Peri-implant diseases affecting the surrounding structures of endosseous dental implants include peri-implant mucositis and peri-implantitis. The prevalence of peri-implantitis ranges between 15% and 20% after 10 y, highlighting the major challenge in clinical practice in the rehabilitation of dental implant patients. The widespread nature of peri-implant bone loss poses difficulties in the management of biological complications affecting the long-term success of osseointegrated implant reconstructions. Metal and titanium particles have been detected in peri-implant supporting tissues. However, it remains unclear what mechanisms could be responsible for the elicitation of particle and ion release and whether these released implant-associated materials have a local and/or systemic impact on the peri-implant soft and hard tissues. Metal particle release as a potential etiologic factor has been intensively studied in the field of orthopedics and is known to provoke aseptic loosening around arthroplasties and is associated with implant failures. In dental medicine, emerging information about metal/titanium particle release suggests that the potential impact of biomaterials at the abutment or bone interfaces may have an influence on the pathogenesis of peri-implant bone loss. This mini-review highlights current evidence of metal particle release around dental implants and future areas for research.
AlbrektssonTCanulloLCochranDDe BruynH. 2016. “Peri-implantitis”: a complication of a foreign body or a man-made “disease.” Facts and fiction. Clin Implant Dent Relat Res. 18(4):840–849.
2.
Al-SabbaghMBhavsarI. 2015. Key local and surgical factors related to implant failure. Dent Clin North Am. 59(1):1–23.
3.
American Academy of Periodontology. 2013. Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. J Periodontol. 84(4):436–443.
4.
Apaza-BedoyaKTarceMBenfattiCAHenriquesBMathewMTTeughelsWSouzaJC. 2017. Synergistic interactions between corrosion and wear at titanium-based dental implant connections: a scoping review. J Periodontal Res52(6):946–954.
5.
BelibasakisGN. 2014. Microbiological and immuno-pathological aspects of peri-implant diseases. Arch Oral Biol. 59(1):66–72.
6.
BiancoPDDucheynePCucklerJM. 1996. Local accumulation of titanium released from a titanium implant in the absence of wear. J Biomed Mater Res. 31(2):227–234.
7.
BitarDParviziJ. 2015. Biological response to prosthetic debris. World J Orthop. 6(2):172–189.
CanulloLSchleeMWagnerWCovaniU; Montegrotto Group for the Study of Peri-implant Disease. 2015. International brainstorming meeting on etiologic and risk factors of peri-implantitis, Montegrotto (Padua, Italy), August 2014. Int J Oral Maxillofac Implants. 30(5):1093–1104.
10.
DerksJSchallerDHakanssonJWennstromJLTomasiCBerglundhT. 2016. Peri-implantitis—onset and pattern of progression. J Clin Periodontol. 43(4):383–388.
11.
DerksJTomasiC. 2015. Peri-implant health and disease: a systematic review of current epidemiology. J Clin Periodontol. 42 Suppl16:S158–S171.
EspositoMGrusovinMGWorthingtonHV. 2012. Interventions for replacing missing teeth: treatment of peri-implantitis. Cochrane Database Syst Rev. 1:CD004970.
14.
FranchiMBacchelliBMartiniDPasqualeVDOrsiniEOttaniVFiniMGiavaresiGGiardinoRRuggeriA. 2004. Early detachment of titanium particles from various different surfaces of endosseous dental implants. Biomaterials. 25(12):2239–2246.
15.
FretwurstTBuzanichGNahlesSWoelberJPRiesemeierHNelsonK. 2016. Metal elements in tissue with dental peri-implantitis: a pilot study. Clin Oral Implants Res. 27(9):1178–1186.
16.
FriskenKWDandieGWLugowskiSJordanG. 2002. A study of titanium release into body organs following the insertion of single threaded screw implants into the mandibles of sheep. Aust Dent J. 47(3):214–217.
17.
GrosseSHauglandHKLillengPEllisonPHallanGHølPJ. 2015. Wear particles and ions from cemented and uncemented titanium-based hip prostheses—a histological and chemical analysis of retrieval material. J Biomed Mater Res B Appl Biomater. 103(3):709–717.
18.
HallabNJJacobsJJ. 2009. Biologic effects of implant debris. Bull NYU Hosp Jt Dis. 67(2):182–188.
19.
HarrisWH. 2001. Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res. (393):66–70.
20.
HeXReichlFXWangYMichalkeBMilzSYangYStolperPLindemaierGGrawMHickelRet al. 2016. Analysis of titanium and other metals in human jawbones with dental implants—a case series study. Dent Mater. 32(8):1042–1051.
21.
HjorthMHSøballeKJakobsenSSLorenzenNDMechlenburgIStillingM. 2014. No association between serum metal ions and implant fixation in large-head metal-on-metal total hip arthroplasty. Acta Orthop. 85(4):355–362.
22.
HoltGMurnaghanCReillyJMeekRM. 2007. The biology of aseptic osteolysis. Clin Orthop Relat Res. 460:240–252.
KhanSTAl-KhedhairyAAMusarratJ. 2015. ZnO and TiO2 nanoparticles as novel antimicrobial agents for oral hygiene: a review. J Nanopart Res. 17(6):276.
25.
