Release and detection of dental corrosion products <i>in vivo</i>: Development of an experimental model in rabbits

Reuling, N; Wisser, W.; Jung, Anna Lena; Denschlag, H. O.

doi:10.1002/jbm.820240802

Cited by 19 publications

(8 citation statements)

References 26 publications

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“…The mechanical movement of the implant at every contraction of the muscle will further stimulate the process. A previous report corresponds well with our results showing that intramuscular metal implants liberate metal ions to the surrounding tissue [42].…”

Section: Discussionsupporting

confidence: 93%

Cobalt‐Chromium‐Molybdenum Alloy Causes Metal Accumulation and Metallothionein Up‐Regulation in Rat Liver and Kidney

Jakobsen

Danscher

Stoltenberg

et al. 2007

Basic Clin Pharma Tox

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Cobalt-chromium-molybdenum (CoCrMo) metal-on-metal hip prosthesis has had a revival due to their excellent wear properties. However, particulate wear debris and metal ions liberated from the CoCrMo alloys might cause carcinogenicity, hypersensitivity, local and general tissue toxicity, genotoxicity and inflammation-generating qualities. Nine months after implanting small pieces of CoCrMo alloy intramuscularly and intraperitoneally in rats, we analysed the accumulation of metals with a multi-element analysis, and the levels of metallothionein I/II with real-time reverse transcriptase-polymerase chain reaction in liver and kidney. We found that metal ions are liberated from CoCrMo alloys and suggest that they are released by dissolucytosis, a process where macrophages causes the metallic surface to release metal ions. Animals with intramuscular implants accumulated metal in liver and kidney and metallohionein I/II were elevated in liver tissue. The present data do not tell whether kidney and liver are the primary target organs or what possible toxicological effect the different metal ions might have, but they show that metal ions are liberated from CoCrMo alloys that are not subjected to mechanical wear and that they accumulate in liver and kidney tissue. That the liberated metal ions affect the tissues is supported by an up-regulation of the detoxifying/pacifying metalloprotein I/II in the liver.Second-generation metal-on-metal hip prosthesis is made by cobalt-chromium-molybdenum (CoCrMo) alloy, because it is well-tolerated and possesses excellent wear properties [1,2] (Jakobsen et al., unpublished results). The alloy consists of 62-67% cobalt and 27-30% chrome, but also includes 5-7% molybdenum and all together less than 1% of manganese, iron, nickel and silicon [3]. However, unwanted side effects could be seen as a result of the released metal ions (Cr The number of metal wear particles has been found to be 13 to 500 times higher than the number of wear polyethylene particles released from conventional hip prostheses [6,9]. The large amount of nano-metal particles and the presumed high levels of metal ions in the tissues around hip prostheses have ignited concerns of carcinogenicity [10,11] and Bouchard et al. has previously suggested a carcinogenic effect of implanted CoCrMo (ASTM F-75); however, no differences in urine, faeces and blood metal concentration were observed [16]. Epidemiological studies have shown a possible increased cancer risk, although the data until now has been inconclusive or contradictory [17][18][19][20][21][22]. Particulate wear debris has been found to accumulate in tissue close to the implant, but also in distant lymph nodes, bone marrow, liver and spleen [23], and metal ions have been shown to be excreted in the urine [4] and through the bile [24]. However, it is still not known whether released metal ions accumulate in cells of different organs [25,26].In the present study, we found that the different metal atoms present in the implants were liberated and accumulated in th...

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Section: Discussionsupporting

confidence: 93%

Cobalt‐Chromium‐Molybdenum Alloy Causes Metal Accumulation and Metallothionein Up‐Regulation in Rat Liver and Kidney

Jakobsen

Danscher

Stoltenberg

et al. 2007

Basic Clin Pharma Tox

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“…After 5 months, local concentrations of Ni in the soft tissue capsules ranged from 53 to 120 g/mL (900-2100 mol/L), which is equal to or above the 850 mol/L necessary to cause ICAM-1 expression seen in the current study. Other studies have shown lower levels of Ni around such implants, 19 and these discrepancies are not well understood, except that the pH, 13,18 type of alloy, [13][14][15] and tissue 19 all play a role. The observation in the current study that toxic con- shows that basal levels of ICAM-1 were not detectable with medium alone (Med).…”

