Analysis of failed commercially pure titanium dental implants: a scanning electron microscopy and energy-dispersive spectrometer x-ray study.
BACKGROUND
The failure of osseointegration in oral rehabilitation has gained importance in current literature and in clinical practice. The integration of titanium dental implants in alveolar bone has been partly ascribed to the biocompatibility of the implant surface oxide layer. The aim of this investigation was to analyze the surface topography and composition of failed titanium dental implants in order to determine possible causes of failure.


METHODS
Twenty-one commercially pure titanium (cpTi) implants were retrieved from 16 patients (mean age of 50.33 +/- 11.81 years). Fourteen implants were retrieved before loading (early failures), six after loading (late failures), and one because of mandibular canal damage. The failure criterion was lack of osseointegration characterized as dental implant mobility. Two unused implants were used as a control group. All implant surfaces were examined by scanning electron microscopy (SEM) and energy-dispersive spectrometer x-ray (EDS) to element analysis. Evaluations were performed on several locations of the same implant.


RESULTS
SEM showed that the surface of all retrieved implants consisted of different degrees of organic residues, appearing mainly as dark stains. The surface topography presented as grooves and ridges along the machined surface similar to control group. Overall, foreign elements such as carbon, oxygen, sodium, calcium, silicon, and aluminum were detected in failed implants. The implants from control group presented no macroscopic contamination and clear signs of titanium.


CONCLUSIONS
These preliminary results do not suggest any material-related cause for implant failures, although different element composition was assessed between failed implants and control implants.
Shibli
Jamil Awad
JA
Dental Research Division, Department of Periodontology, Guarulhos University, Praça Tereza Cristina 01, 07023-070 Guarulhos, São Paulo, Brazil. jshibli@ung.br
Marcantonio
Elcio
E
d'Avila
Susana
S
Guastaldi
Antonio Carlos
AC
Marcantonio
Elcio
E
D001672:Biocompatible Materials / Q000032:analysis; D015921:Dental Implants; D019232:Dental Restoration Failure; D004866:Equipment Contamination; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D013052:Spectrometry, X-Ray Emission; D013499:Surface Properties; D014025:Titanium / Q000032:analysis
D001672:Biocompatible Materials; D015921:Dental Implants; C009495:titanium dioxide; D014025:Titanium