Titanium Dental Implants

A titanium dental implant is usually made out of an alloy of this metal along with several other metals blended together. The most common alloy used has a ratio of 90 parts titanium, 6 parts aluminum and 4 parts vanadium

titanium implants are putting metal and a high milliamperage close to the brain. i have seen a woman who measured nearly 400 milliamps positive charge, and 30 neg charge who had three in her mouth; she paid $9,000 for them. the dr said she could have ran a stereo off her teeth. we removed them. our body runs on electrical impulses, so this can disrupt them (and brain waves). also, dentists and drs will tell you that bone grows to titanium implants. well, it will grow around it. but, it is a foreign object and the body will build up antibodies to it. over time, it will pull away from the bone and can become loose. if you will notice, they say implants last about 15 years or so. they are working on an implant made of diamond, supposed to be available in 5 yrs. but, it will still be a foreign object and pull away from the bone.

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Risks of Removable Appliance / Denture Bone loss Periodontal problems (irritation of gum tissue) Wear and tear on natural teeth Possible speech problems Will need adjustments regularly Comfort tends to be an issue. Block Bone Graft of my bone from Chin, Jawbone, or Hip (High Risk) Chin This procedure requires cutting through the inside of the bottom lip (he cannot cut along my gum line) and removing the bone from your chin. I do not have enough tissue in my gum area to cover the surgical site. Tissue may be used from underneath the tongue to create the flap. The surgical site needs to be covered for at least four months. There will be a scar in front of my lower teeth and this should not bother me. If you lose sensation because of nerve damage, your muscle tone you should not be affected. You will have 1-2" along the inside of my lower jaw and chin. The area may tingle and burn, but apparently You can get used to this? Also, the surgical sites may open up and need to be addressed with antibiotics, drainage, etc. This block of bone would be held in place with small titanium screws. It will take approx. 6 months to 1 year for these grafts to heal and integrate into your jawbone and the surgical sites will be kept covered with my tissue Place 2 more implants and have all 3 implants functioning separately. It will take approx. 6 months to 1 year for the implants to integrate into my jawbone. Crown all 3 implants separately. Keep yourself strong and healthy and hope that it works for a very long time. Have frequent cleanings (every 3 months). I have decided to not use bone from my face or hip. I will attempt either cadaver or artificial bone grafting.
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2002-2003 Scientific Review - Toxicity of Titanium

Titanium has historically maintained the reputation of being an inert, and relatively biocompatible metal, suitable for use as both a medical and dental prosthesis. There are many articles supporting these beliefs, but more recently, there is scientific evidence that titanium, or its corrosion by-products, may cause harmful reactions after traveling through the circulatory, or lymphatic systems. These corrosion by-products can cause reactions in the blood, fibrotic tissue, and in the osteogenic cells.

Wang (1) has shown that titanium particles can cause the osteogenic differentiation of human bone marrow, stroma-derived mesenchymal stem cells, to be suppressed. It also causes decreased cellular viability, proliferation, and inhibition of the extra cellular matrix mineralization. Decreased cellular viability is caused by apoptosis, and an increase in the level of tumor suppressor proteins.

If removal of an existing implant is being considered, the dental personnel should protect themselves from the inhalation of titanium particles. Bermudez (1) showed an increase in the inflammatory reactions within the lungs, such as increase in macrophage, and neutrophil numbers after long-term exposure. Rehn and Seiler (3) have shown that animals exposed to a single dose of titanium did not show any increase in the amount of inflammatory cells in their lungs, and animals exposed to quartz particles exhibited an increase in the amount of inflammatory responses (quartz particles are found in composites).

Ferreira (4) looked at the short-term effects on the spleen after exposure to titanium. After 72 hours of exposure, the spleen showed alterations in morphology, and irregular features within the capsule and medulla. Namely the T4 and B cells. Alterations in the functioning of T and B cells will effect the functioning of the immune system.

Titanium is found in some root canal sealers, i.e.; AH26 and AH Plus. Miletic (5) found both materials to be cytotoxic at doses larger than 55.7 microg ml. Pulger (6) showed that AH26 did have an oestrogenic effect on breast cancer cells, and therefore recommended that endodontists be careful to avoid the leakage of sealer through the apex during root canal treatment.

