Macrophages Related to Dental Implant Failure

Macrophages Related to Dental Implant Failure
March 2003
Olmedo, Daniel DDS, PhD*; Fern??ndez, Mar??a Marta DDS**; Guglielmotti, Mar??a Beatriz DDS***; Cabrini, R??mulo Luis MD, PhDÇƒÜ
Implant Dentistry: Volume 12(1) March 2003 pp 75-80
Lippincott Williams & Wilkins
*Assistant Researcher, Department of Oral Pathology, School of Dentistry, University of Buenos Aires and Histology Department, School of Dentistry, University of C??rdoba, Argentina.
**Assistant Researcher, Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Argentina.
***Head Professor, Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Member of the Scientific Research Career of the National Research Council, Argentina.
ÇƒÜProfessor Emeritus, Department of Oral Pathology, School of Dentistry, University of Buenos Aires, and Department of Radiobiology, National Atomic Energy Commission, Buenos Aires, Argentina.
Reprint requests and correspondence to:
Dr. Daniel Olmedo
C??tedra de Anatom??a Patol??gica, Facultad de Odontolog??a Universidad de Buenos Aires
Marcelo T. de Alvear 2142, 2¨? A, C 1122 AAH
Buenos Aires, Argentina
Phone: 5411-4964-1273
E-mail: gus29@hotmail.com
The authors claim to have no financial interest in any company or any of the products mentioned in this article.
Abstract
Purpose: The aim of this study was to evaluate, histologically and quantitatively, the presence of macrophages loaded with metallic particles in the periimplant soft tissues of failed titanium (Ti) dental implants.
Materials and Methods: The study was performed on sections of metallic Ti implants embedded in methyl methacrylate resin that exhibited macrophages in the soft tissues contiguous with the implant. The volume of periimplant soft tissue was evaluated, and the number of macrophages was determined. The particles within macrophages were analyzed by energy-dispersive x-ray analysis.
Results: Macrophages were more abundant in the zone adjacent to the metallic implant as compared with the zone further away from the implant. Energy-dispersive x-ray analysis revealed the presence of Ti within macrophages.
Conclusions: Macrophages loaded with Ti particles can be associated with a corrosion process. The method proposed would allow for the objective evaluation of the presence of macrophages associated with dental implants and other orthopedic materials that contain Ti or other metals.
The clinical success of osseointegrated implants has made them an important component of rehabilitative dentistry. 1,2 Systemic conditions such as alterations in bone metabolism, hormone balance, corticosteroid therapy, and smoking habits and local conditions such as quantity and quality of bone, traumatic surgical technique, inadequate treatment of the implant surface, and composition of the implant may determine early implant failure. Failure may occur during the phase of periimplant bone healing or at a later date, leading to the loss of osseointegration. 3-14
Furthermore, Gwyniolo 11 has shown that early osseointegration may undergo changes induced by the material itself or by the environment, as have others. 15 Within this context, corrosion is one of the etiological factors that causes complication. 16-23
The term corrosion is used in the broadest sense and is defined as the process of interaction between a solid material and its chemical environment, which leads to a loss of substance from the material, a change in its structural characteristics, or loss of structural integrity. 17 Systemic, local, and remote accumulation of metal ions has been demonstrated in animal models and in humans. 18,24-28 It has been suggested that ions released from implant surfaces could contribute to osteolysis 29 and other problems. 30 When the metallic ions are released into the tissues, they may remain free in the intercellular spaces. Alternatively, macrophages may participate actively in the elimination of these foreign objects. The surface of failed implants may come into contact with osseointegrated bone tissue or soft tissue (bone marrow or fibrous tissue and granulation tissue) among others. The presence of macrophages in failed implants has been associated with the formation of granulation tissue. 31,32
The aim of this study was to evaluate periimplant soft tissue in implants that have failed as determined clinically by mobility in terms of (1) histologic and quantitative assessment and (2) evaluation of the number of macrophages present in soft tissue and the composition of phagocytosed material.
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