KlotzMWTaylorTDGoldbergAJ. 2011. Wear at the titanium-zirconia implant-abutment interface: a pilot study. Int J Oral Maxillofac Implants. 26(5):970–975.
26.
LangNPBerglundhT; Working Group 4 of Seventh European Workshop on Periodontology. 2011. Periimplant diseases: where are we now? Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 38 Suppl11:178–181.
27.
LohmannCHSinghGWillertHGBuchhornGH. 2014. Metallic debris from metal-on-metal total hip arthroplasty regulates periprosthetic tissues. World J Orthop. 5(5):660–666.
28.
MagoneKLuckenbillDGoswamiT. 2015. Metal ions as inflammatory initiators of osteolysis. Arch Orthop Trauma Surg. 135(5):683–695.
29.
MarshallARiesMDPaproskyW; Implant Wear Symposium 2007 Clinical Work Group. 2008. How prevalent are implant wear and osteolysis, and how has the scope of osteolysis changed since 2000?J Am Acad Orthop Surg. 16 Suppl1:S1–S6.
30.
MeyerUBühnerMBüchterAKruse-LöslerBStammTWiesmannHP. 2006. Fast element mapping of titanium wear around implants of different surface structures. Clin Oral Implants Res. 17(2):206–211.
31.
MoraschiniVPoubelLAFerreiraVFBarboza EdosS. 2015. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 44(3):377–388.
32.
Obando-PeredaGAFischerLStach-MachadoDR. 2014. Titanium and zirconia particle-induced pro-inflammatory gene expression in cultured macrophages and osteolysis, inflammatory hyperalgesia and edema in vivo. Life Sci. 97(2):96–106.
33.
OlmedoDFernándezMMGuglielmottiMBCabriniRL. 2003. Macrophages related to dental implant failure. Implant Dent. 12(1):75–80.
34.
OlmedoDGNalliGVerduSPaparellaMLCabriniRL. 2013. Exfoliative cytology and titanium dental implants: a pilot study. J Periodontol. 84(1):78–83.
PajarinenJKouriVPJämsenELiTFMandelinJKonttinenYT. 2013. The response of macrophages to titanium particles is determined by macrophage polarization. Acta Biomater. 9(11):9229–9240.
37.
PetterssonMKelkPBelibasakisGNBylundDMolin ThorenMJohanssonA. 2017. Titanium ions form particles that activate and execute interleukin-1beta release from lipopolysaccharide-primed macrophages. J Periodontal Res. 52(1):21–32.
38.
RackARackTStillerMRiesemeierHZablerSNelsonK. 2010. In vitro synchrotron-based radiography of micro-gap formation at the implant-abutment interface of two-piece dental implants. J Synchrotron Radiat. 17(2):289–294.
39.
RenvertSQuirynenM. 2015. Risk indicators for peri-implantitis: a narrative review. Clin Oral Implants Res. 26 Suppl11:15–44.
40.
SafiotiLMKotsakisGAPozhitkovAEChungWODaubertDM. 2017. Increased levels of dissolved titanium are associated with peri-implantitis—a cross-sectional study. J Periodontol. 88(5):436–442.
41.
SchliephakeHReissGUrbanRNeukamFWGuckelS. 1993. Metal release from titanium fixtures during placement in the mandible: an experimental study. Int J Oral Maxillofac Implants. 8(5):502–511.
42.
SennaPAntoninha Del Bel CuryAKatesSMeirellesL. 2015. Surface damage on dental implants with release of loose particles after insertion into bone. Clin Implant Dent Relat Res. 17(4):681–692.
43.
SousaVNibaliLSprattDDopicoJMardasNPetrieADonosN. 2017. Peri-implant and periodontal microbiome diversity in aggressive periodontitis patients: a pilot study. Clin Oral Implants Res. 28(5):558–570.
44.
SridharSAbidiZWilsonTGJrValderramaPWadhwaniCPalmerKRodriguesDC. 2016. In vitro evaluation of the effects of multiple oral factors on dental implants surfaces. J Oral Implantol. 42(3):248–257.
45.
SridharSWilsonTGJrValderramaPWatkins-CurryPChanJYRodriguesDC. 2016. In vitro evaluation of titanium exfoliation during simulated surgical insertion of dental implants. J Oral Implantol. 42(1):34–40.
46.
StimmelmayrMEdelhoffDGuthJFErdeltKHappeABeuerF. 2012. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study. Dent Mater. 28(12):1215–1220.
47.
Suárez-López del AmoFRudekIEWagnerVPMartinsMDO’ValleFGalindo-MorenoPGiannobileWVWangHLCastilhoRM. 2017. Titanium activates the DNA damage response pathway in oral epithelial cells: a pilot study. Int J Oral Maxillofac Implants. 32(6):1413–1420.
48.
WennerbergAIde-EktessabiAHatkamataSSawaseTJohanssonCAlbrektssonTMartinelliASodervallUOdeliusH. 2004. Titanium release from implants prepared with different surface roughness. Clin Oral Implants Res. 15(5):505–512.
49.
WilsonTGJrValderramaPBurbanoMBlansettJLevineRKesslerHRodriguesDC. 2015. Foreign bodies associated with peri-implantitis human biopsies. J Periodontol. 86(1):9–15.
50.
YuTS. 2004. Effect of titanium-ion on the growth of various bacterial species. J Microbiol. 42(1):47–50.
