Abstract
Diabetes and infections are associated with a high risk of implant failure. However, the effects of such conditions on the electrochemical stability of titanium materials remain unclear. This study evaluated the corrosion behavior of a Ti-6Al-4V alloy, with a smooth surface or conditioned by double-acid-etching, in simulated body fluid with different concentrations of dextrose and lipopolysaccharide. For the electrochemical assay, the open-circuit-potential, electrochemical impedance spectroscopy, and potentiodynamic test were used. The disc surfaces were characterized by scanning electron microscopy and atomic force microscopy. Their surface roughness and Vickers microhardness were also tested. The quantitative data were analyzed by Pearson's correlation and independent t-tests (α = 0.05). In the corrosion parameters, there was a strong lipopolysaccharide correlation with the Ipass (passivation current density), Cdl (double-layer capacitance), and Rp (polarization resistance) values (p<0.05) for the Ti-6Al-4V alloy with surface treatment by double-acid-etching. The combination of dextrose and lipopolysaccharide was correlated with the Icorr (corrosion current density) and Ipass (p<0.05). The acid-treated groups showed a significant increase in Cdl values and reduced Rp values (p<0.05, t-test). According to the topography, there was an increase in surface roughness (R2 = 0.726, p<0.0001 for the smooth surface; R2 = 0.405, p = 0.036 for the double-acid-etching-treated surface). The microhardness of the smooth Ti-6Al-4V alloy decreased (p<0.05) and that of the treated Ti-6Al-4V alloy increased (p<0.0001). Atomic force microscopy showed changes in the microstructure of the Ti-6Al-4V alloy by increasing the surface thickness mainly in the group associated with dextrose and lipopolysaccharide. The combination of dextrose and lipopolysaccharide affected the corrosion behavior of the Ti-6Al-4V alloy surface treated with double-acid-etching. However, no dose-response corrosion behavior could be observed. These results suggest a greater susceptibility to corrosion of titanium implants in diabetic patients with associated infections.
Highlights
Diabetes is a disorder marked by abnormal lipid and glucose metabolism, often with serious complications leading to premature death [1], and it is considered a public health concern worldwide [2]
Regions of active-passive transition were observed in the cyclic polarization curves of the Ti-6Al-4V alloys in the control group (SBF) and for all tested groups (Fig 1)
The formation of negative hysteresis was obvious in the curves, as indicated by arrows, which enables us to state that the passive layer formed is strong and uniform, and that Ti in the presence of dextrose and/or LPS is not susceptible to corrosion by pits or cracks
Summary
Diabetes is a disorder marked by abnormal lipid and glucose metabolism, often with serious complications leading to premature death [1], and it is considered a public health concern worldwide [2]. According to the Centers for Disease Control and Prevention, 10.9 million (26.9%) people aged $65 years and 215,000 people younger than 20 years old had diabetes in the United States in 2010, with estimated annual treatment costs of $174 billion [3]. Periodontal diseases such as periodontitis are two and a half times more likely to occur in individuals with diabetes than in those without it [4]. P. gingivalis and other Gram-negative bacteria produce lipopolysaccharide (LPS), located in the bacterial cell walls [12,13], and its presence dictates the prognosis of implant treatment [12,13,14,15]
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