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)
24683576Nishimura/20145 to 10 week old mice splenocytesIn vitro study
Key resultsSignificantly 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.
25446332Wachi/2015Rats, used to assess cellular responsesAnimal Model
Key resultsThe 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."
25224174Wilson/201536 human peri-implantitis biopsiesProspective Cohort Study
Key resultsAt 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) 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
None available