A case study reported by Munichor (7) found metallic particles inside an inguinal-pelvic mass adjacent to a total hip titanium replacement, and arthroplasty. The 72-year-old patient developed the right pelvic mass after the hip was replaced. A fine needle biopsy was performed, and the histopathology showed fibro connective tissue with chronic inflammation and marked lymph node sinus histiocytosis.

Coen (8) has stated that particular debris from a titanium metal prosthesis induces genomic instability in primary human fibroblast cells. Wouldn't this also be true for titanium implants in the first molar region?

Watanabe (9) placed macrophages in both a fibrous environment of titanium oxide, and particulate environment. The fibrous TiO (2) macrophages exhibited an increase in LDH release, no apoptosis, but a significant change in cellular vacuolars, and cell surface damage. The conclusion of the study was that titanium oxide toxicity was dependant on the shape of the material.

These results were in accord with the work done by Kumazawa (10) who showed that cytotoxicity was dependant on the Titanium particle size, and that the smaller the size, the more toxic it is.

Wilke (11) also showed the increase in LDH as a sign of increased inflammation when human bone marrow cells were incubated with titanium. The production of osteolytic mediators is responsible for the aseptic loosening of hip prosthesis. This would also be true of dental implants located in areas of high masticatory forces.

In conclusion, titanium and its oxidizing by-products are not as inert and biocompatible as once believed. Advances in research technology are showing changes to immune reaction cells in the blood, and the lungs. These findings should be taken into consideration when deciding whether or not to remove an implant on a particular patient. The dentist should also take precautions for their own safety when removing an implant, or when adjusting a titanium partial with a high-speed drill.

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2.7.6. Titanium

It is generally accepted that pure titanium is extremely well tolerated by local tissues and induces neither toxic nor inflammatory reactions (Branemark et al. 1969, Toth et al. 1985, Linder et al. 1988, Pfeiffer et al. 1994). The normal tissue concentration of titanium in humans is 0.2 ppm. Around the titanium implants no clinical tissue toxicity has been observed even at local concentrations higher than 2000 ppm (Hildebrand et al. 1998). In optimal situations, titanium is able to osseointegrate with bone, thus forming a direct contact with bone at the light microscopy level (Branemark et al. 1969). The good bone contact may be due to the ability of titanium to form a Ca-P rich layer on its surface (Hanawa 1991). Titanium is bacteriostatic (Elagli et al. 1992) and does not significantly activate or inhibit different enzyme systems specific to toxic reactions, e.g. β - glucuronidase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase and acid phosphatase (Elagli et al. 1995). The good biocompatibility and corrosion resistance are due to the naturally forming stable titanium oxide (TiO₂) film on titanium surfaces (Zitter et al. 1987, Kasemo et al. 1991).

Particles from titanium arise from the passivation layer of the implant, but they are not titanium ions, but mostly insoluble titanium oxides or suboxides, which are recognized to be biologically inert. Indeed, the passivation layer is immediately reformed after abrasion because of the high oxidizability of titanium. This behavior protects the alloy and prevents the formation of chemical compounds other than oxides (Hildebrand et al. 1998). Tissue discoloration due to titanium oxide particles is sometimes seen around pure titanium implants, but this seems to have no clinical consequences (Onodera et al. 1993, Rosenberg et al. 1993). Experiments with laboratory animals and some limited analyses of human tissues have also revealed evidence of titanium release into distant tissues (Schliephake et al. 1993, Jorgenson et al. 1997).

Wear particles produced by abrasion appear especially in the vicinity of articular prostheses and implants with certain mobility, e.g. uncemented total hip replacements. These particles may induce multiple tissue reactions, including osteolysis, degradation of normal bone structure, severe macrophagic reactions, granuloma, fibrotic capsules and chronic inflammation, which may cause destabilization and loosening of prostheses and implants (Santavirta et al. 1991, Santavirta et al. 1993, Rubash et al. 1998). Particle size and composition are of essential importance in that process. Deleterious reactions have been reported with Ti-6Al-4V based prostheses (Nasser et al. 1990, Rubash et al. 1998), but not with pure titanium implants.

In vitro, pure titanium particles have also been shown to have some effects on cells. Low concentrations may stimulate fibroblast proliferation, while high concentrations may be toxic. At high particle concentrations, titanium caused a decrease in proteolytic and collagenolytic activity in the culture medium. Titanium also elevated the lysosomal enzyme marker, hexosaminidase, except at high concentrations (Maloney et al. 1993).

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