Dental implants-associated release of titanium particles: A systematic review

Area of Science:

• Biomaterials Science
• Dental Implantology
• Histopathology

Background:

• Titanium (Ti) particles have been observed around dental implants for years.
• The presence and characteristics of Ti debris in surrounding soft tissues require systematic investigation.

Purpose of the Study:

• To evaluate the origin, presence, characteristics, and location of Ti particles in peri-implant tissues.
• To systematically review existing literature on Ti particle detection around dental implants.

Main Methods:

• Systematic literature review adhering to PRISMA guidelines.
• Independent review of 141 identified articles, with 26 selected for analysis.
• Evaluation of anatomical location and suspected release mechanisms of Ti particles.

Main Results:

• Titanium and metal-like particles were detected in soft tissues (epithelial cells, connective tissue, inflammatory cells) and hard tissues (bone crest, bone marrow).
• Particle sizes ranged from 100 nm to 54 µm.
• Higher particle concentrations were found at peri-implantitis sites compared to healthy implants.

Conclusions:

• Titanium particles are a frequent finding in peri-implant tissues.
• Particles are located around implants and within epithelial cells, connective tissue, macrophages, and bone.
• Mechanisms of Ti release include friction, corrosion, implantoplasty, and surface treatments.