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 periimplantitis"; "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. K E Y W O R D Sbio-tribocorrosion, debris, peri-implantitis, titanium ions, wear

Objectives To investigate the role of different levels of pH of artificial saliva under simulated oral environment on the corrosion behavior of commercially pure titanium (cp‐Ti) and Ti‐6Al‐4V alloy. Special attention is given to understand the changes in corrosion kinetics and surface characterization of Ti by using electrochemical impedance spectroscopy (EIS). Materials and methods Fifty‐four Ti disks (15‐mm diameter, 2‐mm thickness) were divided into six groups (n = 9) as a function of saliva pH (3, 6.5, and 9) and Ti type. Samples were mechanically polished using standard metallographic procedures. Standard electrochemical tests, such as open circuit potential, EIS, and potentiodynamic tests were conducted in a controlled environment. Data were evaluated by two‐way ANOVA, Tukey multiple comparison test, and independent t‐test (α = 0.05). Ti surfaces were examined using white‐light‐interferometry microscopy and scanning electron microscopy (SEM). Results Saliva pH level significantly affected the corrosion behavior of both Ti types. At low pH, acceleration of ions exchange between Ti and saliva, and reduction of resistance of Ti surface against corrosion were observed (P < 0.05). Corrosion rate was also significantly increased in acidic medium (P < 0.05). Similar corrosion behavior was observed for both Ti types. The white‐light‐interferometry images of Ti surfaces show higher surface changes at low pH level. SEM images do not show detectable changes. No pitting corrosion was observed for any group. Conclusions The pH level of artificial saliva influences the corrosion behavior of cp‐Ti and Ti‐6Al‐4V alloy in that lower pH accelerates the corrosion rate and kinetics. The corrosion products may mitigate the survival rate of dental implants.

Two-piece implant systems are mainly used in oral implantology involving an osseointegrated implant connected to an abutment, which supports prosthetic structures. It is well documented that the presence of microgaps, biofilms and oral fluids at the implant-abutment connection can cause mechanical and biological complications. The aim of this review paper was to report the degradation at the implant-abutment connection by wear and corrosion processes taking place in the oral cavity. Most of the retrieved studies evaluated the wear and corrosion (tribocorrosion) of titanium-based materials used for implants and abutments in artificial saliva. Electrochemical and wear tests together with microscopic techniques were applied to validate the tribocorrosion behavior of the surfaces. A few studies inspected the wear on the inner surfaces of the implant connection as a result of fatigue or removal of abutments. The studies reported increased microgaps after fatigue tests. In addition, data suggest that micromovements occurring at the contacting surfaces can increase the wear of the inner surfaces of the connection. Biofilms and/or glycoproteins act as lubricants, although they can also amplify the corrosion of the surfaces. Consequently, loosening of the implant-abutment connection can take place during mastication. In addition, wear and corrosion debris such as ions and micro- and nanoparticles released into the surrounding tissues can stimulate peri-implant inflammation that can lead to pathologic bone resorption.

Recently, “tribocorrosion,” a research area combining the science of tribology and corrosion, has drawn attention from scientists and engineers belonging to a wide spectrum of research domains. This is due to its practical impact on daily life and also the accompanying economical burdens. It encompasses numerous applications including the offshore, space, and biomedical industry, for instance, in the case of artificial joints (Total Hip Replacement, THR) in orthopedic surgery, where implant metals are constantly exposed to tribological events (joint articulations) in the presence of corrosive solutions, that is, body fluids. Keeping the importance of this upcoming area of research in biomedical applications in mind, it was thought to consolidate the work in this area with some fundamental aspects so that a comprehensive picture of the current state of knowledge can be depicted. Complexity of tribocorrosion processes has been highlighted, as it is influenced by several parameters (mechanical and corrosion) and also due to the lack of an integrated/efficient test system. Finally a review of the recent work in the area of biotribocorrosion is provided, by focusing on orthopedic surgery and dentistry.

Despite reports of CpTi being electrochemically stable down to pH 2.0, this study suggests degradation peaks at near neutral pH values in the presence of motion. At pH 6.0, the passive film layer, typically protecting the surface of titanium may not be reformed cohesively, resulting in more tribocorrosion products at the surface, which are easily sheared off. These findings elevate concern with regard to dental implants because the average pH of the oral cavity is 6.3.

Despite the technological improvements in orthopedic joint replacement implants, wear and corrosion products associated with the metal components of these implants may result in adverse local tissue and perhaps systemic reactions and toxicities. The current review encompasses a literature review of the local and systemic toxicity studies concerning the effect of CoCrMo wear debris released from wear and corrosion of orthopedic implants and prostheses. Release of metallic debris is mainly in the form of micro- and nano-particles, ions of different valences, and oxides composed of Co and Cr. Though these substances alter human biology, their direct effects of these substances on specific tissue types remain poorly understood. This may partially be the consequence of the multivariate research methodologies employed, leading to inconsistent reports. This review proposes the importance of developing new and more appropriate in-vitro methodologies to study the cellular responses and toxicity mediated by joint replacement wear debris in-vivo.

C(dl), capacitance of double layer; E(corr), corrosion potential; EIS, electrochemical impedance spectroscopy; I(corr), corrosion current density; I(pass), passivation current density; LPS, lipopolysaccharide; OCP, open circuit potential; R(p), polarization resistance; Ti, titanium.

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