of titanium and its alloys for dental implant applications in oral environment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 76:1354-1368. [DOI: 10.1016/j.msec.2017.02.159] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 01/28/2023]
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Tasat DR, Domingo MG, Bruno ME, Guglielmotti MB, Olmedo DG. Titanium Nanoparticle Size Influences Trace Concentration Levels in Skin Appendages. Toxicol Pathol 2017; 45:624-632. [DOI: 10.1177/0192623317711808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As a result of biotribocorrosion, the surface of a titanium (Ti) biomedical device can be a potential source of systemic contamination with Ti nanoparticles (NPs). Although NPs can be chemically similar, differences in particle size may lead to different biological responses. The aim of this experimental study was to determine Ti trace levels in skin appendages and plasma and explore the influence of NP size on trace levels using a murine model. Results showed the presence of Ti traces in the nails, hair, and plasma. The concentration of the smallest NPs (5 Nm) was higher than that of 10 Nm NPs in all the studied samples. Irrespective of NP size, Ti levels were always lower in plasma than in skin appendages. Ti levels were higher in nails than in hair. Ti NPs size influenced trace concentration levels in hair/nails, suggesting that 5 Nm Ti particles are more easily eliminated through these skin appendages. Given that the nails showed the highest levels of Ti, and that these skin appendages are not exposed to agents that can leach out Ti, as occurs with hair, we propose the nails as the most suitable and reliable bioindicator for monitoring systemic contamination with Ti.
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Affiliation(s)
- Deborah R. Tasat
- School of Science and Technology, National University of General San Martín, San Martín, Buenos Aires, Argentina
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Mariela G. Domingo
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Marcos E. Bruno
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - María B. Guglielmotti
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
- National Research Council (CONICET), Buenos Aires, Argentina
| | - Daniel G. Olmedo
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
- National Research Council (CONICET), Buenos Aires, Argentina
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Abstract
Cranioplasty remains a difficult procedure for all craniofacial surgeons, particularly when concerning the reconstruction of large lacunae in the skull. Considering the significant clinical and economic impact of the procedure, the search for materials and strategies to provide more comfortable and reliable surgical procedures is one of the most important challenges faced by modern craniofacial medicine.The purpose of this study was to compare the available data regarding the safety and clinical efficacy of materials and techniques currently used for the reconstruction of the skull. Accordingly, the scientific databases were searched for the following keywords autologous bone, biomaterials, cranial reconstruction, cranioplasty, hydroxyapatite, polyetheretherketone, polymethylmethacrylate, and titanium. This literature review emphasizes the benefits and weaknesses of each considered material commonly used for cranioplasty, especially in terms of infectious complications, fractures, and morphological outcomes.As regards the latter, this appears to be very similar among the different materials when custom three-dimensional modeling is used for implant development, suggesting that this criterion is strongly influenced by implant design. However, the overall infection rate can vary from 0% to 30%, apparently dependent on the type of material used, likely in virtue of the wide variation in their chemico-physical composition. Among the different materials used for cranioplasty implants, synthetics such as polyetheretherketone, polymethylmethacrylate, and titanium show a higher primary tear resistance, whereas hydroxyapatite and autologous bone display good biomimetic properties, although the latter has been ascribed a variable reabsorption rate of between 3% and 50%.In short, all cranioplasty procedures and materials have their advantages and disadvantages, and none of the currently available materials meet the criteria required for an ideal implant. Hence, the choice of cranioplasty materials is still essentially reliant on the surgeon's preference.
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Nanocrystalline β-Ta Coating Enhances the Longevity and Bioactivity of Medical Titanium Alloys. METALS 2016. [DOI: 10.3390/met6090221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wang X, Bai S, Li F, Li D, Zhang J, Tian M, Zhang Q, Tong Y, Zhang Z, Wang G, Guo T, Ma C. Effect of plasma nitriding and titanium nitride coating on the corrosion resistance of titanium. J Prosthet Dent 2016; 116:450-6. [DOI: 10.1016/j.prosdent.2016.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 01/02/2016] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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Mitchell SJ, Jeyapalina S, Nichols FR, Agarwal J, Bachus KN. Negative pressure wound therapy limits downgrowth in percutaneous devices. Wound Repair Regen 2016; 24:35-44. [PMID: 26487170 PMCID: PMC4805517 DOI: 10.1111/wrr.12373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/17/2015] [Indexed: 11/27/2022]
Abstract
Maintenance of a soft tissue seal around percutaneous devices is challenged by the downgrowth of periprosthetic tissues-a gateway to potential infection. As negative pressure wound therapy (NPWT) is used clinically to facilitate healing of complex soft tissue pathologies, it was hypothesized that NPWT could limit downgrowth of periprosthetic tissues. To test this hypothesis, 20 hairless guinea pigs were randomly assigned into four groups (n = 5/group). Using a One-Stage (Groups 1 and 3) or a Two-Stage (Groups 2 and 4) surgical procedure, each animal was implanted with a titanium-alloy subdermal device porous-coated with commercially pure, medical grade titanium. Each subdermal device had a smooth titanium-alloy percutaneous post. The One-Stage procedure encompassed insertion of a fully assembled device during a single surgery. The Two-Stage procedure involved the implantation of a subdermal device during the first surgery, and then three weeks later, insertion of a percutaneous post. Groups 1 and 2 served as untreated controls and Groups 3 and 4 received NPWT. Four weeks postimplantation of the post, the devices and surrounding tissues were harvested, and histologically evaluated for downgrowth. Within the untreated control groups, the Two-Stage surgical procedure significantly decreased downgrowth (p = 0.027) when compared with the One-Stage procedure. Independent of the surgical procedures performed, NPWT significantly limited downgrowth (p ≤ 0.05) when compared with the untreated controls.
