Assessment of titanium release following non‐surgical peri‐implantitis treatment: A randomized clinical trial

Abstract

BackgroundPeri‐implantitis is a frequent finding. Initial treatment involves non‐surgical debridement of the implant surface. Recent studies have found a correlation between titanium (Ti) particle release and peri‐implantitis, yet there is a dearth of information regarding the effect of various non‐surgical instrumentation on particle release or peri‐implantitis resolution.Materials and MethodsPatients with peri‐implantitis were recruited for a randomized, blinded, parallel‐group clinical trial. The implants were randomized to treatment composed of Ti curettes (“Mech” group) or implant‐specific treatment composed of rotary polymer microbrushes (“Imp” group). Ti release in submucosal peri‐implant plaque pre‐ and 8 weeks posttreatment was assessed as the primary outcome. Peri‐implant probing depth, bleeding on probing, and suppuration on probing were evaluated and compared between groups.ResultsThirty‐four participants completed treatment; 18 were randomized to the Mech group and 16 to the Imp group. The groups were comparable for Ti levels and probing depths at baseline. A trend was noted for 10‐fold greater Ti dissolution in the Mech group posttreatment compared to the Imp group (p = 0.069). The Imp group had a significant reduction in probing depth posttreatment (p = 0.006), while the Mech group reduction was not significant.ConclusionPeri‐implantitis treated non‐surgically with implant‐specific instruments (Imp group) had a significantly greater decrease in probing depth versus the Mech treatment group. This improvement was linked with a trend for less Ti release to the peri‐implant plaque by the non‐abrasive treatment.

Longitudinal Observation of Micromotion upon Loading of Implant–Abutment Connection

“…Moreover, recent studies have reported that micromotion and fretting wear can break down the Ti passive film, exposing Ti to the action of the surrounding complex media and resulting in the generation of large amounts of debris and continuous release of Ti ions [ 18 ]. A correlation was observed between the release of Ti particles and peri-implantitis [ 19 ]. Micromotion in the IACs can be a risk factor for peri-implantitis in terms of both bacterial and Ti-ion leakage.…”

Correlation between Inflammasomes and Microbiota in Peri-Implantitis

“…While debris from the implant itself may be released to the peri-implant bone, such debris may also be produced at the interface between the prosthesis and the implant or between the implant and the transmucosal abutments [13]. In fact, numerous studies have found titanium particles released from the implants in the surrounding tissues [14][15][16][17][18][19][20][21]. Within this debate, the activation of NLRP3, specifically, may help in finding a biologically plausible explanation for the differences between periodontitis and peri-implantitis.…”

Raising the question of titanium dental implants corrosion and release of titanium ions: discussion of the available evidences and the significance of the phenomenon

“…Згідно результатів отриманих Daubert D. та колегами, рівень розчиненого титану в тканинах, що оточують внутрішньокісткову опору з ознаками периімплантиту, є чинником, що визначає статус периімплантатного ураження та модифікатором мікробіому, корелюючи із його специфічними сигнатурами [32]. Хоча в пізнішому лабораторному дослідженні від 2022 року було встановлено, що ефект релізингу іонів титану значимо не впливає на процес формування біоплівки чи бактеріальну реколонізацію поверхні опори після її очистки [33]. З іншої сторони було констатовано, що саме бактеріальна корозія, включаючи фактор товщини біоплівки, асоційованої з розвитком периімплантиту, провокує виражене зростання вивільнення іонів титану із поверхні імплантату [9,34].…”