Abstract
The objective of this review was to analyze the process of wear of implants leading to the shedding of titanium particles into the peri-implant hard and soft tissues. Titanium is considered highly biocompatible with low corrosion and toxicity, but recent studies indicate that this understanding may be misleading as the properties of the material change drastically when titanium nanoparticles (NPs) are shed from implant surfaces. These NPs are immunogenic and are associated with a macrophage-mediated inflammatory response by the host. The literature discussed in this review indicates that titanium NPs may be shed from implant surfaces at the time of implant placement, under loading conditions, and during implant maintenance procedures. We also discuss the significance of the micro-gap at the implant-abutment interface and the effect of size of the titanium particles on their toxicology. These findings are significant as the titanium particles can have adverse effects on local soft and hard tissues surrounding implants, implant health and prognosis, and even the health of systemic tissues and organs.
Highlights
IntroductionDental implants have become a popular option for the replacement of one or more missing teeth in the oral cavity due to their long-term success rate [1]
The objective of this review was to analyze the process of wear of implants leading to the shedding of titanium particles into the peri-implant hard and soft tissues
The surface damage using ultrasonics has been previously documented in a variety of other studies as well [69,70,71,72,73,74]. These results suggest that the efficacy of ultrasonic scaling of dental implants should be further researched as the resulting titanium wear and implant surface damage may worsen implant health [75]
Summary
Dental implants have become a popular option for the replacement of one or more missing teeth in the oral cavity due to their long-term success rate [1]. To improve osseointegration and biocompatibility while decreasing the rate of implant failure [10] Some of these implants include commercially pure (c.p.) titanium, Titanium. Extensive research concluded that pure titanium and titanium alloys are both highly biocompatible with low toxicity and favorable properties for osseointegration [14] Many of these studies, do not focus on the properties of dental implant materials when they are broken down to smaller particles. Once the titanium particles are shed from the implant surface, they can induce local inflammation They may be transported away from the oral cavity, after which the particles can be found, causing inflammation in distant tissues, with potential systemic involvement [14]. The significance of the size of the particles, and the possible systemic effects the titanium particles can cause following ingestion from the oral cavity will be evaluated
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