title: Increased Levels of Dissolved Titanium Are Associated With Peri-Implantitis - A Cross-Sectional Study.
abstract: Peri-implantitis represents a disruption of the biocompatible interface between the titanium dioxide layer of the implant surface and the peri-implant tissues. Increasing preclinical data suggest that peri-implantitis microbiota not only triggers an inflammatory immune response but also causes electrochemical alterations of the titanium surfaces, i.e., corrosion, that aggravate this inflammatory response. Thus, it was hypothesized that there is an association between dissolution of titanium from dental implants, which suggests corrosion, and peri-implantitis in humans. The objective of this study is to compare levels of dissolved titanium in submucosal plaque collected from healthy implants and implants with peri-implantitis.
  
  
  
  Submucosal plaque from 20 implants with peri-implantitis and 20 healthy implants was collected with sterile curets from 30 participants. Levels of titanium were quantified using inductively coupled plasma mass spectrometry and normalized for mass of bacterial DNA per sample to exclude confounding by varying amounts of plaque per site. Statistical analysis was performed using generalized estimated equations to adjust for clustering of implants per participant.
  
  
  
  Implants with peri-implantitis harbored significantly higher mean levels of titanium (0.85 ± 2.47) versus healthy implants (0.07 ± 0.19) after adjusting for amount of plaque collected per site (P = 0.033).
  
  
  
  Greater levels of dissolved titanium were detected in submucosal plaque around implants with peri-implantitis compared with healthy implants, indicating an association between titanium dissolution and peri-implantitis. Factors triggering titanium dissolution, as well as the role of titanium corrosion in the peri-implant inflammatory process, warrant further investigation.
authors.affiliation: Department of Periodontics, University of Washington, Seattle, WA.
authors.forename: Luciana M
authors.initials: LM
authors.lastname: Safioti
authors.affiliation: Department of Periodontics, University of Washington, Seattle, WA.
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Kotsakis
authors.affiliation: Department of Oral Health Sciences, University of Washington.
authors.forename: Alex E
authors.initials: AE
authors.lastname: Pozhitkov
authors.affiliation: Department of Oral Health Sciences, University of Washington.
authors.forename: Whasun O
authors.initials: WO
authors.lastname: Chung
authors.affiliation: Department of Periodontics, University of Washington, Seattle, WA.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Daubert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D015921:Dental Implants / Q000009:adverse effects; D003773:Dental Plaque / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000139:chemically induced / Q000209:etiology*; D014025:Titanium / Q000009:adverse effects* / Q000032:analysis
chemical_list: D015921:Dental Implants; D014025:Titanium
keywords: Biofilms; corrosion; dental implants; peri-implantitis; titanium