Jorge Toledano-Serrabona*1; Octavi Camps-Font1; Cosme Gay-Escoda1; Eduard Valmaseda-Castellón1; Mario Corte-Rodríguez2; María Montes-Bayón2; Mª Ángeles Sánchez-Garcés1

1Oral Surgery and Implantology, University of Barcelona, Barcelona; 2Department of Physical and Analytical Chemistry, University of Oviedo, Oviedo, Spain

Background: Peri-implantitis is a highly prevalent inflammatory disease affecting the tissues around dental implants. When the rough surface of the implant is exposed to the oral environment, implantoplasty has been proposed as a decontamination technique.

Aim/Hypothesis: To describe the tissue reaction to titanium debris, as well as, to analyze the accumulation of metal ions in blood and organs caused by Ti alloy (Ti-6Al-4V) particles detached from the implant surface during implantoplasty.

Material and Methods: A randomized experimental study in 20 Sprague-Dawley rats was conducted. Rats were assigned to one of three groups: an experimental group with a mandibular defect filled with metallic debris released during implantoplasty, a positive control group with an empty defect and a negative control group. Four weeks after the surgery, rats were euthanized and perilesional tissue surrounding the mandibular defect and visceral tissues (lungs, spleen, liver, and brain) were retrieved. In addition, two blood samples were collected, one before surgery and one before euthanasia. Perilesional tissue was analyzed histologically by hematoxylin-eosin staining, whereas Ti, Al, V concentration was measured by Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry. Descriptive and bivariate analysis of the data was performed using the U-Mann Whitney test to compare differences between groups and the Wilcoxon test to detect changes in pre-post operative blood ions.

Results: All rats with implanted metal debris showed metal particles and a bone fracture callus on the osseous defect. Around metal particles there was a foreign body reaction characterized by the presence of histocytes and multinucleated giant cells. Regarding ion release, the experimental group had a significant higher concentration of Ti ions in all organs studied (p <0.05), except in lung tissue. In addition, there were more V ions in the brain of the experimental group (P = 0.008).

Conclusion and Clinical implications: After four weeks of implantoplasty, the implanted metal debris increased the concentration of metal ions in liver, spleen and brain. Besides, there was an inflammatory reaction with phagocytized metal particles. Although further studies are required to confirm the clinical relevance of these results, implantoplasty should be considered with caution for the treatment of peri-implantitis.

Disclosure of Interest: J. Toledano-Serrabona Conflict with: -This study was supported by Instituto de Salud Carlos III through the project PI20/01596 (Co-founded by European Regional Development Fund. ERDF, a way to build Europe)., O. Camps-Font Conflict with: -This study was supported by Instituto de Salud Carlos III through the project PI20/01596 (Co-founded by European Regional Development Fund. ERDF, a way to build Europe)., Conflict with: -Octavi Camps-Font has participated as co-investigator in clinical trials sponsored by Mundipharma (Cambridge, UK) and Menarini Richerche (Florence, Italy). He also reports grants and non-financial support from Avinent (Santpedor, Spain). C. Gay-Escoda Conflict with: -This study was supported by Instituto de Salud Carlos III through the project PI20/01596 (Co-founded by European Regional Development Fund. ERDF, a way to build Europe)., Conflict with: -Prof. Dr. Cosme Gay-Escoda reports grants, personal fees, and non-financial support from Mundipharma (Cambridge, UK) and Menarini Richerche (Florence, Italy). E. Valmaseda-Castellón Conflict with: -This study was supported by Instituto de Salud Carlos III through the project PI20/01596 (Co-founded by European Regional Development Fund. ERDF, a way to build Europe)., Conflict with: -Prof. Dr. Eduard Valmaseda-Castellón reports personal fees and non-financial support from MozoGrau (Valladolid, Spain). He is the director of the Avinent-University of Barcelona research agreement (Càtedra UB-Avinent), with Avinent (Santpedor, Spain), and has received personal fees from BioHorizons Ibérica (Madrid, Spain), Inibsa Dental (Lliça de Vall, Spain) and Dentsply implants Iberia (Barcelona, Spain) outside the submitted work. In addition, Prof. Dr. Valmaseda- Castellón has also participated as an investigator in clinical trials sponsored by Mundipharma (Cambridge, UK) and Geistlich (Wolhusen, Switzerland)., M. Corte-Rodríguez: None Declared, M. Montes-Bayón: None Declared, M. Á. Sánchez-Garcés Conflict with: This study was supported by Instituto de Salud Carlos III through the project PI20/01596 (Co-founded by European Regional Development Fund. ERDF, a way to build Europe)., Conflict with: Prof. Dra. Mª Ángeles Sánchez-Garcés reports grants, personal fees, and non-financial support from Nobel Biocare, Zimmer and Menarini Richerche (Florence, Italy).

Keywords: dental implants, peri-implantitis, titanium