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Affiliation(s)
- Saranne J. Mitchell
- Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah
- Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
- Department of Bioengineering, University of Utah Salt Lake City, Utah
| | - Sujee Jeyapalina
- Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah
- Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
- Department of Bioengineering, University of Utah Salt Lake City, Utah
| | - Francesca R. Nichols
- Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah
- Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Jayant Agarwal
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Kent N. Bachus
- Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah
- Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
- Department of Bioengineering, University of Utah Salt Lake City, Utah
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Moser R, Zaccarini F, Moser W, Schrittwieser R, Kerbl R. Metals in Human Gall, Bladder, and Kidney Stones Based on an Electron Microprobe Investigation. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2015; 21:1167-1172. [PMID: 26016509 DOI: 10.1017/s1431927615000690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Several particles of copper accompanied by a few particles of nickel, lead, and a compound composed of selenium containing minor Ni, Si, Cu, and Co were found in human gall, kidney, and bladder stones. The investigated particles occur as tiny grains, <10 µm in size, that are irregularly dispersed in the stones. Therefore, they were studied by scanning electron microscopy and qualitatively analyzed by energy dispersive system. One grain of copper contained a small amount of Ni and Zn, and some grains of nickel proved to contain Cr as trace element. Most of the discovered metals formed a single-phase grain. However, a few grains found in two gallstones were associated with inclusions of calcium and apatite. Based on the results presented in this contribution, we argue that most of the studied metals can be classified as endogenous particles, i.e., directly precipitated from the same fluids that formed their host human stones. This observation suggests that the precipitation and accumulation of metals in some human stones can be considered an efficient way to eliminate them from the human body.
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Affiliation(s)
- Reinhard Moser
- 1LKH-Hospital of Leoben,Vordernbergerstraße 42,A 8700,Leoben,Austria
| | - Federica Zaccarini
- 2Department of Applied Geosciences and Geophysics,University of Leoben,Peter Tunner Str. 5,A 8700,Leoben,Austria
| | - Waltraud Moser
- 3LKH-Hospital of Bruck an der Mur,Tragösserstrasse 1,A 8600,Bruck an der Mur,Austria
| | - Rudolf Schrittwieser
- 3LKH-Hospital of Bruck an der Mur,Tragösserstrasse 1,A 8600,Bruck an der Mur,Austria
| | - Reinhold Kerbl
- 1LKH-Hospital of Leoben,Vordernbergerstraße 42,A 8700,Leoben,Austria
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Whitehead KA, Olivier S, Benson PS, Arneborg N, Verran J, Kelly P. The effect of surface properties of polycrystalline, single phase metal coatings on bacterial retention. Int J Food Microbiol 2015; 197:92-7. [PMID: 25576986 DOI: 10.1016/j.ijfoodmicro.2014.12.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/16/2014] [Accepted: 12/24/2014] [Indexed: 10/24/2022]
Abstract
In the food industry microbial contamination of surfaces can result in product spoilage which may lead to potential health problems of the consumer. Surface properties can have a substantial effect on microbial retention. The surface characteristics of chemically different coatings (Cu, Ti, Mo, Ag, Fe) were defined using white light profilometry (micro-topography and surface features), atomic force microscopy (nano-topography) and physicochemical measurements. The Ag coating had the greatest topography measurements and Fe and Mo the least. Mo was the most hydrophobic coating (lowest γAB,γ(+), γ(-)) whilst Ag was the most hydrophilic (greatest γAB,γ(+), γ(-)). The physicochemical results for the Fe, Ti and Cu coatings were found to lie between those of the Ag and Mo coatings. Microbiological retention assays were carried out using Listeria monocytogenes, Escherichia coli and Staphylococcus aureus in order to determine how surface properties influenced microbial retention. It was found that surface chemistry had an effect on microbial retention, whereas the shape of the surface features and nano-topography did not. L. monocytogenes and S. aureus retention to the surfaces were mostly affected by surface micro-topography, whereas retention of E. coli to the coatings was mostly affected by the coating physicochemistry. There was no trend observed between the bacterial cell surface physicochemistry and the coating physicochemistry. This work highlights that different surface properties may be linked to factors affecting microbial retention hence, the use of surface chemistry, topography or physicochemical factors alone to describe microbial retention to a surface is no longer adequate. Moreover, the effects of surface parameters on microbial retention should be considered individually for each bacterial genus.
