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Effect of fluoride prophylactic agents on the mechanical properties of nickel-titanium-based orthodontic wires.

BACKGROUND: Titanium-based alloys have high corrosion resistance because they form a thin, stable oxide layer. Nevertheless, fluoride prophylactic agents can cause corrosion and associated discoloration of titanium-based orthodontic wires. The purpose of this investigation was to study the effects of fluoride prophylactic agents on the mechanical properties of nickel-titanium (Ni-Ti) and copper-nickel-titanium (Cu-Ni-Ti) orthodontic archwires. METHODS: Preformed rectangular Ni-Ti and Cu-Ni-Ti wires were immersed in either an acidulated fluoride agent, a neutral fluoride agent, or distilled water (control) for 1.5 hours at 37 degrees C. After immersion, the loading and unloading elastic modulus and yield strength of the wires were measured with a 3-point bend test in a water bath at 37 degrees C, in accordance with the criteria in the current American National Standard/American Dental Association Specification No. 32 for Orthodontic Wires (2000). Scanning electron microscopy was also used to characterize the effects of the fluoride treatment on the wire topography. RESULTS: Unloading mechanical properties of Ni-Ti orthodontic wires were significantly decreased after exposure to both fluoride agents (1-way analysis of variance [ANOVA] and Dunnett's post hoc, alpha =.05); however, Cu-Ni-Ti wire mechanical properties were not significantly affected by either fluoride agent (1-way ANOVA, alpha =.05). Corrosive changes in surface topography were observed for both wires, with Cu-Ni-Ti appearing to be more severely affected. CONCLUSIONS: The results suggest that using topical fluoride agents with Ni-Ti wire could decrease the functional unloading mechanical properties of the wire and contribute to prolonged orthodontic treatment.

Acidulated Phosphate Fluoride↗

TEM study of calcium phosphate precipitation on bioactive titanium surfaces.

Formation of calcium phosphate on alkali- and heat-treated titanium surfaces was investigated using transmission electron microscopy (TEM). The samples were prepared by immersing the alkali- and heat-treated titanium in a revised simulated body fluid (R-SBF) with the same HCO(3)(-) concentration level as in human blood plasma. The deposition and precipitation on treated titanium surfaces were extracted for TEM examination without thinning process. Electron diffraction of the precipitates revealed that octacalcium phosphate (OCP), instead of hydroxyapatite (HA), directly nucleates from amorphous calcium phosphate. The OCP crystals continuously grew on the titanium surfaces rather than transforming into apatite. Calcium titanate was also identified by electron diffraction. Its role in the formation bioactive calcium phosphate, however, is not clear from this experiment.

Biomimetic Materials↗

The effect of Pt and Pd alloying additions on the corrosion behavior of titanium in fluoride-containing environments.

In this study, we examined the corrosion behaviors of pure titanium, the alloys Ti-6Al-4V and Ti-6Al-7Nb, and the new experimental alloys Ti-Pt and Ti-Pd using anodic polarization and corrosion potential measurements in an environment containing fluoride. Before and after immersion in the test solutions, we made observations using a scanning electron microscope. The test solutions included an artificial saliva containing 0.2% NaF (corresponding to 905 ppm F) and an artificial saliva with a low concentration of oxygen. Although the surfaces of the Ti-Pt and Ti-Pd alloys were not affected by an acidic environment containing fluoride, the surfaces of the pure titanium, the Ti-6Al-4V alloy, and the Ti-6Al-7Nb alloy were markedly roughened by corrosion. The surfaces of the pure titanium, the Ti-6Al-4V alloy, and the Ti-6Al-7Nb alloy were microscopically damaged by corrosion when they were immersed in the solution containing a low concentration of dissolved oxygen, even with a fluoride concentration included in the commercial dentifrices. In this situation, however, the surfaces of the new Ti-Pt and Ti-Pd alloys were not affected. These alloys are expected to be of use in dental work as new titanium alloys with high corrosion resistances.

Alloys↗

Effect of dual ion implantation of calcium and phosphorus on the properties of titanium.

This study is concerned with the effect of dual implantation of calcium and phosphorus upon the structure, corrosion resistance and biocompatibility of titanium. The ions were implanted in sequence, first Ca and then P, both at a dose of 10(17) ions/cm2 at a beam energy of 25 keV. Transmission electron microscopy was used to investigate the microstructure of the implanted layer. The chemical composition of the implanted layer was examined by XPS and SIMS. The corrosion resistance was determined by electrochemical methods in a simulated body fluid (SBF) at a temperature of 37 degrees C. The biocompatibility tests were performed in vitro in a culture of human-derived bone cells (HDBC) in contact with the tested materials. The viability of the cells was determined by an XTT assay and their activity by the measurements of the alkaline phosphatase activity in contact with implanted and non-implanted titanium samples. The in vitro examinations confirmed that, under the conditions prevailing during the experiments, the biocompatibility of Ca + P ion-implanted titanium was satisfactory. TEM results show that the surface layer formed by the Ca + P implantation is amorphous. The corrosion resistance of titanium, examined by the electrochemical methods, appeared to be increased after the Ca + P ion implantation.

