Analysis of titanium and other metals in human jawbones with dental implants – A case series study

He, Xiuli; Reichl, Franz‐Xaver; Wang, Yan; Michalke, Bernhard; Milz, Stefan; Yang, Yang; Stolper, Philipp; Lindemaier, G; Graw, Matthias; Hickel, Reinhard; Högg, Christof

doi:10.1016/j.dental.2016.05.012

Cited by 63 publications

(61 citation statements)

References 37 publications

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“…In the current study, the detrimental effect of titanium particles on peri‐implant supporting tissues was described. Several experimental studies have provided evidences that titanium particles will release into peri‐implant tissues inevitably when placed in the oral cavity . The metal particles or ions derive from dental implants in different ways .…”

Section: Discussionmentioning

confidence: 99%

“…Several experimental studies have provided evidences that titanium particles will release into peri-implant tissues inevitably when placed in the oral cavity. 9,27 The metal particles or ions derive from dental implants in different ways. 28 One possible pattern is mainly due to mechanical Noticeably, there are always synergistic interactions between corrosion and wear at titanium-based dental implant connections in most cases.…”

Section: Real-time Pcrmentioning

confidence: 99%

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Macrophage polarization in aseptic bone resorption around dental implants induced by Ti particles in a murine model

Wang

Liu

Feng

et al. 2019

J of Periodontal Research

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Background and Objectives Titanium particles/ions detected in peri‐implant tissues have been considered as a potential etiologic factor for crestal bone loss around oral implants. However, the definite impact of titanium wear particles on the health of surrounding structures remains undetermined. The purpose of this study was to investigate the effects of titanium particles‐induced foreign body reaction on peri‐implant bone level and the related mechanism by using clodronate liposomes to deplete macrophages. Material and Methods Sprague Dawley rats with custom‐made titanium screw implanted in bilateral maxillary first molar area for 4 weeks to obtain osseointegration were randomly divided into four groups. Twenty microgram titanium particles were introduced into the peri‐implant tissue to induce aseptic foreign body reaction, and macrophages were depleted by the local injection of 100 μL clodronate liposome immediately and re‐injection every 3 days until the sacrifice of the rats (Ti + LipClod group). Titanium‐injected rats also treated with phosphate buffer solution (Ti + PBS) or empty liposome (Ti + Lip) as well as rats injected with PBS alone (Control) were included as controls. Eight weeks later, animals were sacrificed and samples containing implants were collected. Half of the samples were analyzed radiologically to measure bone level change, and macrophage markers (CD68, CCR7, CD163) was also characterized by immunofluorescence to evaluate macrophage number, density, and phenotype distribution (CCR7+M1/CD163+M2). The rest of the samples were used to determine the relative mRNA expression levels of TNF‐α, IL‐1β, IL‐6, and RANKL with real‐time PCR analysis. Results No obvious bacterial contamination was found in all titanium‐injected areas, and the implant survival rate was 100% with no implant loss. Compared with Ti + PBS and Ti + Lip group, macrophage density (1.64 ± 0.86%) infiltrated into peri‐implant tissue and bone loss (0.17 ± 0.03 mm) around implant decreased significantly in the Ti + LipClod group. Immunofluorescence analysis showed that more macrophage infiltrated into peri‐implant tissue in the Ti + PBS and Ti + Lip groups, predominantly with M1 phenotype. In contrast, the macrophage density was lower and M2 phenotype was dominant in the Control group, while macrophages density was significantly reduced and the M1 type macrophages were slightly more than M2 type in the Ti + LipClod group. Accordingly, TNF‐α, IL‐1β, IL6, and RANKL mRNA expression increased significantly in the Ti + PBS and Ti + Lip groups compared with Control and Ti + LipClod groups. Conclusions Titanium particles had a negative effect on peri‐implant tissue by activating macrophages which induced an M1 macrophage phenotype promoting local secretion of inflammatory cytokines. It was found that clodronate liposome treatment attenuated the severity of inflammation and bone loss by depletion of macrophages. Therefore, the present study revealed the marked impact of macrophage polarization with respect to peri‐implant bone loss caused...