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Affiliation(s)
- Kathryn A Whitehead
- School of Health Care Science, Manchester Metropolitan University, Chester St, Manchester M1 5GD, UK; Surface Engineering Group, Manchester Metropolitan University, Chester St, Manchester M1 5GD, UK.
| | - Sebastien Olivier
- Ecole Nationale Superieure des Ingnieurs en Arts Chimiques et Technologies, 118 Route de Narbonne, 31077 Toulouse, Cedex 4, France
| | - Paul S Benson
- School of Health Care Science, Manchester Metropolitan University, Chester St, Manchester M1 5GD, UK
| | - Nils Arneborg
- Department of Food Science, Food Microbiology, Faculty of Science, University of Copenhagen, Denmark
| | - Joanna Verran
- School of Research Enterprise and Development, Manchester Metropolitan University, Chester St, Manchester M1 5GD, UK
| | - Peter Kelly
- Surface Engineering Group, Manchester Metropolitan University, Chester St, Manchester M1 5GD, UK
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Matusiewicz H. Potential release of in vivo trace metals from metallic medical implants in the human body: from ions to nanoparticles--a systematic analytical review. Acta Biomater 2014; 10:2379-403. [PMID: 24565531 DOI: 10.1016/j.actbio.2014.02.027] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/04/2013] [Accepted: 02/13/2014] [Indexed: 02/06/2023]
Abstract
Metal ion release from metallic materials, e.g. metallic alloys and pure metals, implanted into the human body in dental and orthopedic surgery is becoming a major cause for concern. This review briefly provides an overview of both metallic alloys and pure metals used in implant materials in dental and orthopedic surgery. Additionally, a short section is dedicated to important biomaterials and their corrosive behavior in both real solutions and various types of media that model human biological fluids and tissues. The present review gives an overview of analytical methods, techniques and different approaches applied to the measurement of in vivo trace metals released into body fluids and tissues from patients carrying metal-on-metal prostheses and metal dental implants. Reference levels of ion concentrations in body fluids and tissues that have been determined by a host of studies are compiled, reviewed and presented in this paper. Finally, a collection of published clinical data on in vivo released trace metals from metallic medical implants is included.
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Guillemot F. Recent advances in the design of titanium alloys for orthopedic applications. Expert Rev Med Devices 2014; 2:741-8. [PMID: 16293101 DOI: 10.1586/17434440.2.6.741] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To increase an orthopedic implant's lifetime, research trends have included the development of new titanium alloys made of nontoxic elements with suitable mechanical properties (low Young's modulus - high fatigue strength), good workability and corrosion resistance. In accordance with the background on titanium and metallic biomaterials, recent interesting developments in titanium-based biomaterials are reported in this review, with a special emphasis on the design of new metastable beta-titanium alloys for orthopedic applications. In addition, as the concept of titanium alloys can now be regarded as relatively old, having emerged at the beginning of the 1980s, the author suggests some future directions that would permit the emergence of a new generation of titanium implants.
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Affiliation(s)
- Fabien Guillemot
- INSERM U-577 Biomatériaux et Réparation Tissulaire, Université Victor Segalen Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France.
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Evaluation of taper joints with combined fatigue and crevice corrosion testing: comparison to human explanted modular prostheses. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 34:69-77. [PMID: 24268235 DOI: 10.1016/j.msec.2013.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 08/27/2013] [Accepted: 10/09/2013] [Indexed: 11/22/2022]
Abstract
The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses.
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Maho A, Detriche S, Delhalle J, Mekhalif Z. Sol–gel synthesis of tantalum oxide and phosphonic acid-modified carbon nanotubes composite coatings on titanium surfaces. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:2686-97. [DOI: 10.1016/j.msec.2013.02.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 01/14/2013] [Accepted: 02/17/2013] [Indexed: 01/16/2023]
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Serra G, Morais L, Elias CN, Semenova IP, Valiev R, Salimgareeva G, Pithon M, Lacerda R. Nanostructured severe plastic deformation processed titanium for orthodontic mini-implants. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:4197-202. [PMID: 23910333 DOI: 10.1016/j.msec.2013.06.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 10/31/2011] [Accepted: 06/09/2013] [Indexed: 11/29/2022]
Abstract
Titanium mini-implants have been successfully used as anchorage devices in Orthodontics. Commercially pure titanium (cpTi) was recently replaced by Ti-6Al-4V alloy as the mini-implant material base due to the higher strength properties of the alloy. However, the lower corrosion resistance and the lower biocompatibility have been lowering the success rate of Ti-6Al-4V mini-implants. Nanostructured titanium (nTi) is commercially pure titanium that was nanostructured by a specific technique of severe plastic deformation. It is bioinert, does not contain potentially toxic or allergic additives, and has higher specific strength properties than any other titanium applied in medical implants. The higher strength properties associated to the higher biocompatibility make nTi potentially useful for orthodontic mini-implant applications, theoretically overcoming cpTi and Ti-6Al-4V mini-implants. The purposes of the this work were to process nTi, to mechanically compare cpTi, Ti-6Al-4V, and nTi mini-implants by torque test, and to evaluate both the surface morphology and the fracture surface characteristics of them by SEM. Torque test results showed significant increase in the maximum torque resistance of nTi mini-implants when compared to cpTi mini-implants, and no statistical difference between Ti-6Al-4V and nTi mini-implants. SEM analysis demonstrated smooth surface morphology and transgranular fracture aspect for nTi mini-implants. Since nanostructured titanium mini-implants have mechanical properties comparable to titanium alloy mini-implants, and biocompatibility comparable to commercially pure titanium mini-implants, it is suggestive that nanostructured titanium can replace Ti-6Al-4V alloy as the material base for mini-implants.
