EC Dental Science

Review Article Volume 24 Issue 4 - 2025

Metal Particles: A Conundrum in Peri-Implant Tissues

Pooja AjitSankardas* and Sidney H Stein

Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Union Avenue, Memphis, TN, USA

*Corresponding Author: Pooja AjitSankardas, Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Union Avenue, Memphis, TN, USA
Received: February 14, 2025; Published: March 31, 2025



Dental implants are a popular treatment alternative to replace missing teeth; however, little is known regarding the consequences of dental implant corrosion, wear and metal particle release that occurs over time. Recent research has demonstrated metal particles in tissues surrounding dental implants, but the bioinert nature of these particles remains conflicted. The aim of this narrative review is to shed light on the different ways metal particles can be released into the environment, and their effect on microbial dysbiosis and the inflammatory immune response. In conclusion, this review creates awareness among clinicians regarding the effects of metal particles and their significance in implant dentistry. The importance of understanding the role of these particles is essential in achieving long term success of dental implants and preventing peri-implant diseases.

Keywords:Dental Implant; Peri Implant Disease; Titanium; Peri Implant Soft Tissue

    1. Branemark PI., et al. “Osseointegrated implants in the treatment of the edentulous jaw- Experience from a 10-year period”. Scandinavian Journal of Plastic and Reconstructive Surgery. Supplementum 16 (1977): 1-132.
    2. Mombelli A., et al. “The epidemiology of peri-implantitis”. Clinical Oral Implants Research6 (2012): 67-76.
    3. Sansone V., et al. “The effects on bone cells of metal ions released from orthopaedic implants. A review”. Clinical Cases in Mineral and Bone Metabolism1 (2013): 34-40.
    4. Harris WH., et al. “Extensive localized bone resorption in the femur following total hip replacement”. Journal of Bone and Joint Surgery, American Volume5 (1976): 612-618.
    5. Fretwurst T., et al. “Is metal particle release associated with peri-implant bone destruction? an emerging concept”. Journal of Dental Research3 (2018): 259-265.
    6. Sundfeldt, M., et al. “Aseptic loosening, not only a question of wear: a review of different theories”. Acta Orthopaedica 2 (2006): 177-197.
    7. Pettersson M., et al. “Titanium ions form particles that activate and execute interleukin-1b release from lipopolysaccharide-primed macrophages”. Journal of Periodontal Research 1 (2017): 21-32.
    8. Wachi T., et al. “Release of titanium ions from an implant surface and their effect on cytokine production related to alveolar bone resorption”. Toxicology 327 (2015): 1-9.
    9. He X., et al. “Analysis of titanium and other metals in human jawbones with dental implants - A case series study”. Dental Materials 8 (2016): 1042-1051.
    10. Schliephake H., et al. “Metal release from titanium fixtures during placement in the mandible: An experimental study”. International Journal of Oral and Maxillofacial Implants 5 (1993): 502-511.
    11. Pettersson M., et al. “Release of titanium after insertion of dental implants with different surface characteristics - an ex vivo animal study”. Acta Biomaterialia Odontologica Scandinavica 1 (2017): 63-73.
    12. Wennerberg A., et al. “Titanium release from implants prepared with different surface roughness”. Clinical Oral Implants Research5 (2004): 505-512.
    13. Allsobrook OFL., et al. “Descriptive study of the longevity of dental implant surgery drills”. Clinical Implant Dentistry and Related Research 3 (2011): 244-254.
    14. Blum K., et al. “Fatigue induced changes in conical implant-abutment connections”. Dental Materials 11 (2015): 1415-1426.
    15. Alrabeah GO., et al. “Reduction of tribocorrosion products when using the platform-switching concept”. Journal of Dental Research 9 (2018): 995-1002.
    16. Larsson C., et al. “Bone response to surface modified titanium implants studies on electropolished implants with different oxide thicknesses and morphology”. Biomaterials13 (1994): 1062-1074.
    17. Sridhar S., et al. “In vitro evaluation of titanium exfoliation during simulated surgical insertion of dental implants”. Journal of Oral Implantology 1 (2016): 34-40.
    18. Barao VA., et al. “The role of lipopolysaccharide on the electrochemical behavior of titanium”. Journal of Dental Research5 (2011): 613- 618.
    19. Noguti J., et al. “The role of fluoride on the process of titanium corrosion in oral cavity”. Biometals5 (2012): 859-862.
    20. Peñarrieta-Juanito G., et al. “Surface damage of dental implant systems and ions release after exposure to fluoride and hydrogen peroxide”. Journal of Periodontal Research 1 (2019): 46-52.
