Kim Kyeong Tae, Eo Mi Young, Nguyen Truc Thi Hoang, Kim Soung Min
Department of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea.
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
Int J Implant Dent. 2019 Mar 11;5(1):10. doi: 10.1186/s40729-019-0162-x.
Titanium is a commonly used inert bio-implant material within the medical and dental fields. Although the use of titanium is thought to be safe with a high success rate, in some cases, there are rare reports of problems caused by titanium. In most of these problematic reports, only individual reports are dominant and comprehensive reporting has not been performed. This comprehensive article has been prepared to review the toxicity of titanium materials within the medical and dental fields.
We used online searching tools including MEDLINE (PubMed), Embase, Cochrane Library, and Google Scholar by combining keywords such as "titanium implant toxicity," "titanium implant corrosion," "titanium implant allergy," and "yellow nail syndrome." Recently updated data has been collected and compiled into one of four categories: "the toxicity of titanium," "the toxicity of titanium alloys," "the toxicity of titanium implants," and "diseases related to titanium."
Recent studies with regard to titanium toxicity have been increasing and have now expanded to the medical field in addition to the fields of environmental research and basic science. Problems that may arise in titanium-based dental implants include the generation of titanium and titanium alloy particles and ions deposited into surrounding tissues due to the corrosion and wear of implants, resulting in bone loss due to inflammatory reactions, which may lead to osseointegration failure of the dental implant. These titanium ions and particles are systemically deposited and can lead to toxic reactions in other tissues such as yellow nail syndrome. Additionally, implant failure and allergic reactions can occur due to hypersensitivity reactions. Zirconia implants can be considered as an alternative; however, limitations still exist due to a lack of long-term clinical data.
Clinicians should pay attention to the use of titanium dental implants and need to be aware of the problems that may arise from the use of titanium implants and should be able to diagnose them, in spite of very rare occurrence. Within the limitation of this study, it was suggested that we should be aware the rare problems of titanium toxicity.
钛是医学和牙科领域常用的惰性生物植入材料。尽管人们认为使用钛是安全的，成功率很高，但在某些情况下，也有罕见的关于钛引起问题的报道。在大多数这些有问题的报道中，只有个别报道占主导地位，尚未进行全面报道。本文撰写的目的是综述医学和牙科领域中钛材料的毒性。
我们使用了在线搜索工具，包括MEDLINE（PubMed）、Embase、Cochrane图书馆和谷歌学术，通过组合“钛植入物毒性”、“钛植入物腐蚀”、“钛植入物过敏”和“黄甲综合征”等关键词进行搜索。最近更新的数据已被收集并编入以下四类之一：“钛的毒性”、“钛合金的毒性”、“钛植入物的毒性”以及“与钛相关的疾病”。
关于钛毒性的最新研究不断增加，现在除了环境研究和基础科学领域外，还扩展到了医学领域。基于钛的牙科植入物可能出现的问题包括：由于植入物的腐蚀和磨损，会产生钛和钛合金颗粒及离子并沉积到周围组织中，因炎症反应导致骨质流失，这可能会导致牙科植入物的骨整合失败。这些钛离子和颗粒会在全身沉积，并可能在其他组织中引发毒性反应，如黄甲综合征。此外，过敏反应还可能导致植入物失败和过敏反应。氧化锆植入物可被视为一种替代选择；然而，由于缺乏长期临床数据，其仍存在局限性。
临床医生应关注钛牙科植入物的使用，需要意识到使用钛植入物可能出现的问题，并应能够进行诊断，尽管这种情况非常罕见。在本研究的局限性内，建议我们应意识到钛毒性的罕见问题。