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Affiliation(s)
- Glaucio Serra
- Fluminense Federal University - Nova Friburgo, Rio de Janeiro, Brazil.
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23
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Matykina E, Arrabal R, Mohedano M, Pardo A, Merino MC, Rivero E. Stability of plasma electrolytic oxidation coating on titanium in artificial saliva. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:37-51. [PMID: 23073838 DOI: 10.1007/s10856-012-4787-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 10/03/2012] [Indexed: 06/01/2023]
Abstract
Bioactive PEO coating on titanium with high Ca/P ratio was fabricated and characterized with respect to its morphology, composition and microstructure. Long-term electrochemical stability of the coating and Ti(4+) ion release was evaluated in artificial saliva. Influence of the lactic acid and fluoride ions on corrosion protection mechanism of the coated titanium was assessed using AC and DC electrochemical tests. The PEO-treated titanium maintained high passivity in the broad range of potentials up to 2.5 V (Ag/AgCl) for up to 8 weeks of immersion in unmodified saliva and exhibited Ti(4+) ion release <0.002 µg cm(-2) days(-1). The high corrosion resistance of the coating is determined by diffusion of reacting species through the coating and resistance of the inner dense part of the coating adjacent to the substrate. Acidification of saliva in the absence of fluoride ions does not affect the surface passivity, but the presence of 0.1 % of fluoride ions at pH ≤4.0 causes loss of adhesion of the coating due to inwards migration of fluoride ions and their adsorption at the substrate/coating interface in the presence of polarisation.
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Affiliation(s)
- E Matykina
- Departamento de Ciencia de Materiales, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain.
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Mg ion implantation on SLA-treated titanium surface and its effects on the behavior of mesenchymal stem cell. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012; 33:1554-60. [PMID: 23827608 DOI: 10.1016/j.msec.2012.12.061] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/16/2012] [Accepted: 12/17/2012] [Indexed: 12/17/2022]
Abstract
Magnesium (Mg) is one of the most important ions associated with bone osseointegration. The aim of this study was to evaluate the cellular effects of Mg implantation in titanium (Ti) surfaces treated with sand blast using large grit and acid etching (SLA). Mg ions were implanted into the surface via vacuum arc source ion implantation. The surface morphology, chemical properties, and the amount of Mg ion release were evaluated by scanning electron microscopy (SEM), Auger electron spectroscopy (AES), Rutherford backscattering spectroscopy (RBS), and inductively coupled plasma-optical emission spectrometer (ICP-OES). Human mesenchymal stem cells (hMSCs) were used to evaluate cellular parameters such as proliferation, cytotoxicity, and adhesion morphology by MTS assay, live/dead assay, and SEM. Furthermore, osteoblast differentiation was determined on the basis of alkaline phosphatase (ALP) activity and the degree of calcium accumulation. In the Mg ion-implanted disk, 2.3×10(16) ions/cm(2) was retained. However, after Mg ion implantation, the surface morphology did not change. Implanted Mg ions were rapidly released during the first 7 days in vitro. The MTS assay, live/dead assay, and SEM demonstrated increased cell attachment and growth on the Mg ion-implanted surface. In particular, Mg ion implantation increased the initial cell adhesion, and in an osteoblast differentiation assay, ALP activity and calcium accumulation. These findings suggest that Mg ion implantation using the plasma source ion implantation (PSII) technique may be useful for SLA-treated Ti dental implants to improve their osseointegration capacity.
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Malkoç S, Öztürk F, Çörekçi B, Bozkurt BS, Hakki SS. Real-time cell analysis of the cytotoxicity of orthodontic mini-implants on human gingival fibroblasts and mouse osteoblasts. Am J Orthod Dentofacial Orthop 2012; 141:419-26. [DOI: 10.1016/j.ajodo.2011.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 12/01/2011] [Accepted: 12/01/2011] [Indexed: 10/28/2022]
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26
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Maho A, Linden S, Arnould C, Detriche S, Delhalle J, Mekhalif Z. Tantalum oxide/carbon nanotubes composite coatings on titanium, and their functionalization with organophosphonic molecular films: a high quality scaffold for hydroxyapatite growth. J Colloid Interface Sci 2012; 371:150-8. [PMID: 22284449 DOI: 10.1016/j.jcis.2011.12.066] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 12/21/2011] [Accepted: 12/22/2011] [Indexed: 11/24/2022]
Abstract
Nowadays, titanium is a very commonly used biomaterial for the preparation of orthopedic and dental implants. Its excellent mechanical and biochemical bulk properties are nevertheless counterbalanced by its propensity to long term degradation in physiological conditions and its weak osseointegrative capacities. In this context, surface modifications can significantly hinder titanium weaknesses. The approach considered in this work relies on the preparation of thin composite coatings based on tantalum oxide and carbon nanotubes by sol-gel process. Tantalum is particularly interesting for its high biocompatibility and bioactivity, as well as its strong resistance to bio-corrosion. Carbon nanotubes are exploited to reinforce the compactness and homogeneity of the coatings, and can act as a favorable factor to strengthen the interaction with bone components by biomimicry. The composite layers are further modified with specific organophosphonic acid molecular films, able to chemically bind the tantalum oxide surface and improve the hydroxyapatite formation process. The characteristics and the qualities of these hybrid inorganic/organic coatings are evaluated by XPS, SEM, TEM, peeling tests, contact angle measurements, and electrochemical characterizations (free potential, polarization curves).
