Titanium allergy: could it affect dental implant integration?

Purpose: Degradation products of metallic biomaterials including titanium may result in metal hypersensitivity reaction. Hypersensitivity to biomaterials is often described in terms of vague pain, skin rashes, fatigue and malaise and in some cases implant loss. Recently, titanium hypersensitivity has been suggested as one of the factors responsible for implant failure. Although titanium hypersensitivity is a growing concern, epidemiological data on incidence of titanium‐related allergic reactions are still lacking. Materials and methods: A computer search of electronic databases primarily MEDLINE and PUBMED was performed with the following key words: ‘titanium hypersensitivity’, ‘titanium allergy’, ‘titanium release’ without any language restriction. Manual searches of the bibliographies of all the retrieved articles were also performed. In addition, a complementary hand search was also conducted to identify recent articles and case reports. Results: Most of the literature comprised case reports and prospective in vivo/in vitro trials. One hundred and twenty‐seven publications were selected for full text reading. The bulk of the literature originated from the orthopaedic discipline, reporting wear debris following knee/hip arthroplasties. The rest comprised osteosynthesis (plates/screws), oral implant/dental materials, dermatology/cardiac‐pacemaker, pathology/cancer, biomaterials and general reports. Conclusion: This review of the literature indicates that titanium can induce hypersensitivity in susceptible patients and could play a critical role in implant failure. Furthermore, this review supports the need for long‐term clinical and radiographic follow‐up of all implant patients who are sensitive to metals. At present, we know little about titanium hypersensitivity, but it cannot be excluded as a reason for implant failure. To cite this article:
Siddiqi A, Payne AGT, De Silva RK, Duncan WJ. Titanium allergy: could it affect dental implant integration?
Clin. Oral Impl. Res. 22 , 2011; 673–680
doi: 10.1111/j.1600‐0501.2010.02081.x     

Ganglion cyst of the temporomandibular joint

Ganglion cysts of the temporomandibular joint are rare and arise from myxoid degeneration of die collagenous tissue of the capsule of the joint as a result of trauma.     

The biomaterial-mediated healing of critical size bone defects in the ovariectomized rat

Summary

This study demonstrated an impaired biomaterial-mediated bone regeneration in a critical sized calvarial defect established within an ovariectomized rat model. Histological and microtomographic evidences were supported by an impaired osteoblastic gene expression and altered expression of estrogen receptors and adipogenic markers.

Introduction

This work aims to address the bone regeneration process in the ovariectomized rat model, by assessing a calvarial critical size defect implanted with a biocompatible bovine bone mineral graft.

Methods

Animals were randomly divided into two groups: Ovx (bilateral ovariectomy) and Sham (control surgery). Following 8 weeks, all animals were submitted to a surgical bicortical craniotomy (5-mm circular critical size defect), which was filled with a biocompatible mineral graft. Animals were euthanized at 1, 3, and 6 months following graft implantation (n?=?10), and results on the orthotopic bone regeneration process were blindly evaluated by radiographic, microtomographic, histological, histomorphometric, and gene expression techniques.

Results

In the attained model, in both Sham and Ovx groups, the bone regenerative process was found to occur in a slow-paced manner. Likewise, a qualitative evaluation of the microtomographic and histological analysis, as well as quantitative data from histomorphometric indexes, revealed reduced bone regeneration in Ovx animals, at the assayed time points. Significant differences were attained at the 3 and 6 months. Gene expression analysis revealed a reduced expression of osteoblastic-related genes and an altered expression of estrogen receptors and adipogenic markers, within the regenerating bone of Ovx animals.

Conclusions

Due to the similarities between the osteoporotic animal model and the human condition of postmenopausal osteoporosis, it might be relevant to consider the potential clinical implication of the osteoporotic condition in the biomaterial-mediated bone tissue healing/regeneration process.     

Dependent component analysis for the magnetogastrographic detection of human electrical response activity

The detection of the basic electric rhythm (BER), composed of a 3 cycles min(-1) oscillation, can be performed using SQUID magnetometers. However, the electric response activity (ERA), which is generated when the stomach is performing a mechanical activity, was detected mainly by invasive electrical measurements and only recently was one report published describing its detection by magnetic measurements. This study was performed with the aim of detecting the ERA noninvasively after a meal. MGG recordings were made with a 74-channel first-order gradiometer (Magnes II, biomagnetic technologies) housed in a shielded room. Seven nonsymptomatic volunteers were measured in the study. Initially a 10 min recording was performed with the subject in the fasted state. A 250 kcal meal was given to the subject without moving out of the magnetometers and two epochs of 10 min each were acquired. The signals were processed to remove cardiac interference by an algorithm based on a variation of independent component analysis (ICA), then autoregressive and wavelet analysis was performed. Preliminary results have shown that there is an increase in the signal power at higher frequencies around (0.6 Hz-1.3 Hz) usually associated with the basic electric rhythm. The center of the frequency band and its width varied from subject to subject, demonstrating the importance of pre-prandial acquisition as a control. Another interesting finding was an increase in power after about 5 min of meal ingestion. This period roughly agrees with the lag phase of gastric emptying, measured by scintigraphy and other techniques. We confirm that MGG can detect the electric response activity in normal volunteers. Further improvements in signal processing and standardization of signal acquisition are necessary to ascertain its possible use in clinical situations.