Contamination of titanium dental implants: a narrative review

Abstract

Contamination of titanium dental implants may lead to implant failure. There are two major types of contaminants: the inorganic and organic contaminants. The inorganic contaminants mostly consist of elements such as calcium, phosphorus, chlorine, sulphur, sodium, silicon, fluorine and some organic carbons. Whereas organic contaminants consist of hydrocarbon, carboxylates, salts of organic acids, nitrogen from ammonium and bacterial cells/byproducts. Contaminants can alter the surface energy, chemical purity, thickness and composition of the oxide layer, however, we lack clinical evidence that contaminations have any effect at all. However, surface cleanliness seems to be essential for implant osseointegration.These contaminants may cause dental implants to fail in its function to restore missing teeth and also cause a financial burden to the patient and the health care services to invest in decontamination methods. Therefore, it is important to discuss the aetiology of dental implant failures. In this narrative review, we discuss two major types of contaminants: the inorganic and organic contaminants including bacterial contaminants. This review also aims to discuss the potential effect of contamination on Ti dental implants.

Assessing the Efficacy of Whole-Body Titanium Dental Implant Surface Modifications in Inducing Adhesion, Proliferation, and Osteogenesis in Human Adipose Tissue Stem Cells

“…A large body of evidence asserts that many contaminants, being either metallic or nonmetallic, such as C, Mg, Fe, Al, Ca, P, Sr, and F, are introduced onto the implant surface voluntarily (commercially pure titanium grades and titanium alloys) or, in spite of the strict control measures, during the manufacturing process or handling [ 19 , 46 , 47 ]. We previously demonstrated that machined and laser micro-patterned treatments showed no traceable surface impurity or modification, whereas “sandblasting” introduced elemental traces of C, Fe, Al, and O [ 48 ], thus chemically impacting the surface, changing its composition, and influencing the tissue and cell activity [ 19 , 46 , 47 ]. Another factor that has to be taken into account is the fact that any approach to modifying the surface roughness alters the surface chemistry, finally altering the protein adsorption/adhesion, i.e., Ca 2+ and Mg 2+ [ 12 ].…”

Surface Functionalisation of Dental Implants with a Composite Coating of Alendronate and Hydrolysed Collagen: DFT and EIS Studies

“…The results revealed the presence of inorganic and organic contaminants on many implants. To ensure appropriate implant’s surface characteristics, manufacturers use various surface treatments and processes such as high-temperature acid etching, anodising, sand and grit blasting, plasma spraying, or surface polishing [ 5 , 6 , 7 , 8 ]. For example, some studies have shown that rough implant surfaces favour the proliferation of bone-forming cells, or osteoblasts [ 7 , 8 , 9 ], which is why surface treatment with Al 2 O 3 particles as abrasive agents is commonly used.…”

Improved Adsorption of the Antimicrobial Agent Poly (Hexamethylene) Biguanide on Ti-Al-V Alloys by NaOH Treatment and Impact of Mass Coverage and Contamination on Cytocompatibility

“…While water contact angles on freshly cleaned TiO 2 are usually reported in the range of 15 • -30 • or below, air-exposed and untreated samples can give readings in the range of 40 • -60 • and higher [5,6]. Both, inorganic and organic contamination can lead to implant failure by reducing cell attachment leading to impaired osseointegration [7]. It is therefore of interest to prepare the surface of a Ti6Al4V implant, so that the interface properties remain persistent, as they were tested and the surface is protected from being subsequently altered.…”