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Affiliation(s)
- A Maho
- Laboratory of Chemistry and Electrochemistry of Surfaces, Facultés Universitaires Notre-Dame de la Paix, Namur, Belgium
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Evaluation of Metal Concentrations in Hair and Nail After Orthognathic Surgery. J Craniofac Surg 2011; 22:68-72. [DOI: 10.1097/scs.0b013e3181f6c456] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Taira M, Kagiya T, Harada H, Sasaki M, Kimura S, Narushima T, Nezu T, Araki Y. Microscopic observations and inflammatory cytokine productions of human macrophage phagocytising submicron titanium particles. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2010; 21:267-275. [PMID: 19644653 DOI: 10.1007/s10856-009-3834-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Accepted: 07/21/2009] [Indexed: 05/28/2023]
Abstract
This study was performed to microscopically observe and measure inflammatory cytokine production by human macrophages phagocytosing submicron titanium (Ti) particles. Observations with secondary electron microscopy (SEM), SEM/electron probe microanalysis (EPMA) and transmission electron microscopy (TEM) indicated that macrophages [phorbol-12-myristate-13-acetate (PMA)-differentiated THP-1 cells] at 24 h in culture actively phagocytosed and accumulated submicron Ti particles in intracellular phagosomes, in which refinement of Ti particles occurred. The macrophages were also cultured for 24 h in four media with and without submicron Ti particles and lipopolysaccharide (LPS; components of bacteria). Whilst neither stimulus reduced cell viability, submicron Ti particles and LPS activation independently and synergistically caused the macrophages to produce three inflammatory cytokines (TNF-alpha, IL-1beta and IL-6) at high levels in the culture supernatants. The inflammatory and osteolysis conditions caused by macrophages phagocytosing submicron Ti particles would be worsened by challenge with LPS in patients wearing Ti prostheses.
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Affiliation(s)
- Masayuki Taira
- Department of Dental Materials Science and Technology, Iwate Medical University School of Dentistry, Morioka, Japan.
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Lee S, Goh BT, Lai SH, Tideman H, Stoelinga PJW, Jansen JA. Peri-implant and systemic release of metallic elements following insertion of a mandibular modular endoprosthesis in Macaca fascicularis. Acta Biomater 2009; 5:3640-6. [PMID: 19481181 DOI: 10.1016/j.actbio.2009.05.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 04/27/2009] [Accepted: 05/21/2009] [Indexed: 11/19/2022]
Abstract
The aim of this study was to assess the release of metal elements from a Ti6Al4V modular endoprosthesis for mandibular reconstruction. Ten monkeys were included, seven of the animals had an endoprosthesis inserted and three served as controls. Mucosa, regional lymph nodes and distant organs, were assessed after the implant had been in place for 12 months, using light (LM) and transmission electron microscopy (TEM) and inductively coupled plasma optical emission spectroscopy (ICP). Blood was also drawn from all animals for elemental analysis using ICP. LM and TEM evaluation showed no detectable metal particles in the mucosa surrounding the endoprosthesis, nor in the regional lymph nodes and distant organs. Blood analysis revealed that titanium and vanadium were detectable in comparable amounts in the test (Ti: 1.63+/-0.54, Va: 0.42+/-0.08) as well as in the control group (Ti: 2.07+/-0.55, Va: 0.37+/-0.07). The amount of aluminum appeared to be higher in the control group (31.77+/-11.67) compared with the test group (20.41+/-9.13), but this difference was not statistically significant. ICP showed that no titanium, vanadium or aluminum was detectable in the mucosa surrounding the endoprosthesis. In addition, no titanium and vanadium were found in the lymph nodes and distant organs using ICP. On the other hand, using ICP, the aluminum content was found to be higher in the right regional lymph nodes and all examined distant organs as compared to the control group (lymph nodes: 11.55+/-22.15 vs. 0.36+/-0.61, lung: 6.24+/-11.28 vs. 1.40+/-2.15, liver: 1.66+/-0.99 vs. 0, kidney: 15.69+/-24.88 vs 0, spleen: 2.75+/-3.09 vs. 0.49+/-0.43). However, only for the kidney and liver the higher amount of aluminum was statistically significant. In conclusion, this study quantified the release of only aluminum in lymph nodes and distant organs, when using a modular endoprosthesis made of Ti-6Al-4V for mandibular reconstruction.
