1
|
Jain R, Sehdev B, Chaudhari P, Panda S, Verma B, Mishra S, Ghadage M, Mehta M. Pre and post-operative serum levels of titanium cobalt and aluminium after implant placement. Bioinformation 2024; 20:690-694. [PMID: 39131521 PMCID: PMC11312326 DOI: 10.6026/973206300200690] [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: 06/01/2024] [Revised: 06/30/2024] [Accepted: 06/30/2024] [Indexed: 08/13/2024] Open
Abstract
The preoperative serum levels and postoperative serum levels of titanium, cobalt and aluminium from dental implants in order to assess the release of these ions and to assess any risk of toxicity from these ions after dental implant placement is of interest to dentists. It was observed that there was very slight increase in serum concentration of titanium, cobalt and aluminium after 12 months of placement of implants as compared to before placement of implants. However the increase was non-significant statistically. Our study concluded that the use of dental implants does not pose any risk of toxicity of metal ions like titanium, aluminium and cobalt because of very slight non-significant increase in serum levels of these ions 12 months after implant placement.
Collapse
Affiliation(s)
- Richa Jain
- Department of Periodontology, College of Dental Sciences and Hospital, Rau, Indore, M.P., India
| | - Bhumika Sehdev
- Department of Periodontology, RKDF Dental College and Research Center, Bhopal, M.P., India
| | - Pratik Chaudhari
- Department of Periodontology, College of Dental Sciences and Hospital, Rau, Indore, M.P., India
| | - Sanjukta Panda
- Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Binoo Verma
- Department of Prosthodontics Crown & Bridge and Implantology, Bhabha College of Dental Sciences, Bhopal, M.P., India
| | | | - Mahesh Ghadage
- Department of Prosthodontics and Crown & Bridge, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, India
| | - Miral Mehta
- Department of Pedodontics, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| |
Collapse
|
2
|
Altay B, Çoban E. Dental Implant Corrosion Products May Accumulate in the Human Body. J Oral Maxillofac Surg 2024; 82:56-64. [PMID: 37898154 DOI: 10.1016/j.joms.2023.09.022] [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: 06/19/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Corrosion products resulting from the degradation of the dental implant surface due to biological fluids and infection may accumulate in the body and lead to clinical consequences. PURPOSE The primary aim of this study is to measure the accumulation of dental implant corrosion products in the human body and the secondary aim is to estimate the association between corrosion products and fatigue. STUDY DESIGN, SETTING, SAMPLE This study was designed as a prospective cross-sectional and was conducted with patients presenting at to the Department of Oral and Maxillofacial Surgery. The study included patients with Grade IV dental implants made of pure titanium (Ti) at the bone level and Grade V abutments composed of Ti, aluminum (Al), and vanadium (V). Individuals possessing different metallic implants and those prone to metal exposure were not included in the study. Blood and hair samples were procured from each participant and subsequently analyzed. PREDICTOR VARIABLES The predictor variable is implant exposure, and it was divided into 3 groups; Group I, patients with healthy dental implants; Group II, patients with peri-implantitis; Control Group, individuals without dental implants. MAIN OUTCOME VARIABLES The primary outcome variables are Al, Ti, V levels in blood and hair samples and the secondary outcome variable is the fatigue questionnaire score. COVARIATES Age and gender, along with the dental implant number and duration of exposure within the study groups, are utilized as covariates. ANALYSES Groups were compared using the Kruskal-Wallis and Mann-Whitney U-tests. Spearman's correlation coefficient determined relationships between groups, signifying significance with P values <.05. RESULTS The sample consisted of 30 patients aged 18 to 68, with 53% being female and 47% male. The differences among the 3 groups in the median values of blood Ti, V; hair Al, Ti, V; and fatigue questionnaire scores were not statistically significant (P > .05). However, the median blood Al value was statistically higher in Group II (P < .05). CONCLUSIONS AND RELEVANCE While the presence of healthy dental implants may not affect the accumulation of Al, Ti, and V within the body, patients with peri-implantitis exhibited elevated blood Al levels, possibly due to infection influencing the corrosion process.
