Is Titanium Alloy Ti-6Al-4 V Cytotoxic to Gingival Fibroblasts-A Systematic Review

Overview

Journal Clin Exp Dent Res

Publisher Wiley

Specialty Dentistry

Date 2021 May 21

PMID 34018703

Citations 12

Authors

Jonathan Willis

Siwei Li

St John Crean

Fadi N Barrak

Affiliations

Soon will be listed here.

Abstract

Objectives: Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts.

Materials And Methods: A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references.

Results: After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies.

Conclusion: Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.

Citing Articles

Impact of topography and added TiN-coating on adult human dermal fibroblasts after seeding on titanium surface in-vitro.

Hauschild G, Hardes J, Dudda M, Streitburger A, Wahrenburg M J Biomater Appl. 2024; 38(8):905-914.

PMID: 38358702 PMC: 10893772. DOI: 10.1177/08853282241233194.

Biocompatibility and osseointegration properties of a novel high strength and low modulus β- Ti10Mo6Zr4Sn3Nb alloy.

Liu J, Wang K, Li X, Zhang X, Gong X, Zhu Y Front Bioeng Biotechnol. 2023; 11:1127929.

PMID: 36865033 PMC: 9972097. DOI: 10.3389/fbioe.2023.1127929.

Investigation of the Wetting Properties of Thalassemia Patients' Blood Samples on Grade 5 Titanium Implant Surfaces: A Pilot Study.

Temelci A, Yilmaz H, Unsal G, Uyanik L, Yazman D, Ayali A Biomimetics (Basel). 2023; 8(1).

PMID: 36648811 PMC: 9844454. DOI: 10.3390/biomimetics8010025.

Comparison of the Biological Behavior and Topographical Surface Assessment of a Minimally Invasive Dental Implant and a Standard Implant: An In Vitro Study.

Attik N, Phantarasmy M, Abouelleil H, Chevalier C, Barraco A, Grosgogeat B Materials (Basel). 2022; 15(21).

PMID: 36363140 PMC: 9655689. DOI: 10.3390/ma15217540.

Evaluation of the inflammatory and osteogenic response induced by titanium particles released during implantoplasty of dental implants.

Toledano-Serrabona J, Bosch B, Diez-Tercero L, Gil F, Camps-Font O, Valmaseda-Castellon E Sci Rep. 2022; 12(1):15790.

PMID: 36138061 PMC: 9500064. DOI: 10.1038/s41598-022-20100-2.

References

Wang L, Mao J, Zhang G, Tu M . Nano-cerium-element-doped titanium dioxide induces apoptosis of Bel 7402 human hepatoma cells in the presence of visible light. World J Gastroenterol. 2007; 13(29):4011-4. PMC: 4171178. DOI: 10.3748/wjg.v13.i29.4011. View

Fretwurst T, Buzanich G, Nahles S, Woelber J, Riesemeier H, Nelson K . Metal elements in tissue with dental peri-implantitis: a pilot study. Clin Oral Implants Res. 2015; 27(9):1178-86. DOI: 10.1111/clr.12718. View

Costa B, Tokuhara C, Rocha L, Oliveira R, Lisboa-Filho P, Pessoa J . Vanadium ionic species from degradation of Ti-6Al-4V metallic implants: In vitro cytotoxicity and speciation evaluation. Mater Sci Eng C Mater Biol Appl. 2019; 96:730-739. DOI: 10.1016/j.msec.2018.11.090. View

Haleem-Smith H, Argintar E, Bush C, Hampton D, Postma W, Chen F . Biological responses of human mesenchymal stem cells to titanium wear debris particles. J Orthop Res. 2011; 30(6):853-63. PMC: 3319839. DOI: 10.1002/jor.22002. View

Chandar S, Kotian R, Madhyastha P, Kabekkodu S, Rao P . evaluation of cytotoxicity and corrosion behavior of commercially pure titanium and Ti-6Al-4V alloy for dental implants. J Indian Prosthodont Soc. 2017; 17(1):35-40. PMC: 5308082. DOI: 10.4103/0972-4052.197936. View