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Affiliation(s)
- S Lee
- Department of Oral and Maxillofacial Surgery, National Dental Centre, Singapore 168938, Singapore.
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de Morais LS, Serra GG, Albuquerque Palermo EF, Andrade LR, Müller CA, Meyers MA, Elias CN. Systemic levels of metallic ions released from orthodontic mini-implants. Am J Orthod Dentofacial Orthop 2009; 135:522-9. [DOI: 10.1016/j.ajodo.2007.04.045] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 04/03/2007] [Accepted: 04/17/2007] [Indexed: 10/20/2022]
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Olmedo D, Duffó G, Cabrini R, Guglielmotti M. Local effect of titanium implant corrosion: an experimental study in rats. Int J Oral Maxillofac Surg 2008; 37:1032-8. [DOI: 10.1016/j.ijom.2008.05.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 12/28/2007] [Accepted: 05/21/2008] [Indexed: 10/21/2022]
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32
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Kimball PM, Flattery M, McDougan F, Kasirajan V. Cellular immunity impaired among patients on left ventricular assist device for 6 months. Ann Thorac Surg 2008; 85:1656-61. [PMID: 18442560 DOI: 10.1016/j.athoracsur.2008.01.050] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Revised: 01/16/2008] [Accepted: 01/17/2008] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sustained maintenance on left ventricular assist device (LVAD) is associated with an increased frequency of severe infections. Although temporary changes in cellular immunity are seen immediately after implantation, the consequence of sustained LVAD treatment on immunity is unknown. METHODS In vitro functional and phenotypic markers of T cell activation and 6 month clinical outcome were compared between patients with > or = 6-month LVAD therapy and heart failure control patients. RESULTS Recipients of LVADs had more infections (45.5% versus 0%; p < 0.05) and mortality (54% versus 16%; p < 0.05) than control patients. T-cell proliferative responses were lower among LVAD recipients than control patients when challenged with phytohemagglutinin (3.4 +/- 4.7 versus 28.5 +/- 19.6; p < 0.01), anti-CD3 (4.3 +/- 4.5 versus 16.4 +/- 17; p < 0.01), and staphylococcal enterotoxin B (7.2 +/- 6.3 versus 26.1 +/- 15.6; p = 0.002). Proliferative hyporesponsiveness among LVAD recipients was not caused by apoptosis (2.6% +/- 2.7% versus 2.7% +/- 2.1%; p = 0.94) or insufficient CD4+ cells (42.1% +/- 11.3% versus 40.2% +/- 7.5%; p = 0.71) relative to control patients. Instead, CD3+ cells from LVAD patients expressed less interleukin 2 (2.5% +/- 1.5% versus 5.2% +/- 3.1%; p = 0.03) and tumor necrosis factor-alpha (6.0% +/- 3.5% versus 25.8% +/- 8.7%; p < 0.001) and more interleukin 10 (5.8% +/- 6.1% versus 2.6% +/- 2.1%; p < 0.05). In addition, suppressive T-regulatory cells were more prevalent in LVAD patients than control patients (12.9% +/- 3.2% versus 1.2% +/- 1.1%; p < 0.001). CONCLUSIONS Cellular immunity is compromised among long-term LVAD recipients because of a downregulatory cytokine imbalance and emergence of suppressive T-regulatory cells.
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Affiliation(s)
- Pam M Kimball
- Department of Surgery, Virginia Commonwealth University Hospitals, Richmond, Virginia 23298, USA.
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Velich N, Kádár B, Kiss G, Kovács K, Réti F, Szigeti K, Garagiola U, Szabó G. Effect of human organism on the oxide layer formed on titanium osteosynthesis plates: a surface analytical study. J Craniofac Surg 2007; 17:1144-9. [PMID: 17119419 DOI: 10.1097/01.scs.0000236441.20592.f7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The question of whether or not to remove the titanium osteosynthesis plates used in maxillofacial surgery is not yet answered. These plates can be left a long time in the organism if there is no harmful interaction between the plates and the organism. The authors examined the properties of the surface oxide layers formed on osteosynthesis titanium plates by subsequent thermal and anodic oxidation, together with the properties of plates removed from patients after three years. Surface analytical method Secondary Ion Mass Spectroscopy (SIMS) was chosen. It was found that inside of the about 200-mum thick oxide on the original plates the concentration of impurities is much lower than near the oxide/titanium interface. On the surface of plates removed from the human body, a C (carbon), Ca (calcium) and P (phosphorus) enrichment was detected, suggesting a biological interaction between the organism and the plate. The passivating layer formed with thermal and anodic oxidation has not changed significantly in three years; it resisted to the corrosive effect of the human organism.
