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Dissolution of titanium wear particles in the oral environment, and their accumulation in the surrounding tissues have been associated with failure of dental implants (DI). The goal of this study is to investigate the effect of mechanical forces involved in surgical insertion of DI on surface wear and metal particle generation. It was hypothesized that mechanical factors associated with implant placement can lead to the generation of titanium particles in the oral environment. The testing methodology for surface evaluation employed simulated surgical insertion, followed by removal of DI in different densities of simulated bone material. Torsional forces were monitored for the insertion and removal of DI. The surface of the simulated bone materials was inspected with optical microscopy to detect traces of metallic particles that may have been generated during the procedure. Further characterization of the composition of powders collected from osteotomy cavities was conducted with powder X-ray diffraction. The results showed that the different densities of simulated bone material affected the torsional forces associated with implant insertion. However, the mechanical factors involved in the implant insertion/removal procedure did not generate wear particles, as confirmed by powder X-ray experiments.
Key Words: dental implant, titanium, peri-implantitis
ABBREVIATIONS
DI: dental implants
PCF: pounds per cubic foot
Ti: titanium
XRD: X-ray diffraction
INTRODUCTION
The ability of titanium to osseointegrate propelled the titanium (Ti) dental implants (DI) industry into accelerated development and commercial success.1 In the United States, approximately 500 000 patients undergo surgical insertion of DI every year2 with reported success rates of about 95%.3 It has been demonstrated that the success of an implant depends on bone quality and volume, peri-implant clinical parameters, and implant stability.4,5 It can be noted that bone quality and degree of surgical trauma correlate with biological failure of implants.6 Higher ratio of compact to trabecular bone in the mandible leads to higher survival rates of implants inserted in the anterior mandible than in the maxilla.7 In addition, bone density along the same jaw can vary considerably. For example, the density of bone in the mandible is reported to vary from 0.31 g/cm3 to 0.55 g/cm3.8 Clinical failures of dental implants have also been associated with early postsurgical stages where blood supply, bone healing, and primary stability play key roles.9
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