Effects of simulated body fluids (SFB) on titanium surfaces Joerg Meyle 1* and Sabine Groeger 1 1Department of Periodontology, Justus-Liebig-University, Giessen, Germany Objective: Ankylotic anchorage of titanium (Ti) based materials in human bone is of crucial importance for successful implant therapy. It is essential to understand interactions between implant surfaces and the organism. Implants perforate the mucosa and soft tissue adhesion is susceptible to bacterial challenge causing peri-implantitis, a major threat to long-term success. After coating with blood, serum proteins adhere on the oxide layer, interacting with surrounding body fluid to form bio-reactive surfaces. The aim of this in vitro study was to analyze the solubility of titanium and possible effects of simulated body fluids on implants with different surface modifications. Materials and methods: Ti implants with 4 surfaces were used (bio-functionalized, hydroxyapatite (HA) coated, acid-etched, machined, n=2). Implants were incubated 4h to 4d in simulated body fluids (SFB) containing: Hank´s buffered salt solution (HBSS) 100% and HBSS containing 25% and 50% human serum (HS). Surfaces were investigated by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). Supernatants (SN) were analyzed using inductively coupled plasma mass spectrometry (ICP). Results: Implants with HA covered surfaces showed development of crystal-plates on top of primary structures after 4d (100% HBSS). XPS showed that crystal plates contained calcium (Ca) (13%) and phosphorus (P) (10%). ICP of SN showed decrease of Ca and P (-7.1±3.1 ; -5.1±5.1mg/l, 4d). Independent of the implant surface no titanium was detectable in SN after any incubation time using 100% HBSS. After HBSS/HS (25%, 50%) incubation primary structures appeared more porous and flattened. XPS analysis detected 1% or less Ca and P. Decrease of Ca and P in SN was -16.8±2.3 and -0.07±3.2mg/ml. The concentration of Ti increased significantly (p<0.05) from 8.8 and 5.5µg/l after 4h to 16.1 and 12.0µg/l after 4d. (25% HS). Using 50% HS Ti concentration raised from 12.3 and 8.7µg/l (4h) up to 20.9 and 36.8µg/l (4d). Etched/machined implants showed crystalline coverage containing Ca and P (5% and 4%). ICP of SN showed decrease of Ca ; P (-14.9±8.5 ; -9.5±6.1mg/l, 4d). Incubation in HBSS/HS (25%, 50%) induced non-crystalline coverage without Ca or P. Content of Ca and P in SN was -3.7±2.3 and +7.7±3.3mg/ml. In fluids containing 25% HS, concentration of Ti elevated from 7.1 and 7.6µg/l after 4h to 20.8 and 17.7µg/l after 4d. In 50% HS Ti concentration was 9.6 and 7.4µg/l (4h) rising to 21.5 and 19.1µg/l (4d). Conclusions: Incubation in HBSS induced formation of crystal-like plates on surfaces of modified and crystal covers on non-modified implants, both containing Ca and P. Presence of serum did not provide development of HA-like structures, rather a dissolving effect appeared. Titanium was clearly dissolved from all implant surface types into the surrounding fluid containing serum in a time dependent manner. This effect also was dependent on the serum concentration of the medium. This study was supported by DENTSPLY Implants.
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