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Affiliation(s)
- Norbert Velich
- Semmelweis University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery and Dentistry, Budapest, Hungary
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Theologie-Lygidakis N, Iatrou I, Eliades G, Papanikolaou S. A retrieval study on morphological and chemical changes of titanium osteosynthesis plates and adjacent tissues. J Craniomaxillofac Surg 2007; 35:168-76. [PMID: 17583522 DOI: 10.1016/j.jcms.2007.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 01/31/2007] [Indexed: 10/23/2022] Open
Abstract
AIM To examine (a) morphological and chemical changes of retrieved titanium osteosynthesis plates, (b) findings in adjacent soft tissues during plate removal and to evaluate possible correlations among the above-mentioned issues. MATERIAL AND METHODS Ninety-four osteosynthesis plates were retrieved, of which 60 were studied and evaluated (including the adjacent soft tissue) in more details, 4-36 months following osteosynthesis in 26 trauma cases, 12 orthognathic and 6 maxillofacial reconstructive cases. Selected clinical parameters during plate removal, were studied. Specialized laboratory methods including light and electron microscopy as well as spectrometry and X-ray microanalysis were used to analyse the retrieved material. RESULTS Plates showed major mechanical changes (scratches, scraping and deformation) without corrosion. Soft tissue inflammation-mainly mild and chronic-was found in 53 of 94 plates removed, a statistically significant percentage. Pigmented deposits in the soft tissues manifested only traces of titanium when analysed elementally. There was no statistically significant correlation between the laboratory findings of plates and tissues, or between plate morphology and clinical findings recorded. CONCLUSIONS According to the findings of this study, inflammation in tissues adjacent to osteosynthesis plates should not be attributed to mechanical changes in the plates. Pigmented tissue deposits were neither found to be titanium to the extent previously reported, nor were they correlated with tissue inflammation. These findings lead to the assumption that titanium plates do not have to be removed to avoid local inflammatory problems.
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Hoffmann B, Feldmann M, Ziegler G. Sol–gel and precursor-derived coatings with cover function on medical alloys. ACTA ACUST UNITED AC 2007. [DOI: 10.1039/b707996f] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Meyer U, Bühner M, Büchter A, Kruse-Lösler B, Stamm T, Wiesmann HP. Fast element mapping of titanium wear around implants of different surface structures. Clin Oral Implants Res 2006; 17:206-11. [PMID: 16584417 DOI: 10.1111/j.1600-0501.2005.01184.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biological probes. A new scanning electron microscopy-energy dispersive spectroscopy detection method was used to map the features of titanium contamination in peri-implant bone around implants with different surface structures. The amount of titanium wear was highest adjacent to titanium-plasma-sprayed surfaces, followed by sandblastered large grid acid-etched and smooth surfaces. A high sensitivity of titanium detection over large areas of bone tissue was observed. A high spatial resolution of titanium wear particles (20 nm) could be reached and correlated to the ultrastructural morphological features of peri-implant tissue. Cells adjacent to titanium wear revealed no signs of morphological alterations on a nanoscale level at early periods of implant/bone interaction. The new technique may serve as a fast and effective tool to evaluate titanium release effects in biological probes.
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Affiliation(s)
- Ulrich Meyer
- Department of Maxillofacial and Plastic Facial Surgery, University of Düsseldorf, Düsseldorf, Germany.
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Zaffe D. Some considerations on biomaterials and bone. Micron 2005; 36:583-92. [PMID: 16169740 DOI: 10.1016/j.micron.2005.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Revised: 05/19/2005] [Accepted: 05/20/2005] [Indexed: 10/25/2022]
Abstract
Osteoinduction is a property not traditionally attributed to Calcium Phosphate ceramics. Histologic, SEM and X-ray microanalyses of a biopsy of pulmonary alveolar microlithiasis allow to discredit this opinion. Bone, even lamellar type, was ectopically formed on microliths undergoing osteoclastic erosion. The SEM and X-ray microanalyses of coral granules implanted in humans indicate an osteoconductive property for both Calcium and Phosphorus. Analysis of in vitro allows to propose an enhancement of the osteocapability of coral. Lamellar bone formation in the near absence of loads undermines the opinion which sees a correlation between lamellar bone and mechanical loads. Analysis of the bone surrounding an uncemented titanium hip prosthesis highlights that both remodeled and newly formed bone have lamellae oriented parallel to prosthesis surfaces, i.e. orthogonal to loads, as opposed to that of lamellar bone of osteons which are oriented parallel to loads. Analysis of longitudinal sections of cortical bone under polarized light points out that lamellae are displaced parallel to the cement line surface both in the conic end of osteons and in Volkman's canals with thick wall, i.e. undergoing sloped load directions. In conclusion, there may be a relationship between lamellae formation and gravity.
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Affiliation(s)
- Davide Zaffe
- Department of Anatomy and Histology, Section of Human Anatomy, University of Modena and Reggio Emilia, 41100 Modena, Italy.