Wang J, Sanderson B, Wang H . Cyto- and genotoxicity of ultrafine TiO2 particles in cultured human lymphoblastoid cells. Mutat Res. 2007; 628(2):99-106. DOI: 10.1016/j.mrgentox.2006.12.003. View

Humphrey S, Williamson R . A review of saliva: normal composition, flow, and function. J Prosthet Dent. 2001; 85(2):162-9. DOI: 10.1067/mpr.2001.113778. View

Siqueira de Morais L, Serra G, Albuquerque Palermo E, Andrade L, Muller C, Andre Meyers M . Systemic levels of metallic ions released from orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2009; 135(4):522-9. DOI: 10.1016/j.ajodo.2007.04.045. View

Zhou W, Wang F, Monje A, Elnayef B, Huang W, Wu Y . Feasibility of Dental Implant Replacement in Failed Sites: A Systematic Review. Int J Oral Maxillofac Implants. 2016; 31(3):535-45. DOI: 10.11607/jomi.4312. View

10.

Saulacic N, Schaller B . Prevalence of Peri-Implantitis in Implants with Turned and Rough Surfaces: a Systematic Review. J Oral Maxillofac Res. 2019; 10(1):e1. PMC: 6498817. DOI: 10.5037/jomr.2019.10101. View

11.

Baliga S, Muglikar S, Kale R . Salivary pH: A diagnostic biomarker. J Indian Soc Periodontol. 2013; 17(4):461-5. PMC: 3800408. DOI: 10.4103/0972-124X.118317. View

12.

Kim T, Balakrishnan A, Lee B, Kim W, Dvorankova B, Smetana K . In vitro fibroblast response to ultra fine grained titanium produced by a severe plastic deformation process. J Mater Sci Mater Med. 2007; 19(2):553-7. DOI: 10.1007/s10856-007-3204-5. View

13.

Kao C, Ding S, He H, Chou M, Huang T . Cytotoxicity of orthodontic wire corroded in fluoride solution in vitro. Angle Orthod. 2007; 77(2):349-54. DOI: 10.2319/0003-3219(2007)077[0349:COOWCI]2.0.CO;2. View

14.

Mombelli A, Hashim D, Cionca N . What is the impact of titanium particles and biocorrosion on implant survival and complications? A critical review. Clin Oral Implants Res. 2018; 29 Suppl 18:37-53. DOI: 10.1111/clr.13305. View

15.

Malkoc S, Ozturk F, Corekci B, Bozkurt B, Hakki S . Real-time cell analysis of the cytotoxicity of orthodontic mini-implants on human gingival fibroblasts and mouse osteoblasts. Am J Orthod Dentofacial Orthop. 2012; 141(4):419-26. DOI: 10.1016/j.ajodo.2011.12.009. View

16.

Galeotti A, Uomo R, Spagnuolo G, Paduano S, Cimino R, Valletta R . Effect of pH on in vitro biocompatibility of orthodontic miniscrew implants. Prog Orthod. 2013; 14:15. PMC: 4394406. DOI: 10.1186/2196-1042-14-15. View

17.

Dalal A, Pawar V, McAllister K, Weaver C, Hallab N . Orthopedic implant cobalt-alloy particles produce greater toxicity and inflammatory cytokines than titanium alloy and zirconium alloy-based particles in vitro, in human osteoblasts, fibroblasts, and macrophages. J Biomed Mater Res A. 2012; 100(8):2147-58. DOI: 10.1002/jbm.a.34122. View

18.

Medvedev A, Molotnikov A, Lapovok R, Zeller R, Berner S, Habersetzer P . Microstructure and mechanical properties of Ti-15Zr alloy used as dental implant material. J Mech Behav Biomed Mater. 2016; 62:384-398. DOI: 10.1016/j.jmbbm.2016.05.008. View

19.

Derks J, Tomasi C . Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2014; 42 Suppl 16:S158-71. DOI: 10.1111/jcpe.12334. View

20.

Yao J, Lewallen E, Trousdale W, Xu W, Thaler R, Salib C . Local Cellular Responses to Titanium Dioxide from Orthopedic Implants. Biores Open Access. 2017; 6(1):94-103. PMC: 5627672. DOI: 10.1089/biores.2017.0017. View