Corrosion of Titanium Implants and Connected Prosthetic Alloys Using Lactic Acid Immersion Test
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Journal of Dental Health, Oral Disorders & Therapy Research Article Open Access Corrosion of titanium implants and connected prosthetic alloys using lactic acid immersion test Abstract Volume 11 Issue 3 - 2020 Background/purpose: Combination of dental titanium implants with other Wilhelm Niedermeier,1 Katrin Huesker2 prosthetic metallic components may lead to metal ion release that increases 1Department of Prosthetic Dentistry, School for Dental and the risk of adverse reactions in patients. The present study therefore aimed to Oral Medicine, University of Cologne, Germany determine in vitro metal ion dissolution from different alloy combinations. 2Department of Immuno-Toxicology, Institute for Medical Materials and methods: Dental alloys were subjected to a lactic acid immersion Diagnostics (IMD), Germany test together with titanium implants and matched with controls. Between day Correspondence: Wilhelm Niedermeier, School for Dental 1 and 38, open direct current potentials (DCP) between the samples and the and Oral Medicine, University of Cologne, Kerpener Str. electrolyte were recorded and metal dissociation inside the electrolyte was 32, D-50931 Cologne, Germany, Tel +4922147896746, Fax assessed using ICP-MS. +4922147896756, Email Results: Absolute DCPs of the different alloys increased significantly (p<0.001) Received: June 06, 2020 | Published: June 23, 2020 from 100-150mV to 490-580 mV within the first two weeks of immersion, dropping to about 450mV later on largely independent of the material. Titanium showed highest dissociation rates (2.00-12.06µg/cm2 per day; p=0.0002); all other components demonstrated poor corrosive dissolution (<0.6µg/cm2 per day). After immersion of 38 days, titanium still yielded high dissociation (0.64-1.38µg/ cm2 per day) for all test groups. Presence of fine gold inside the electrolyte significantly increased dissociation of titanium (p=0.027). Dissociation of iron indicated contamination from tool components used for implant production. Optical examination of non-precious metal surfaces showed no corrosive discoloration after 5 or 26 weeks of lactic acid immersion. Conclusion: Within the limitations of this study, there is no objection against the use of non-precious alloys for the fabrication of components and prostheses supported on titanium implants if gold is not present inside the same electrolyte. Keywords: corrosion, oral galvanism, dental alloys, titanium, lactic acid immersion, ICP-MS Abbreviations: DCP, direct current potentials; MEA, multi- Biologic incompatibility against metallic substances does not element-analysis appear before single metallic components are dissociated to ions which react with proteins in order to cause an allergic reaction, if a specific Introduction allergic predisposition exists in an individual.3,4This can be one of 5 1 the reasons for denture incompatibility and associated symptoms. Osseointegrated implants are a benefit for reconstructive dentistry. Besides, electric fields generated by DC potentials (DCPs) of different Among all materials used for the fabrication of dental implants, metals or alloys can lead to cell reactions inside the oral cavity like titanium is still first choice because of its stability, easy processing and apoptosis, proliferation, inflammation and leukoplakia.6−9 biological acceptance. Nevertheless, titanium is a metal and therefore, it is prone to corrosion and possible biologic incompatibility, On the other hand, abutments and dentures supported on dental particularly in the case of combination with other metals or alloys. implants must have considerable stability in order to tolerate The risk of dissociation of metallic structures increases with the masticatory forces. Specially in cases of implant supported free- number of different metals and the difference of their electrochemical end prostheses, high flexural fatigue strength must be provided that potential. Thereby, the position inside the electrochemical series is not sufficiently ensured utilising gracile non-metallic or titanium of metals indicatesthe corrosive properties of the single elements. abutments and denture components.10 Also, surface properties of Among the commonly used components of dental alloys, corrosive titanium favour accumulation of biofilms compared to other non- potentials of non-precious metals like chromium (-0.74V), titanium precious dental alloys.11 In addition, it can no longer remain unheeded (-0.34V), cobalt (-0.28V) and molybdenum (-0.20V) significantly that pure titanium as well as its alloys show a rather high rate of differ from gold (between +1.4 and +1.69V, according