Collapse
Affiliation(s)
- Berkan Altay
- Assistant Professor, Department Head, Department of Oral and Maxillofacial Surgery, Kırıkkale University, Kırıkkale, Turkey.
| | - Elif Çoban
- Resarch Assistant, Department of Oral and Maxillofacial Surgery, Kütahya Health Sciences University, Kütahya, Turkey
| |
Collapse
|
3
|
Chen L, Tong Z, Luo H, Qu Y, Gu X, Si M. Titanium particles in peri-implantitis: distribution, pathogenesis and prospects. Int J Oral Sci 2023; 15:49. [PMID: 37996420 PMCID: PMC10667540 DOI: 10.1038/s41368-023-00256-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
Collapse
Affiliation(s)
- Long Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zian Tong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Hongke Luo
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yuan Qu
- Zhejiang University-University of Edinburgh Institute, International Campus, Zhejiang University, Haining, China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
| |
Collapse
|
4
|
Ha JY, Eo MY, Sodnom-Ish B, Mustakim KR, Myoung H, Kim SM. Electron microscopic analysis of necrotic bone and failed implant surface in a patient with medication-related osteonecrosis of the jaw. Maxillofac Plast Reconstr Surg 2023; 45:34. [PMID: 37789223 PMCID: PMC10547673 DOI: 10.1186/s40902-023-00402-9] [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: 07/02/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Bisphosphonates (BP), a commonly used medication for various bone diseases, have been known to have severe complications such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). Failure of dental implants has also been found in patients with medication-related osteonecrosis of the jaw (MRONJ). In this study, we analyzed the necrotic bone tissues and the surface of the failed implants removed from the jaw in patients treated with BPs and antiresorptive agents. RESULTS Chronic inflammatory cells with collagen and fibrous tissues and bone sequestrum were shown at 5.0 × , 10.0 × , 20.0 × , and 40.0 × magnified histologic sections in the bone and fibrotic scar tissues removed from patients with MRONJ due to osteonecrosis. Hardened bone tissues with microcracked bony resorbed lacunae were observed in SEM. Unlike the previously published comparative data where immune cells, such as dendritic cells, were found in the failed implant surface, these immune cells were not identified in the BRONJ-related peri-implantitis tissues through the TEM investigations. Furthermore, EDS revealed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, silicon, and sulfur elements were found. CONCLUSION Hardened bone tissues with microcracked bony resorbed lacunae were observed in the SEM findings, which were considered as the main characteristic of the osteonecrosis of the jaw. Immune cells, such as dendritic cells were not identified in the TEM. EDS showed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, and silicon elements were found. Furthermore, it was revealed that sulfur was found, which was considered to be one of the complicated causes of implant failure in patients with BRONJ.
Collapse
Affiliation(s)
- Ji Young Ha
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Kezia Rachellea Mustakim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
- Oral and Maxillofacial Microvascular Reconstruction Lab, Brong Ahafo Regional Hospital, Ghana Health Service, P.O. Box 27, Sunyani, Brong Ahafo, Ghana.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Freitag L, Spinell T, Kröger A, Würfl G, Lauseker M, Hickel R, Kebschull M. Dental implant material related changes in molecular signatures in peri-implantitis - A systematic review and integrative analysis of omics in-vitro studies. Dent Mater 2023; 39:101-113. [PMID: 36526446 DOI: 10.1016/j.dental.2022.11.022] [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: 07/09/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Since peri-implantitis differs clinically and histopathologically from periodontitis, implant wear debris is considered to play a role in the destructive processes. This work aims to systematically review if titanium particles affect oral-related cells through changes in molecular signatures (e.g., transcriptome, proteome, epigenome), thereby promoting peri-implantitis. METHODS Leveraging three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies examining titanium exposure in oral-related cells. After risk of bias assessments, lists of differentially expressed genes, proteins, and results of functional enrichment analyses were compiled. The significance of overlapping genes across multiple studies was assessed via Monte Carlo simulation and their ranking was verified using rank aggregation. RESULTS Out of 2104 screened articles we found 12 eligible publications. A significant overlap of gene expression in oral-related cells exposed to titanium particles was found in four studies. Furthermore, changes in biological processes like immune/inflammatory or stress response as well as toll-like receptor (TLR) and mitogen-activated protein kinase (MAPK) signaling pathways were linked to titanium in transcriptome and proteome studies. Epigenetic changes caused by titanium were detected but inconsistent. CONCLUSION An influence of titanium implant wear debris on the development and progression of peri-implantitis is plausible but needs to be proven in further studies. Limitations arise from small sample sizes of included studies and insufficient publication of re-analyzable data.
