Little is known of the release of trace elements in vivo from dental implant materials. Conflicting data have been reported in the literature as to the levels of trace elements released and their potential consequences, mainly because of sampling and analytical methodological errors. In this study methods for average concentration levels of Al, Cr, Co, Mo, Ni, Ti, and V in organs were developed using rabbit tissue from an in vivo implantation study. At least 50% of the brain, liver, lung, kidney, and spleen were taken minimizing contamination. The tissue was homogenized by cryogenic milling at LN2 temperature and then freeze-dried. Samples were digested in nitric acid and hydrogen peroxide using microwave energy. Standard reference materials were utilized for quality control. One liver sample was analyzed 10 times to assess the method precision. Absorbance values in blanks, standards, and test samples were measured using a Varian GTA 95 graphite furnace and 875 spectrophotometer. Very satisfactory method precision and quality control were recorded. Low or very low levels of the trace elements were found in the various organs.
Background: Titanium is generally considered a safe metal to use in implantation but some studies have suggested that particulate titanium may cause health problems either at the site overlying the implant or in distant organs, particularly after frictional wear of a medical prosthesis. It was the purpose of this investigation to study the levels of dissemination of titanium from threaded screw type implants following placement of single implants in sheep mandibles. Method: Twelve sheep were implanted with a single 10x3.75mm self-tapping implant for time intervals of one, four and eight to 12 weeks. Four unoperated sheep served as controls. Regional lymph nodes, lungs, spleens and livers were dissected, frozen and subsequently analysed by Graphite Furnace Atomic Absorption Spectroscopy. Results: Results associated with successful implants showed no statistically significant different levels of titanium in any organ compared to controls, although some minor elevations in titanium levels within the lungs and regional lymph nodes were noted. Two implants failed to integrate and these showed higher levels of titanium in the lungs (2.2-3.8 times the mean of the controls) and regional lymph nodes (7-9.4 times the levels in controls). Conclusions: Debris from a single implant insertion is at such a low level that it is unlikely to pose a health problem. Even though the number of failed implants was low, multiple failed implants may result in considerably more titanium release which can track through the regional lymph nodes. Results suggest that sheep would be an excellent model for following biological changes associated with successful and failed implants and the effect this may have on titanium release.
Passivation of Ti6Al4V and cpTi implants using methods based on the ASTM-F86 nitric acid protocol are used with the intention of reducing their surface reactivity, and consequently the corrosion potential, in the highly corrosive biologic milieu. The ASTM-F86 passivation protocol was originally developed for surgical implants made of stainless steel and chrome cobalt alloy. Using X-ray photoelectron spectroscopy (XPS) to examine the effect of nitric acid passivation on the surface oxide layer of mill-annealed Ti6Al4V and cpTi, we have found that such treatment actually reduced the oxide thickness on the alloy while having no significant effect on the pure metal. These results correlated with observations obtained using graphite furnace atomic absorption spectrophotometry (GFAAS) to detect trace element release from solid, mill-annealed, Ti6Al4V and cpTi into serum-containing culture medium. We detected significantly greater levels of Ti, Al, and V in the presence of passivated compared to nonpassivated Ti6Al4V. In contrast, nitric acid passivation did not influence Ti release from mill-annealed cpTi. These results, derived from two mill-annealed Ti-based metals, would indicate that re-examination of ASTM-F86-based passivation protocols with respect to Ti6Al4V should be considered in view of the widespread use of this alloy for biomedical devices.
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