title: Titanium-Silver Alloy Miniplates for Mandibular Fixation: In Vitro and In Vivo Study.
abstract: OBJECTIVE
  Titanium (Ti) alloys have received considerable attention as materials for oral and maxillofacial surgery, which require high mechanical strength, osteosynthesis, and biocompatibility. The objective was to implant miniplates fabricated from commercially pure Ti (CP Ti) and newly developed Ti-silver (Ag) alloy in fractured mandibles of adult dogs after preliminary mechanical and biological characterization.
  
  
  METHODS
  The surface characteristics, biocompatibility, and pre-osteoblast adhesion and proliferation of CP Ti (grade 3) and Ti-Ag (2 at% Ag) alloys were evaluated. Next, the bending strength of 6- and 8-hole miniplates fabricated from CP Ti and Ti-Ag was compared according to ISO (International Organization for Standardization) 9585. Six-hole miniplates were implanted for 12 weeks in fractured mandibles of adult dogs. The Ag ion concentration in each alloy and implanted bone block with soft tissue was measured by inductively coupled plasma mass spectroscopy after euthanasia according to ISO 10993-12.
  
  
  RESULTS
  Precipitated Ag was detected in Ti-Ag by alpha- and beta-phase Ti in x-ray powder diffraction. The biocompatibility with pre-osteoblasts of Ti-Ag and CP Ti was comparable in terms of cytotoxicity, cell adhesion, and proliferation (P > .05). Ti-Ag miniplates had up to 3-fold greater bending strength than CP Ti miniplates (P < .05). An in vivo study showed that CP Ti and Ti-Ag miniplates had comparable soft and hard tissue regeneration ability (P > .05). Ag ions were detected in Ti-Ag alloys and applied mandible blocks.
  
  
  CONCLUSIONS
  The results of this study suggest that Ti-Ag alloys can be used to produce miniplates with high mechanical properties, as well as considerable biocompatibility, osteosynthesis ability, and Ag ion-release properties. Further studies, including preclinical investigations, are required to enable clinical use of Ti-Ag bone plates.
authors.affiliation: Attending Doctor, Institute of Tissue Regeneration Engineering, Dankook University, Cheonan, Republic of Korea.
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Assistant Lecturer, Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Kwon
authors.affiliation: Assistant Lecturer, Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
authors.forename: Seung-Kyun
authors.initials: SK
authors.lastname: Moon
authors.affiliation: Assistant Lecturer, Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
authors.forename: Soo-Hyuk
authors.initials: SH
authors.lastname: Uhm
authors.affiliation: Professor, Department of Dentistry, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Choi
authors.affiliation: Researcher, Biomaterials Korea Incorporation, Seoul, Republic of Korea.
authors.forename: Uk-Hyon
authors.initials: UH
authors.lastname: Joo
authors.affiliation: Professor, Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
authors.forename: Kwang-Mahn
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Professor, Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul and Department of Dental Hygiene, Kyungdong University, Wonju, Republic of Korea. Electronic address: kimkn@yuhs.ac.
authors.forename: Kyoung-Nam
authors.initials: KN
authors.lastname: Kim
mesh_terms: D000497:Alloys / Q000737:chemistry*; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry*; D001860:Bone Plates; D004285:Dogs; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D066298:In Vitro Techniques; D008337:Mandibular Fractures / Q000601:surgery*; D008422:Materials Testing; D012834:Silver / Q000737:chemistry*; D013054:Spectrophotometry, Atomic; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry*
chemical_list: D000497:Alloys; D001672:Biocompatible Materials; D012834:Silver; D014025:Titanium