Collapse
Affiliation(s)
- Lena Freitag
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Thomas Spinell
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany.
| | - Annika Kröger
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | | | - Michael Lauseker
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY, USA
| |
Collapse
|
7
|
Silva MD, Walton TR, Alrabeah GO, Layton DM, Petridis H. Comparison of Corrosion Products From Implant and Various Gold-Based Abutment Couplings: The Effect of Gold Plating. J ORAL IMPLANTOL 2021; 47:370-379. [PMID: 33263748 DOI: 10.1563/aaid-joi-d-19-00139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study compared titanium (Ti), palladium (Pd), platinum (Pt), and gold (Au) ion release following induced accelerated tribocorrosion from three Au alloy abutment groups coupled with Ti implants over time; investigated contacting surface structural changes; and explored the effect of Au plating. Three abutment groups, G (n = 8, GoldAdapt, Nobel Biocare), N (n = 8, cast UCLA, Biomet3i), and P (n = 8, cast UCLA, Biomet3i, Au plated), coupled with implants (Nobel Biocare), immersed in 1% lactic acid, were cyclically loaded. Ions released (ppb) at T1, T2, and T3, simulating 3, 5, and 12 months of function, respectively, were quantified by inductively coupled plasma mass spectrometry (ICP-MS) and compared. Surface degradation and fretted particle composition after T3 were evaluated with scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDX). ICP-MS data were nonparametric, expressed as medians and interquartile ranges. SEM/EDX showed pitting, crevice corrosion, and fretted particles on the components. Released ion concentrations in all groups across time significantly decreased for Pd (P < .001, median range: 1.70-0.09), Pt (P = .021, 0.55-0.00), and Au (P < .001, 1.01-0.00) and increased for Ti (P = .018, 2.49-5.84). Total Ti release was greater than other ions combined for G (P = .012, 9.86-2.30) and N (P < .001, 13.59-5.70) but not for P (P = .141, 8.21-3.53). Total Ti release did not differ between groups (P = .36) but was less variable across group P. On average, total ion release was 13.77 ppb (interquartile range 8.91-26.03 ppb) across the 12-month simulation. Tribocorrosion of Ti implants coupled with Au abutments in a simulated environment was evidenced by fretted particles, pitting, and crevice corrosion of the coupling surfaces and release of ions. More Ti was released compared with Pd, Pt, and Au and continued to increase with time. Abutment composition influenced ion release. Au-plated abutments appeared to subdue variation in and minimize high-concentration spikes of titanium.
