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Removal of titanium implants from the temporal bone: histologic findings
C T van der Pouw1, C B Johansson, E A Mylanus
1Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands.
The American Journal of Otology
|February 10, 1998
Summary
Histologic examination of bone tissue around removed titanium implants showed increased osseointegration with longer implantation times. However, the cause of persistent pain and its immediate relief after implant removal remained unexplained.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Histopathology
Background:
- Titanium implants are used for bone anchoring, particularly in percutaneous applications.
- Long-standing pain in the implant area led to the removal of three such implants.
- Histologic examination was performed to investigate the bone-to-implant interface and potential causes of pain.
Observation:
- Three patients with titanium implants experienced persistent pain, necessitating implant removal after 8, 18, and 31 months.
- Histologic analysis included qualitative and quantitative assessment of bone tissue surrounding the implants.
- Direct bone-to-metal contact and bone volume within screw threads were measured.
Findings:
- Qualitative histologic findings were similar across all samples.
- Quantitative analysis revealed that osseointegration, measured by direct bone-to-metal contact and bone volume, increased with longer implantation durations.
- No definitive histologic explanation was found for the patients' pain or the immediate pain relief upon implant removal.
Implications:
- Osseointegration of titanium implants is time-dependent.
- The etiology of pain associated with percutaneous bone-anchored implants requires further investigation beyond direct bone-to-implant contact.
- Understanding implant-tissue interactions is crucial for managing complications like chronic pain.