Titanium particles: An emerging risk factor for peri-implant bone loss

Zoë Berryman; Laura Bridger; Haizal Mohd Hussaini; Alison M. Rich; Momen Atieh; Andrew Tawse-Smith

Saudi Dental Journal (Sep 2020)

Titanium particles: An emerging risk factor for peri-implant bone loss

Zoë Berryman,
Laura Bridger,
Haizal Mohd Hussaini,
Alison M. Rich,
Momen Atieh,
Andrew Tawse-Smith

Affiliations

Zoë Berryman: Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
Laura Bridger: Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
Haizal Mohd Hussaini: Department of Oral Diagnostic and Surgical Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
Alison M. Rich: Department of Oral Diagnostic and Surgical Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
Momen Atieh: Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
Andrew Tawse-Smith: Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Corresponding author at: Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 310 Great King Street, PO Box 56, Dunedin 9054, New Zealand.

Journal volume & issue: Vol. 32, no. 6
pp. 283 – 292

Abstract

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Objective: To investigate the presence of titanium particles in peri-implant tissues in cases diagnosed with peri-implantitis, and to identify immunological reactions that these particles may elicit. Methods: Ten peri-implant tissue biopsies of patients diagnosed clinically and radiographically with peri-implantitis were obtained from the archives of Oral Pathology Centre, University of Otago. The inclusion criteria involves: bleeding on probing, ≥6 mm probing depth and ≥3 mm radiographic bone loss around the dental implant. Peri-implant tissue samples were evaluated using scanning electron microscopy-energy dispersive x-ray spectroscopy (SEM-EDS) to identify of sites with/without titanium particles. Antibodies against human transforming growth factor beta 1 (TGF-β1), receptor activator of nuclear factor kappa-B ligand (RANKL), interleukin 33 (IL-33) and cluster of differentiation 68 (CD68) were used to stain the specimens. ImageJ software was used to standardise the sampling area, compare and characterise the inflammatory infiltrate in tissues with/without titanium particles. Inflammatory cytokines positivity was assessed using the immunoreactive scores (IRSs). Results: Light microscopy and SEM-EDS analysis identified titanium wear particles in 90% of the tissue samples, associated with a mixed chronic inflammatory infiltrate. Quantification analysis of RANKL revealed significantly higher IRS and intensity scores (p < 0.05) in areas containing titanium. High intensity, proportion and IRSs of TGF-β1 and IL-33 were observed in areas with titanium. CD68 had higher IRSs in the absence of titanium particles. Conclusions: Significant overexpression of the cytokine RANKL was observed, with a trend for over-expression of IL-33 and TGF-B1 in areas with titanium. Further studies with large sample size and appropriate control group for quantification analysis is needed to confirm the role of titanium particles in initiating bone loss.

Published in Saudi Dental Journal

ISSN: 1013-9052 (Print); 1658-3558 (Online)
Publisher: Elsevier
Country of publisher: Saudi Arabia
LCC subjects: Medicine: Dentistry
Website: https://www.journals.elsevier.com/saudi-dental-journal/

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