Section: Discussionmentioning

confidence: 97%

“…1 The corrosion of Ni-based dental alloys has been well documented in vitro [12][13][14] and in vivo, [15][16][17] particularly if the pH of the corroding solution falls below 6.0, 18 a common condition in the mouth. Implanted Ni-based alloys have been shown to elevate Ni levels locally 15,19 and systemically, 20,21 and cellular damage and an inflammatory response have been noted around these implants. 17,22 The biological liabilities of Ni which is released from dental alloys remain undefined.…”

Section: Introductionmentioning

confidence: 98%

Effect of Ni ions on expression of intercellular adhesion molecule 1 by endothelial cells

Wataha

Sun

Hanks

et al. 1997

J. Biomed. Mater. Res.

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Previous studies have shown that Ni-based alloys implanted into soft tissues cause an infiltration of inflammatory cells around the implant. This phenomenon is potentially important to dental alloys which are adjacent to oral tissues. To help define the mechanisms by which Ni causes an infiltration of inflammatory cells, we exposed endothelial cells in vitro to Ni ions and measured the expression of intercellular adhesion molecule 1 (ICAM-1). ICAM-1 is known to be involved in the recruitment of inflammatory cells from the bloodstream. We also exposed macrophages to Ni ions to test the hypothesis that Ni might alter cytokine secretion and subsequently cause expression of ICAM-1 on endothelial cells. The results showed that Ni ions could promote the expression of ICAM-1 on endothelial cells, but only at concentrations which were high enough (850 mumol/L for 24 h) to suppress cell metabolic activity. Although we had previous evidence that Ni could cause macrophages to secrete cytokines such as interleukin 1 beta, Ni-exposed macrophage supernatants did not induce expression of ICAM-1 on endothelial cells at concentrations subtoxic to the macrophages (85 mumol/L). At subtoxic concentrations, Ni ions were able to suppress ICAM-1 expression on endothelial cells which were stimulated with lipopolysaccharide. Thus, Ni ions either promoted or suppressed the expression of ICAM-1 depending on their concentration. This dual action of Ni ions may be important in vivo where a gradient of concentrations of released ions is likely to exist around the implanted biomaterial. Further studies are necessary to determine the effect of time of exposure and the molecular mechanisms of increased ICAM-1 expression.

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“…Over a period of 17 months all patients (n = 327) scheduled for total hip replacement (THR) were subjected to the exclusion criteria of other metallic implants, dental prostheses with cobalt alloys 24,25 and rheumatoid or osteoarthritis of other major joints. Of the 327 patients, 62 with unilateral osteoarthritis or necrosis of the femoral head satisfied these criteria and consented to be included in the study.…”

Section: Methodsmentioning

confidence: 99%

Elevated Serum Cobalt With Metal-on-Metal Articulating Surfaces

Brodner¹,

Bitzan²,

Meisinger³

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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We determined serum cobalt levels in 55 patients by atomic absorption spectrophotometry before and after implantation of uncemented total hip arthroplasties. In a randomised, prospective trial 27 wrought Co-28Cr-6Mo-0.2C metal-on-metal articulations were compared with 28 ceramic-on-polyethylene hips which did not contain cobalt. Other sources of iatrogenic cobalt loading were excluded. The metal-on-metal group produced detectable serum cobalt levels (median 1.1 g/l after one year) which were significantly different (p < 0.0001) from those of the ceramic-on-polyethylene control group (median below detection limit of 0.3 g/l after one year). Our findings indicate that metal-on-metal bearings generate some systemic release of cobalt.

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Release and detection of dental corrosion products in vivo: Development of an experimental model in rabbits

Cited by 19 publications

References 26 publications

Cobalt‐Chromium‐Molybdenum Alloy Causes Metal Accumulation and Metallothionein Up‐Regulation in Rat Liver and Kidney

Cobalt‐Chromium‐Molybdenum Alloy Causes Metal Accumulation and Metallothionein Up‐Regulation in Rat Liver and Kidney

Effect of Ni ions on expression of intercellular adhesion molecule 1 by endothelial cells

Elevated Serum Cobalt With Metal-on-Metal Articulating Surfaces

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