Collapse
Affiliation(s)
- Matilde D Silva
- Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, United Kingdom
| | | | - Ghada O Alrabeah
- Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, United Kingdom.,Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Haralampos Petridis
- Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, United Kingdom
| |
Collapse
|
8
|
Zhou Z, Shi Q, Wang J, Chen X, Hao Y, Zhang Y, Wang X. The unfavorable role of titanium particles released from dental implants. Nanotheranostics 2021; 5:321-332. [PMID: 33732603 PMCID: PMC7961127 DOI: 10.7150/ntno.56401] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Titanium is considered to be a metal material with the best biological safety. Studies have proved that the titanium implanted in the bone continuously releases titanium particles (Ti particles), significantly increasing the total titanium content in human body. Generally, Ti particles are released slowly without causing a systemic immune response. However, the continuous increased local concentration may result in damage to the intraepithelial homeostasis, aggravation of inflammatory reaction in the surrounding tissues, bone resorption and implant detachment. They also migrate with blood flow and aggregate in the distal organ. The release of Ti particles is affected by the score of the implant surface structure, microenvironment wear and corrosion, medical operation wear, and so on, but the specific mechanism is not clear. Thus, it difficult to prevent the release completely. This paper reviews the causes of the Ti particles formation, the damage to the surrounding tissue, and its mechanism, in particular, methods for reducing the release and toxicity of the Ti particles.
Collapse
Affiliation(s)
- Zilan Zhou
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Quan Shi
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jie Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Xiaohang Chen
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Yujia Hao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| |
Collapse
|
9
|
Ion Release from Dental Implants, Prosthetic Abutments and Crowns under Physiological and Acidic Conditions. COATINGS 2021. [DOI: 10.3390/coatings11010098] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ion release from dental implants and prosthetic restoration can affect osteointegration and implant viability over a long period of time. Therefore, the aim of this study was to study the ion release from implants and crowns, with and without intermediate anodized abutments, in two different media, simulating clinical conditions. The implants, intermediate prosthetic abutments and Cr–Co crowns were divided into two groups depending on the media: Hanks’ solution and 1% lactic acid, simulating body fluids and microbiologically conditioned fluids, respectively. The study followed the ISO 10271:2011 and 10993-15:2000 standards modified to simulate the replacement of fluids in the oral environment. The ions’ release was measured by inductively coupled plasma mass spectroscopy (ICP-EOS), and only aluminum, chromium, cobalt, titanium and vanadium were identified. Ion concentration was higher in lactic acid than in Hanks’ solution at all time points (p < 0.05). Only vanadium showed a very low ion release in lactic acid, with no statistically significant differences from the ion release in Hanks’ solution (p = 0.524). Both anodized abutments and the immersion medium influenced the release of ions and affected the corrosion of these structures. The presence of an intermediate anodized abutment also affected ion release, as the level of ions was lower in groups with this component.
Collapse
|
10
|
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.
Collapse
|
11
|
Lützner J, Günther KP, Postler A, Morlock M. Metal Ion Release after Hip and Knee Arthroplasty - Causes, Biological Effects and Diagnostics. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2019; 158:369-382. [PMID: 31820432 DOI: 10.1055/a-0929-8121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
All metal implants in human bodies corrode which results in metal ions release. This is not necessarily a problem and represents for most patients no hazard. However, if a critical metal ion concentration is exceeded, local or rarely systemic problems can occur. This article summarizes the mechanisms of metal ion release and its clinical consequences. Several situations can result in increased metal ion release: metal-on-metal hip arthroplasties with increased wear, increased micromotion at taper interfaces, direct metal-metal contact (polyethylene wear, impingement), erroneously used metal heads after ceramic head fracture. Possible problems are in most cases located close to the concerned joint. Furthermore, there are reports about toxic damage to several organs. Most of these reports refer to erroneously used metal heads in revisions after a broken ceramic head. There is currently no evidence of carcinogenic or teratogenic effects of implants but data is not sufficient to exclude possible effects. Cobalt and chromium blood levels (favorably in whole blood) should be measured in patients with suspected elevated metal ions. According to current knowledge levels below 2 µg/l seem to be uncritical, levels between 2 and 7 µg/l are considered borderline with unknown biological consequences and levels above 7 µg/l indicate a local problem which should be further diagnosed. Metal ion levels always need to be interpreted together with clinical symptoms and imaging results.