to its oxidation corrosion which can harm the surrounding peri-implant tissues and state). Considering this, there must be a smaller affinity to dissolution lead to systemic problems.12,13 among non-precious metals themselves when they are combined Since implant supported full titanium dentures revealed diverse in electrolyte solution. On the other hand, gold with its high redox material faults, this study aimed to clarify the risk of corrosion potential is able to interfere with non-precious metals in order to resulting from a combined use of titanium implants and different generate corrosive processes at their surfaces.2 dental alloys with the help of in vitro tests. Submit Manuscript | http://medcraveonline.com J Dent Health Oral Disord Ther. 2020;11(3):86‒92. 86 ©2020 Niedermeier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Corrosion of titanium implants and connected prosthetic alloys using lactic acid immersion test ©2020 Niedermeier et al. 87 Materials and methods abutment connection screws were out of titanium grade 4 (ISO 5832- 2, Klein SA, Biel/Bienne, Switzerland).10 Test groups Fine gold samples (Au 999.9, Degussa, Hanau, Germany) Each 5 dental implants assembled with the itemized abutment with a size of 16 x 14 mm and a thickness of 0.5 mm were ground systems were objected to 4 test groups: superficially using metal-free diamond paper with a roughness of 800 ® Ti-Ti Titanium abutment (SiM 24° angulated titanium base and (Telum K 800, Karl Sommer, Loebau, Germany) to achieve equal SiM 5 cone 00307144) connected with titanium fixture using a surface quality. titanium screw (PS 22). Corrosion assay set-up Ti-Ti& Au Titanium abutment (SiM 24° angulated titanium base In order to mimic the clinical situation and to standardise the and SiM 5 cone 00307144) connected with titanium fixture using a parameters in vitro, the lactic acid immersion test according to DIN titanium screw (PS 22) and separate fine gold sample. EN ISO 1027114 was applied as the best available testto investigate Ti-CCM Titanium abutment (SiM 24° angulated titanium base corrosive properties of the different metallic components; this test is and SiM 5 cone 00307144 out of cobalt-chromium-molybdenum generally regarded the relevant standard to studyin-vitro corrosionof 13,14 alloy=CCM) connected with titanium fixture using a titanium screw metallic materials in dentistry. (PS 22). To achieve a clean and metal-free test environment, all samples, Ti-CCM & Au Titanium abutment (SiM 24° angulated titanium glass tanks, silicone hose pipes and plastic tweezers used in the base and SiM 5 cone 00307144 out of CCM alloy) connected with experimental set-up were separately cleaned up using ultrasonic bath titanium fixture using a titanium screw (PS 22)and separate fine gold and a neutral cleansing agent, and were rinsed with pure water (aqua sample. bidest.: Braun, Melsungen, Germany) for 5x3min. Metals and alloys The fixtures were placed inside a silicone hose pipe covering the entire osseointegration surface up to -0.5 mm marginal height All fixtures had a diameter of 4 mm and a length of 12 mm and were sealed with silicone glue at the apical end (Figure 1). This (BredentblueSKY®, bSKY4012: Bredent, Ulm, Germany) and were procedure should imitate an end osseous implant bed during electro- fabricated out of titanium grade 4 (ISO 5832-2, Klein SA, Biel/ chemical processes. A preliminary test showed that this “pseudo- Bienne, Switzerland). Two-piece angulated abutments were out of osseo integrated surface” emitted only a part of about 15-20% of titanium grade 4 (ISO 5832-2, Klein SA, Biel/Bienne, Switzerland). corrosion products compared to the non-covered surface. This effect CCM-SiM 5 cones were specially fabricated for this study as a copy of was factored accordingly in calculating the corrosive surface of the the serial titanium part SiM 5 cone, and were made out of CCM alloy samples (Table 1). (Co-Cr28-Mo, MicroMelt®, Klein SA, Biel/Bienne, Switzerland). All Table 1 Sample surfaces inclusive pseudo-osseointegrated areas as well as ratio between electrolyte volume and sample surface; abbreviations see in “materials and methods, ff: test groups” Surface (mm2) of samples inclusive “osseointegrated” Test series Electrolyte volume/sample surface (ml/mm2) areas x 0.175 Ti CCM Au Ti CCM Au Ti-Ti 210.8 0.237 Ti-Ti& Au 210.8 478 0.237 0.105 Ti-CCM 96.6 114.2 0.518 0.438 Ti-CCM&Au 96.6 114.2 478 0.518 0.438 0.105 All samples were placed in an electrolyte solution (volume 50ml) consisting 0.9% NaCl (Isotonic saline 0.9%: Braun, Melsungen, Germany) and 0.1 mol/l lactic acid ((S)-Lactic acid: Caelo, Hilden, Germany) resulting in pH 5.2 (SevenGo Duo®: Mettler-Toledo, Gießen, Germany). Samples were always placed in the electrolyte without laminar