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Section: Discussionmentioning

confidence: 99%

Section: Real-time Pcrmentioning

confidence: 99%

Macrophage polarization in aseptic bone resorption around dental implants induced by Ti particles in a murine model

Wang

Liu

Feng

et al. 2019

J of Periodontal Research

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“…Titanium (Ti) is the main dental implant material due to its excellent physical‐chemical properties and high biocompatibility with oral tissues . Nonetheless, once exposed to the oral environment, dental implants can be affected by mechanical and chemical degradation processes, such as surface corrosion and wear, which leads to the release and accumulation of Ti particles in the peri‐implant surrounding tissues . In contact with biological fluids, these particles can dissolve and generate Ti ions .…”

Section: Introductionmentioning

confidence: 99%

Titanium particles and ions favor dysbiosis in oral biofilms

Souza

Oliveira

Bertolini

et al. 2019

J of Periodontal Research

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Objective To evaluate the effect of titanium (Ti) particles and ions on oral biofilm growth and composition. Background Particles and ions of Ti released from dental implants can trigger unfavorable biological responses in human cells. However, their effect on oral biofilms composition has not been tested. Methods In this blind in situ study, volunteers wore a palatal appliance containing Ti disks for 7 days to allow biofilm formation. Disks were then collected and biofilms were treated, in vitro, with Ti particles (0.75% and 1%), ions (10 and 20 ppm), or a combination of both (1% particles + 20 ppm ions). Biofilms exposed only to medium was used as control group. After 24 hours, biofilms were collected and analyzed by checkerboard DNA‐DNA hybridization. Direct effects of Ti particles and ions on biofilm/cellular morphology were evaluated by transmission electron microscopy (TEM). Results Ti particles affected biofilm composition, increasing population of four bacterial species (P < .05), while Ti ions showed higher levels of putative pathogens from the orange complex with reduction in species from the yellow complex (P < .05), compared with control. The combination of particles + ions increased green complex and reduced yellow complex proportions (P < .05). TEM showed clusters of particles agglomerated in extracellular environment, while Ti ions were precipitated in both extracellular and intracellular sites. Conclusions Ti products, especially Ti ions, have the potential to change the microbiological composition of biofilms formed on Ti surfaces. Therefore, the presence of Ti products around dental implants may contribute to microbial dysbiosis and peri‐implantitis.

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“…A postmortem study analyzed the levels of titanium and other metallic elements in mandibular bone of four subjects with implants (test group) and six subjects without implants (control group) (He et al, 2016). Titanium levels were three times higher in the test than in the control group (1,940 ± 469 μg/kg-bone vs. 634 ± 58 μg/kg bone weight, respectively).…”

Section: Titanium Particles In Human Peri-implant Tissues and Assocmentioning

confidence: 99%

What is the impact of titanium particles and biocorrosion on implant survival and complications? A critical review

Mombelli

Hashim

2018

Clinical Oral Implants Res

145

137

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Objectives To compile the current evidence regarding the association between the release of titanium particles and biologic complications of dental implants. Material and methods This is a critical review. We searched the literature using the terms “corrosion,” “allergy,” “hypersensitivity,” or “particles” together with “titanium,” “Ti,” “TiO2.” The bibliographies of identified publications and previously published review articles were scanned to find additional related articles. We included clinical studies, in vivo and in vitro experiments. Results Titanium particles and degradation products of titanium have been detected in oral and nonoral tissues. Particles are released from surfaces of dental implants because of material degradation in a process called tribocorrosion. It involves mechanical wear and environmental factors, notably contact to chemical agents and interaction with substances produced by adherent biofilm and inflammatory cells. In vitro, titanium particles can interfere with cell function and promote inflammation. A temporal association between exposure to titanium and occurrence of tissue reactions suggested hypersensitivity in a limited number of cases. However, there is poor specificity as the observed reactions could be initiated by other factors associated with the placement of implants. Titanium particles are commonly detected in healthy and diseased peri‐implant mucosa alike, at low levels even in gingiva of individuals without titanium implants. Rather than being the trigger of disease, higher concentrations of titanium in peri‐implantitis lesions could be the consequence of the presence of biofilms and inflammation. Conclusion There is an association between biocorrosion, presence of titanium particles, and biological implant complications, but there is insufficient evidence to prove a unidirectional causal relationship.

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Analysis of titanium and other metals in human jawbones with dental implants – A case series study

Abstract: Ti released from dental implants can be detected in human mandibular bone and bone marrow tissues, and the distribution of Ti in human bone was related to the distance to the implant.

Cited by 63 publications

References 37 publications

Macrophage polarization in aseptic bone resorption around dental implants induced by Ti particles in a murine model

Macrophage polarization in aseptic bone resorption around dental implants induced by Ti particles in a murine model

Titanium particles and ions favor dysbiosis in oral biofilms

What is the impact of titanium particles and biocorrosion on implant survival and complications? A critical review

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