Abstract
The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical detrimental effects to the patients. Most studies were performed by in vitro electrochemical tests and complemented with microscopic techniques to evaluate the corrosion behavior of the protective passive oxide film layer, namely TiO2. Results revealed that bacterial accumulation, dietary, inflammation, infection, and therapeutic solutions decrease the pH of the oral environment leading to the corrosion of titanium. Some therapeutic products used as mouthwash negatively affect the corrosion behavior of the titanium oxide film and promote changes on the implant surface. In addition, toothpaste and bleaching agents, can amplify the chemical reactivity of titanium since fluor ions interacting with the titanium oxide film. Furthermore, the number of in vivo studies is limited although corrosion signs have been found in retrieved implants. Histological evaluation revealed titanium macro- and micro-scale particles on the peri-implant tissues. As a consequence, progressive damage of the dental implants and the evolution of inflammatory reactions depend on the size, chemical composition, and concentration of submicron- and nanoparticles in the surrounding tissues and internalized by the cells. In fact, the damage of the implant surfaces results in the loss of material that compromises the implant surfaces, implant-abutment connections, and the interaction with soft tissues. The corrosion can be an initial trigger point for the development of biological or mechanical failures in dental implants.
Highlights
Among the currently available biomedical materials, the long-term success rates of titanium-based dental implants have supported the use of titanium and its alloys to manufacture implants and prosthetic devices [1,2]
The nature, chemical composition, and thickness of the protective oxide layer can be altered in certain environmental conditions, which exposes the titanium to corrosive substances [7,8]
It is well known that the release of metallic ions and oxide particles induce chronic peri-implant inflammations since they act as foreign debris, and stimulate the attraction of macrophages, neutrophils, and T lymphocytes from immune system
Summary
Among the currently available biomedical materials, the long-term success rates of titanium-based dental implants have supported the use of titanium and its alloys to manufacture implants and prosthetic devices [1,2]. The oral environment is a challenge for biomedical metallic materials such as titanium once the pH oscillates due to the variation of acidic substances from dietary, therapeutic solutions, and bacteria metabolism [3,4,5]. Lactic, hydrochloric, and hydrofluoric acids are the main acidic substances responsible for the corrosion of titanium-based implants in the oral environment [3,13,14,15]. The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical adverse effects to the patients. The present work aims to summarize the current data regarding the clinical significance of implant corrosion and how such a phenomenon is widespread in clinical practice
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