    21. Abey S., et al. “Electrochemical behavior of titanium in artificial saliva: influence of pH”. Journal of Oral Implantology 1 (2014): 3-10.
    22. Nikolopoulou F. “Saliva and dental implants”. Implant Dentistry 4 (2006): 372-376.
    23. Louropoulou A., et al. “Titanium surface alterations following the use of different mechanical instruments: A systematic review”. Clinical Oral Implants Research 6 (2012): 643-658.
    24. Schwarz F., et al. “Surgical therapy of advanced ligature-induced peri-implantitis defects: cone-beam computed tomographic and histological analysis”. Journal of Clinical Periodontology 10 (2011): 939‐949.
    25. Eger M., et al. “Scaling of titanium implants entrains inflammation-induced osteolysis”. Scientific Reports 7 (2017): 39612.
    26. Harrel SK., et al. “Titanium particles generated during ultrasonic scaling of implants”. Journal of Periodontology 3 (2019): 241-246.
    27. Schliephake H., et al. “Metal release from titanium fixtures during placement in the mandible: an experimental study”. International Journal of Oral and Maxillofacial Implants 5 (1993): 502-511.
    28. Olmedo D., et al. “Macrophages related to dental implant failure”. Implant Dentistry 1 (2003): 75-80.
    29. Olmedo DG., et al. “Oral mucosa tissue response to titanium cover screws”. Journal of Periodontology 8 (2012): 973-980.
    30. Flatebø RS., et al. “Host response to titanium dental implant placement evaluated in a human oral model”. Journal of Periodontology7 (2006): 1201-1210.
    31. Flatebø RS., et al. “Mapping of titanium particles in peri-implant oral mucosa by laser ablation inductively coupled plasma mass spectrometry and high-resolution optical darkfield microscopy”. Journal of Oral Pathology and Medicine 5 (2011): 412-420.
    32. Wilson TG Jr., et al. “Foreign bodies associated with peri-implantitis human biopsies”. Journal of Periodontology1 (2015): 9-15.
    33. Fretwurst T., et al. “Metal elements in tissue with dental peri-implantitis: a pilot study”. Clinical Oral Implants Research 9 (2016): 1178-1186.
    34. Olmedo DG., et al. “Exfoliative cytology and titanium dental implants: a pilot study”. Periodontology1 (2013): 78-83.
    35. Safioti LM., et al. “Increased levels of dissolved titanium are associated with peri-implantitis. A cross sectional study”. Journal of Periodontology5 (2017): 436-442.
    36. Makihira S., et al. “Titanium ion induces necrosis and sensitivity to lipopolysaccharide in gingival epithelial-like cells”. Toxicology in Vitro 7 (2010): 1905-1910.
    37. Mine Y., et al. “Impact of titanium ions on osteoblast-, osteoclast- and gingival epithelial-like cells”. Journal of Prosthodontic Research 1 (2010): 1-6.
    38. Kumazawa R., et al. “Effects of Ti ions and particles on neutrophil function and morphology”. Biomaterials 17 (2002): 3757-3764.
    39. Irshad M., et al. “Influence of titanium on in vitro fibroblast-Porphyromonas gingivalis interaction in peri-implantitis”. Journal of Clinical Periodontology 9 (2013): 841-849.
    40. Happe A., et al. “The biologic effect of particulate titanium contaminants of dental implants on human osteoblasts and gingival fibroblasts”. International Journal of Oral and Maxillofacial Implants 3 (2019): 673-680.
    41. Bressan E., et al. “Metal nanoparticles released from dental implant surfaces: potential contribution to chronic inflammation and peri-implant bone loss”. Materials (Basel)12 (2019): 2036.
    42. Pajarinen J., et al. “The response of macrophages to titanium particles is determined by macrophage polarization”. Acta Biomaterialia 11 (2013): 9229-9240.
    43. Fretwurst T., et al. “Characterization of macrophages infiltrating peri-implantitis lesions”. Clinical Oral Implants Research 3 (2020): 274-281.
    44. Schwarz F., et al. “Peri-implantitis”. Journal of Clinical Periodontology 20 (2018): S246-S266.
    45. Berglundh T and Carcuac O. “Composition of human peri-implantitis and periodontitis lesions”. Journal of Dental Research11 (2014): 1083-1088.
    46. Albrektsson T., et al. “Is marginal bone loss around oral implants the result of a provoked foreign body reaction?” Clinical Implant Dentistry and Related Research 2 (2014): 155-165.
    47. Trindade R., et al. “Foreign body reaction to biomaterials: on mechanisms for buildup and breakdown of osseointegration”. Clinical Implant Dentistry and Related Research 1 (2016): 192-203.
    48. Nakagawa M., et al. “Effects of fluoride and dissolved oxygen concentrations on the corrosion behavior of pure titanium and titanium alloys”. Dental Materials Journal 2 (2002): 83-92.
    49. Souza JGS., et al. “Titanium particles and ions favor dysbiosis in oral biofilms”. Journal of Periodontal Research 2 (2020): 258-266.

Pooja AjitSankardas and Sidney H Stein. “Metal Particles: A Conundrum in Peri-Implant Tissues”. EC Dental Science 24.4 (2025): 01-07.

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