Collapse
Affiliation(s)
- Jörg Lützner
- University Center of Orthopaedics and Trauma Surgery, TU Dresden
| | | | - Anne Postler
- University Center of Orthopaedics and Trauma Surgery, TU Dresden
| | | |
Collapse
|
12
|
Alrabeah GO, Knowles JC, Petridis H. Reduction of Tribocorrosion Products When Using the Platform-Switching Concept. J Dent Res 2018; 97:995-1002. [PMID: 29578825 DOI: 10.1177/0022034518765751] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The reduced marginal bone loss observed when using the platform-switching concept may be the result of reduced amounts of tribocorrosion products released to the peri-implant tissues. Therefore, the purpose of this study was to compare the tribocorrosion product release from various platform-matched and platform-switched implant-abutment couplings under cyclic loading. Forty-eight titanium implants were coupled with pure titanium, gold alloy, cobalt-chrome alloy, and zirconia abutments forming either platform-switched or platform-matched groups ( n = 6). The specimens were subjected to cyclic occlusal forces in a wet acidic environment for 24 h followed by static aqueous immersion for 6 d. The amount of metal ions released was measured using inductively coupled plasma mass spectrometry. Microscopic evaluations were performed pre- and postimmersion under scanning electron microscope (SEM) equipped with energy-dispersive spectroscopy X-ray for corrosion assessment at the interface and wear particle characterization. All platform-switched groups showed less metal ion release compared with their platform-matched counterparts within each abutment material group ( P < 0.001). Implants connected to platform-matched cobalt-chrome abutments demonstrated the highest total mean metal ion release (218 ppb), while the least total mean ion release (11 ppb) was observed in the implants connected to platform-switched titanium abutments ( P ≤ 0.001). Titanium was released from all test groups, with its highest mean release (108 ppb) observed in the implants connected to platform-matched gold abutments ( P < 0.001). SEM images showed surface tribocorrosion features such as pitting and bands of fretting scars. Wear particles were mostly titanium, ranging from submicron to 48 µm in length. The platform-matched groups demonstrated a higher amount of metal ion release and more surface damage. These findings highlight the positive effect of the platform-switching concept in the reduction of tribocorrosion products released from dental implants, which consequently may minimize the adverse tissue reactions that lead to peri-implant bone loss.
Collapse
Affiliation(s)
- G O Alrabeah
- 1 Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK.,2 Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK.,3 Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - J C Knowles
- 2 Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK.,4 Institute of Tissue Regeneration Engineering (ITREN) and Department of Nanobiomedical Science and BK21 Plus NBM, Global Research Center for Regenerative Medicine, Dankook University, 518-10 Anseo-dong, Dongnam-gu, Cheonan, Chungcheongnam-do, Republic of Korea.,5 The Discoveries Centre for Regenerative and Precision Medicine, UCL Campus, Gower Street, London, UK
| | - H Petridis
- 1 Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| |
Collapse
|
13
|
Alrabeah GO, Brett P, Knowles JC, Petridis H. The effect of metal ions released from different dental implant-abutment couples on osteoblast function and secretion of bone resorbing mediators. J Dent 2017; 66:91-101. [PMID: 28800964 DOI: 10.1016/j.jdent.2017.08.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/30/2017] [Accepted: 08/02/2017] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The etiology of the reduced marginal bone loss observed around platform-switched implant-abutment connections is not clear but could be related to the release of variable amounts of corrosion products. The present study evaluated the effect of different concentrations of metal ions released from different implant abutment couples on osteoblastic cell viability, apoptosis and expression of genes related to bone resorption. METHODS Osteoblastic cells were exposed to five conditions of culture media prepared containing metal ions (titanium, aluminum, vanadium, cobalt, chromium and molybdenum) in different concentrations representing the amounts released from platform-matched and platform-switched implant-abutment couples as a result of an earlier accelerated corrosion experiment. Cell viability was evaluated over 21days using the Alamar Blue assay. Induction of apoptosis was measured after 24h of exposure using flow cytometry. Expression of interleukin-6, interleukin-8, cyclooxygenase-2, caspase-8, osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (RANKL) by osteoblastic cells were analysed after