Effect of the Size of Titanium Particles Released from Dental Implants on Immunological Response

Callejas, Juan Antonio; Mur, Francisco Javier Gil; Brizuela-Velasco, Aritza; Pérez, Román A.; Bosch, Begoña M.

doi:10.3390/ijms23137333

Cited by 11 publications

(3 citation statements)

References 49 publications

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“…It appears that titanium particles do not tend to be encapsulated in the tissues around dental implants, but instead migrate through peri-implant tissues causing immune reactions, with smaller particles tending to produce greater toxicity and enhanced pro-inflammatory response ( 125 ). In relation to this, it is known that particles of a diameter smaller than 1 µm, or nanoparticles, generate the most biological toxicity and can induce cellular mutations.…”

Section: Synergistic Activation Of Pro-inflammatory Pathwaysmentioning

confidence: 99%

Osteoimmune regulation underlies oral implant osseointegration and its perturbation

et al. 2023

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In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1–M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.

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Section: Synergistic Activation Of Pro-inflammatory Pathwaysmentioning

confidence: 99%

Osteoimmune regulation underlies oral implant osseointegration and its perturbation

et al. 2023

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“…In addition, it is also important to consider the effect of the size and surface area of the released particles which has been demonstrated to influence negatively on the biological behavior of the cells [22,[28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty

et al. 2023

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Objectives Our aim is to study titanium remains in a bone model during standardized implantoplasty under different isolation and protective modalities. Material and methods Forty implants were placed in artificial spongy bone blocks mimicking a horizontal bone loss and implant neck protrusion of 5 mm. Samples were randomly divided into four groups (n = 10), which were treated as follows: rubber dam (A), a dental adhesive paste (B), bone wax (C), and an unprotected positive control (D). Implantoplasty was performed using carbide and diamond burs under strict water cooling and standardized suction. After removal of the respective isolation materials, the bone blocks were thoroughly rinsed with tap water for 3 min and titanium chips were collected using a filter integrated in the model. The filter paper was removed and dissolved in 37% hydrochloric acid for 2 h at 120 °C and the titanium remnants were quantified using atomic absorption spectrometry. Results None of the test groups were able to completely prevent titanium particle contamination. Rubber dam (691 ± 249 µg) and bone wax (516 ± 157 µg) were found to be significantly more protective than the positive control (2313 ± 747 µg) (p < 0.001) with respect to the amount of titanium particles that remained in the bone model after implantoplasty. The adhesive paste group (1863.5 ± 538 µg) was not significantly different from the positive control (p = 0.19). Conclusions Despite some limitations of the present study, titanium particles resulting from a standardized implantoplasty can be assumed to be significantly reduced when the tissues/bone were protected with rubber dam and bone wax, or a combination, depending on individual accessibility. Clinical relevance Tissue protective measures to reduce or avoid particle contamination during implantoplasty is possible and should be considered and further clinically assessed to avoid iatrogenic inflammatory reactions.

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“…Despite the progress and reported survival rates of 95% or higher over 5-10 years for titanium oral implants [10], the demand for metal-free alternatives is rising. On the one hand, concerns regarding the potential release of titanium particles exist [11], which may lead to titanium hypersensitivity or titanium allergy [12,13]. On the other hand, aesthetics may be hampered due to the grey color of the titanium, which might be problematic for patients with a thin gingival phenotype in the anterior regions [14].…”

Section: Introductionmentioning

confidence: 99%

Fracture Resistance of a Two-Piece Zirconia Implant System after Artificial Loading and/or Hydrothermal Aging—An In Vitro Investigation

Kohal,

Schikofski,

Adolfsson

et al. 2023

JFB

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The purpose of the present study was to assess the fracture resistance of a two-piece alumina-toughened zirconia implant system with a carbon-reinforced PEEK abutment screw. Methods: Thirty-two implants with screw-retained zirconia abutments were divided into four groups of eight samples each. Group 0 (control group) was neither loaded nor aged in a chewing simulator; group H was hydrothermally aged; group L was loaded with 98 N; and group HL was subjected to both hydrothermal aging and loading in a chewing simulator. One sample of each group was evaluated for t-m phase transformation, and the others were loaded until fracture. A one-way ANOVA was applied to evaluate differences between the groups. Results: No implant fracture occurred during the artificial chewing simulation. Furthermore, there were no statistically significant differences (p > 0.05) between the groups in terms of fracture resistance (group 0: 783 ± 43 N; group H: 742 ± 43 N; group L: 757 ± 86 N; group HL: 740 ± 43 N) and bending moment (group 0: 433 ± 26 Ncm; group H: 413 ± 23 Ncm; group L: 422 ± 49 Ncm; group HL: 408 ± 27 Ncm). Conclusions: Within the limitations of the present investigation, it can be concluded that artificial loading and hydrothermal aging do not reduce the fracture resistance of the investigated implant system.

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Effect of the Size of Titanium Particles Released from Dental Implants on Immunological Response

Cited by 11 publications

References 49 publications

Osteoimmune regulation underlies oral implant osseointegration and its perturbation

Osteoimmune regulation underlies oral implant osseointegration and its perturbation

In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty

Fracture Resistance of a Two-Piece Zirconia Implant System after Artificial Loading and/or Hydrothermal Aging—An In Vitro Investigation

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