Title

Titanium Ions May Contribute to Inflammation and Resulting Peri-Implantitis in Patients

Clinical Question

Do titanium ions from dental implants cause or increase the severity of inflammation associated with peri-implantitis?

Clinical Bottom Line

All studies found titanium ions to be associated with inflammatory factors and cytokine production. However, no studies have found a definitive answer for the exact mechanism for the introduction of titanium ions or their role in the peri-implantitis. Further research is warranted to determine their potential role in the etiology and pathogenesis of peri-implantitis.

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
24683576	Nishimura/2014	5 to 10 week old mice splenocytes	In vitro study
Key results	Significantly higher values for cytokine production were observed in the presence of titanium ions. After the two groups were analyzed (one with Ti ions and the other without), the study suggests that titanium ions enhance cytokine production induced by periodontopathic bacterial lipopolysaccharide (LPS) in splenocytes.
25446332	Wachi/2015	Rats, used to assess cellular responses	Animal Model
Key results	The data from the study suggests that titanium ions may be "responsible for the infiltration of monocytes and osteoclast differentiation by increasing the sensitivity of gingival epithelial cells to microorganisms in the oral cavity."
25224174	Wilson/2015	36 human peri-implantitis biopsies	Prospective Cohort Study
Key results	At the scanning electron microscope level, "the predominant foreign bodies found were titanium and dental cement" in the inflammatory lesion areas. These two foreign materials "were surrounded by inflammatory cells."

Evidence Search

(implantitis) OR (titanium ions) OR (inflammation) OR (cytokine)

Comments on
The Evidence

Validity: Very few of the studies looking at the influence of Ti ions on implantitis deal with humans. The research showing the potential pathways in animals has been demonstrated, but definitive research in humans has not yet been performed.

Applicability

Currently, titanium implants are the most commonly used type, and failures appear to occur infrequently. The role of Ti ions in clinical complications remains to be determined.

Specialty

(General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)

Keywords

Dental implants, peri-implantitis, titanium ions

ID#

2904

Date of submission

04/13/2015

E-mail

todda@livemail.uthscsa.edu

Author

Austin Todd

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Thomas Oates, DMD, PhD

Faculty mentor e-mail

oates@utshsca.edu

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

None available