[Follow-up examinations after removal of titanium plates coated with anodic titanium oxide ceramic]

Transformation of the titanium metal surface with titanium oxides produced in various ways belongs among the most up-to-date procedures. The authors as pioneers in this field (e.g. Nobel Biocare TiUnite surface), have been utilizing for more than 15 years dental root implants and fixing elements (for mandibular osteosynthesis) coated with titanium oxide ceramics, produced by anodic oxidation and thermal treatment. The aim of this work was to assess the extent to which a titanium oxide ceramic coating influences the fate of plates applied for osteosynthesis within the human body. During a 5-year period (1995-1999), 108 of 1396 titanium oxide ceramic plates had to be removed for various reasons: loosening of the plate [47], osteomyelitis [25], a palpable swelling and tenderness [21] at the request of the patient for psychological reasons (13) or breaking of the plate [2]. When these 108 plates were removed, it was not possible to detect metallosis in even a single case; nor was there any tissue damage that could be attributed to the surface of the plates, whereas the literature data indicate that such damage is relatively frequent in the environment of traditional titanium fixing elements. The present investigation confirms the favourable properties of the titanium oxide ceramic surface.