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Bertoldi C, Pradelli JM, Consolo U, Zaffe D. Release of elements from retrieved maxillofacial plates and screws. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2005; 16:857-61. [PMID: 16167115 DOI: 10.1007/s10856-005-3575-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Accepted: 03/07/2005] [Indexed: 05/04/2023]
Abstract
Vitallium appliances and surrounding tissues were investigated to evaluate the release and accumulation of elements. Four microplates, sixteen screws and surrounding tissues were removed from three patients presenting inflammation 4 to 6 years after surgery and were submitted to SEM and X-ray microprobe analysis. Histology was performed on paraffin or PMMA sections of tissues.A continuous release of elements from metallic appliances into soft tissues was observed. Cobalt, chromium, and nickel were detected in soft and boney tissues in close proximity to the appliance. Aluminium, as a component of screw coatings, accumulated in soft tissues, and a remarkable amount of aluminium was detected in the dense lamella of lamellar bone. The results suggest that coatings containing aluminium should be avoided and the time these appliances are allowed to remain in patients should be shortened. Further studies on element release and the fate of aluminium in bone are warranted.
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Affiliation(s)
- C Bertoldi
- Department of Neurosciences, Head-Neck and Rehabilitation, Section of Dentistry and Maxillofacial Surgery, University of Modena and Reggio Emilia, Italy
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Spriano S, Bosetti M, Bronzoni M, Vernè E, Maina G, Bergo V, Cannas M. Surface properties and cell response of low metal ion release Ti-6Al-7Nb alloy after multi-step chemical and thermal treatments. Biomaterials 2005; 26:1219-29. [PMID: 15475051 DOI: 10.1016/j.biomaterials.2004.04.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2004] [Accepted: 04/08/2004] [Indexed: 10/26/2022]
Abstract
Ti-6Al-7Nb samples treated by innovative multi-step chemical and thermal processes were characterized in order to evaluate their surface properties and cell interaction. The main object was to asses if the treatments were effective in order to obtain a surface presenting at the same time bone-like apatite induction ability, low metal ion release, good cell response and high protein binding. The morphology, crystallographic structure, porosity and wettability of the treated materials were investigated, as well as their interaction with simulated body fluid during soaking for different times. Cytotoxicity, protein adsorption tests and in vitro fibroblast and osteoblast-like cell cultures were also performed.
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Affiliation(s)
- Silvia Spriano
- Material Science and Chemical Engineering Department, University of Turin, Turin, Italy.
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Spriano S, Bronzoni M, Vernè E, Maina G, Bergo V, Windler M. Characterization of surface modified Ti-6Al-7Nb alloy. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2005; 16:301-312. [PMID: 15803274 DOI: 10.1007/s10856-005-0628-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2004] [Accepted: 11/17/2004] [Indexed: 05/24/2023]
Abstract
In the last years different types of surface modifications were developed with the aim of improving the osteointegration ability of titanium alloys. The chemical composition, crystallographic structure and morphology of a surface layer can be modified in order to obtain a better interaction between the implant, the cells and the organic fluids. The final goal is to obtain a more efficient bone growth also in critical clinical cases. In the present paper were reported several data about the characterization of the Ti-6Al-7Nb alloy treated by two innovative surface treatments. They consist of blasting, followed by a two step chemical etching and heat treatment performed in air or in vacuum. TEM, XRD and SEM investigations were performed in order to assess the structure and morphology of the modified surfaces. The surface chemical composition was investigated by XPS ad AES analyses. The ability to interact with physiological fluids was tested by immersion of the treated materials in an acellular simulated body fluid (SBF). Metal ion concentration analyses of the fluid and SEM observations of the samples were performed after different times of soaking. The mechanical characterization involved scratch and fatigue tests. The surface of treated samples shows chemical, structural and morphological modifications. The passivation pre-treatment has influence on the surface modification. The treated samples evidenced a quite low metal ion release and interact with SBF solution, showing a moderate bioactivity. A relevant decrease in fatigue strength was observed on modified samples.
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Affiliation(s)
- S Spriano
- Material Science and Chemical Engineering Department, Politecnico di Torino, Italy.
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Zaffe D, Bertoldi C, Consolo U. Accumulation of aluminium in lamellar bone after implantation of titanium plates, Ti-6Al-4V screws, hydroxyapatite granules. Biomaterials 2004; 25:3837-44. [PMID: 15020159 DOI: 10.1016/j.biomaterials.2003.10.020] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2003] [Accepted: 10/07/2003] [Indexed: 11/16/2022]
Abstract
Titanium plates, Ti6Al4V screws and surrounding tissues, and biopsies of hydroxyapatite (Osprovit) grafts of maxillary sinus lifting were investigated to evaluate the release and accumulation of ions. Optical microscopy, SEM and X-ray microanalysis were carried out to evaluate the plates and screws removed from patients presenting inflammation and biopsies. Ions release from metallic appliances or leaching from granules towards soft tissues was observed. An accumulation of aluminium but not titanium was found in soft tissues. A peculiar accumulation of aluminium in the dense lamella of newly formed bone was recorded. The results seem to indicate that biological perturbations may be related to aluminium release from the tested biomaterials. The aluminium content of these biomaterials, its diffusion and accumulation are discussed. Further studies on ion release from biomaterials and aluminium fate in skeletal tissues are suggested.
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Affiliation(s)
- Davide Zaffe
- Department of Anatomy, Section of Human Anatomy, University of Modena and Reggio Emilia, Via del Pozzo 71, Policlinico, 41100 Modena, MO, Italy.
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