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Oral Mucosa Tissue Response to Titanium Cover Screws
Author(s) -
Olmedo Daniel G.,
Paparella María L.,
Spielberg Martín,
Brandizzi Daniel,
Guglielmotti María B.,
Cabrini Rómulo L.
Publication year - 2012
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2011.110392
Subject(s) - titanium , oral mucosa , connective tissue , scanning electron microscope , materials science , pathology , implant , dentistry , junctional epithelium , soft tissue , immunohistochemistry , biomedical engineering , medicine , chemistry , metallurgy , composite material , surgery
Background: Titanium is the most widely used metal in dental implantology. The release of particles from metal structures into the biologic milieu may be the result of electrochemical processes (corrosion) and/or mechanical disruption during insertion, abutment connection, or removal of failing implants. The aim of the present study is to evaluate tissue response of human oral mucosa adjacent to titanium cover screws. Methods: One hundred fifty‐three biopsies of the supra‐implant oral mucosa adjacent to the cover screw of submerged dental implants were analyzed. Histologic studies were performed to analyze epithelial and connective tissue as well as the presence of metal particles, which were identified using microchemical analysis. Langerhans cells, macrophages, and T lymphocytes were studied using immunohistochemical techniques. The surface of the cover screws was evaluated by scanning electron microscopy (SEM). Results: Forty‐one percent of mucosa biopsies exhibited metal particles in different layers of the section thickness. Particle number and size varied greatly among specimens. Immunohistochemical study confirmed the presence of macrophages and T lymphocytes associated with the metal particles. Microchemical analysis revealed the presence of titanium in the particles. On SEM analysis, the surface of the screws exhibited depressions and irregularities. Conclusions: The biologic effects seen in the mucosa in contact with the cover screws might be associated with the presence of titanium or other elements, such as aluminum or vanadium. The potential long‐term biologic effects of particles on soft tissues adjacent to metallic devices should be further investigated because these effects might affect the clinical outcome of the implant.