exposure for 1, 3 and 21days using real-time quantitative polymerase chain reaction assay RESULTS: Metal ions in concentrations representing the platform-matched groups led to a reduction in cell viability (P<0.01) up to 7days of exposure. Stimulated cells showed higher rates of early apoptosis (P<0.01) compared to non-treated cells. Metal ions up-regulated the expression of interleukin-6, interleukin-8, cyclooxygenase-2 and RANKL in a dose dependent manner after 1day of exposure (P<0.05). The up-regulation was more pronounced in the groups containing the corrosion products of platform-matched implant-abutment couples. CONCLUSION Osteoblastic cell viability, apoptosis, and regulation of bone resorbing mediators were significantly altered in the presence of metal ions. The change in cytokine levels expressed was directly proportional to the metal ion concentration. CLINICAL SIGNIFICANCE The observed biological responses to decreased amounts of metal ions released from platform-switched implant-abutment couples compared to platform-matched couples may partly explain the positive radiographic findings in respect to crestal bone level when utilising the "platform-switching" concept, which highlights the possible role of corrosion products in the mediation of crestal bone loss around dental implants.
Collapse
Affiliation(s)
- Ghada O Alrabeah
- Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK; Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,; Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - Peter Brett
- Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - Jonathan C Knowles
- Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - Haralampos Petridis
- Prosthodontic Unit, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK.
| |
Collapse
|
14
|
Noronha Oliveira M, Schunemann WVH, Mathew MT, Henriques B, Magini RS, Teughels W, Souza JCM. Can degradation products released from dental implants affect peri-implant tissues? J Periodontal Res 2017; 53:1-11. [PMID: 28766712 DOI: 10.1111/jre.12479] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2017] [Indexed: 12/13/2022]
Abstract
This study aimed to assess the literature available on the effects, on peri-implant tissues, of degradation products released from dental implants as a consequence of therapeutic treatment for peri-implantitis and/or of wear-corrosion of titanium. A literature review of the PubMed medline database was performed up to December 31, 2016. The following search terms were used: "titanium wear and dental implant"; "titanium corrosion and dental implant"; "bio-tribocorrosion"; "peri-implantitis"; "treatment of peri-implantitis"; "titanium particles release and dental implant"; and "titanium ion release and dental implant". The keywords were applied to the database in different combinations without limits of time period or type of work. In addition, the reference lists of relevant articles were searched for further studies. Seventy-nine relevant scientific articles on the topic were retrieved. The results showed that pro-inflammatory cytokines, infiltration of inflammatory response cells and activation of the osteoclasts activity are stimulated in peri-implant tissues in the presence of metal particles and ions. Moreover, degenerative changes were reported in macrophages and neutrophils that phagocytosed titanium microparticles, and mutations occurred in human cells cultured in medium containing titanium-based nanoparticles. Debris released from the degradation of dental implants has cytotoxic and genotoxic potential for peri-implant tissues. Thus, the amount and physicochemical properties of the degradation products determine the magnitude of the detrimental effect on peri-implant tissues.
Collapse
Affiliation(s)
- M Noronha Oliveira
- Post-graduate Program in Dentistry (PPGO), Center for Research and Education on Dental Implants (CEPID), School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - W V H Schunemann
- Post-graduate Program in Dentistry (PPGO), Center for Research and Education on Dental Implants (CEPID), School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - M T Mathew
- Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA.,Department of Restorative Dentistry, UIC College of Dentistry, Chicago, IL, USA
| | - B Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - R S Magini
- Post-graduate Program in Dentistry (PPGO), Center for Research and Education on Dental Implants (CEPID), School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - W Teughels
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - J C M Souza
- Post-graduate Program in Dentistry (PPGO), Center for Research and Education on Dental Implants (CEPID), School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.,Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA.,Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| |
Collapse
|