Is titanium alloy Ti‐6Al‐4 V cytotoxic to gingival fibroblasts—A systematic review

Abstract

Objectives: Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts. Materials and methods:A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references.Results: After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies. Conclusion:Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.

Physicochemical and Biological Characterization of Ti6Al4V Particles Obtained by Implantoplasty: An In Vitro Study. Part I

“…Even so, the release of V ions is an undesired event, as it reflects degradation of the alloy. A recent systematic review reported that when Ti6Al4V is affected by corrosion or wear, the release of V and Al particles has a greater cytotoxic effect compared to commercially pure Ti [ 4 ]. However, the amounts of V ions in our sample were relatively small (parts per billion [ppb]).…”

“…The first is that several studies report that shear or wear debris from this alloy can trigger an inflammatory reaction that can lead to osteolysis and loss of the prosthesis. Another issue of this alloy is of potential V ion releasing, which can be toxic to the human body [ 3 , 4 ]. Besides, this alloy has some disadvantages such as low surface hardness, low fatigue strength, low wear properties and high coefficient of friction [ 5 ].…”

The advances in nanomedicine for bone and cartilage repair

“…The corrosion products can induce cell death and potential immune response. For instance, the Ti6Al4V alloy contains toxic vanadium (the effects of vanadium compounds have been described as carcinogenic, immunotoxic and neurotoxic, and it has been reported that metal particles less than 10 µm in diameter can be internalized by cells, potentially triggering cytotoxicity, chromosomal damage and oxidative stress) can lead to the failure of the implants [ 179 ]. Therefore, in order to improve the osseointegration of Ti alloy, researchers have developed several methods to optimize the implants.…”

Diffusion of Vanadium Ions in Artificial Saliva and Its Elimination from the Oral Cavity by Pharmacological Compounds Present in Mouthwashes

“…However, as they are inserted into the oral cavity, they can be subjected to corrosion and wear phenomena, with consequent release of metal ions into the human body [ 4 , 5 , 6 ]. These released metal ions and particles may have deleterious systemic and local effects; for instance, they are related to the failure of implant-supported oral rehabilitations and thus matter of concern for the scientific community [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”