Alkaline Phosphatase↗

In vivo evaluation of plasma-sprayed titanium coating after alkali modification.

In this paper, plasma-sprayed titanium coatings were modified by alkali treatment. The changes in chemical composition and structure of coatings were examined by SEM and AES. The results obtained indicated that a net-like microscopic texture feature, which was full of the interconnected fine porosity, appeared on the surface of alkali-modified titanium coatings. The surface chemical composition was also altered by alkali modification. A sodium titanate compound was formed on the surface of the titanium coating and replaced the native passivating oxide layer. Its thickness was measured as about 150 nm which was about 10 times of that of the as-sprayed coating. The bone bonding ability of titanium coatings were investigated using a canine model. The histological examination and SEM observation demonstrated that more new bone was formed on the surface of alkali-modified implants and grew more rapidly into the porosity. The alkali-modified implants were found to appose directly to the surrounding bone. In contrast, a gap was observed at the interface between the as-sprayed implants and bone. The push-out test showed that alkali-modified implants had a higher shear strength than as-sprayed implants after 1 month of implantation. An interfacial layer, containing Ti, Ca and P, was found to form at the interface between bone and the alkali-modified implant by EDS analysis.

Alloys↗

Synthesis of a poly(L-lysine)-calcium phosphate hybrid on titanium surfaces for enhanced bioactivity.

Titanium has been a successful implant material owing to its excellent strength to weight ratio, toughness, and bioinert oxide surface. Significant progress has been made on the improvement of titanium's bioactivity by coating its oxide surface with calcium phosphates and bioactive molecules. Here, we report on the coating of titanium with a poly(L-lysine)-calcium phosphate hybrid material with a nanoscale texture. This hybrid coating was grown by first nucleating seed crystals of calcium phosphate, directly on the Ti surface and then exposing this surface to solutions containing Ca(2+), PO(4)(3-), and poly(L-lysine). The resultant hybrid coating was characterized by electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis, X-ray photoelectron spectroscopy, and elemental analysis. This material contained 14% by weight poly(L-lysine), and this organic component decreased greatly the dimensions of the surface features, thus enhancing surface area relative to the inorganic control. The highly textured hybrid material was more susceptible than the control to acidic and enzymatic degradation. The amino acid cysteine was covalently linked to the hybrid material, demonstrating the potential of this coating for further functionalization. These hybrid coatings may prove useful in enhancing the bioactivity of titanium.

Calcium Chloride↗

Reduced platelet adhesion to titanium metal coated with apatite, albumin-apatite composite or laminin-apatite composite.

Titanium metal coated with apatite (HA-Ti), albumin-apatite composite (AA-Ti) or laminin-apatite composite (LA-Ti) was prepared by the immersion of NaOH- and heat-treated titanium metal in a calcium phosphate solution, or one supplemented with albumin or laminin. Platelet adhesion to the obtained materials under flow conditions was investigated in real time using a cone- and plate-type viscometer and fluorescence labeled platelets. Adhesion and activation of the platelets on the HA-Ti, AA-Ti and LA-Ti were definitely suppressed as compared with those on untreated titanium metal with a mirror surface. Furthermore, the numbers of platelets adhered to AA-Ti and LA-Ti are smaller than those adhered to HA-Ti, although the differences were not statistically significant. These findings suggest that HA-Ti, AA-Ti and LA-Ti, especially AA-Ti and LA-Ti, would exhibit thromboresistance that is superior to commercially pure titanium metal in terms of platelet adhesion.

Adult↗

Blood plasma contact activation on silicon, titanium and aluminium.

In the present work, blood plasma protein deposition to spontaneously air oxidized silicon, titanium and aluminium was re-investigated in vitro. Immunological- and null ellipsometry methods were used to detect and quantitate adsorbed proteins, RIA methods to study the retention of preadsorbed 125I-HSA upon exposure to buffer or blood plasma, and kallikrein-specific colorimetric substrate S-2302 to follow the surface generation of kallikrein. The results show that the contact activation of coagulation and complement systems are connected on Si and Ti, but not on Al, via coagulation factor XII. Preadsorbed 125I-HSA was most readily displaced on silicon, followed by titanium and aluminium. The surfaces displayed different antibody binding patterns after short and long-time exposures to plasma. Titanium and silicon bound anti-HMWK after 1 min in plasma, but aluminium did not. When the plasma incubation time was prolonged up to 2h the anti-HMWK binding disappeared totally on titanium and decreased on silicon. During the same time period, anti-C3c binding increased to the three types of surfaces. Also, the anti-C3c binding onto Si and Ti, but not Al, disappeared after incubation in Factor XII deficient plasma or when a specific coagulation factor XII (Factor XII) inhibitor, corn trypsin inhibitor (CTI) was added to normal plasma. The surface contacted plasmas cleaved the kallikrein-specific reagent S-2302 both after single surface contact, and after reincubation of surfaces in fresh plasma. The results show that C3b and Factor XIIa and their degradation products were retained at the surfaces.

Adsorption↗

On-line analysis of CAL72 cells on two different titanium surfaces in a perfusion micro-bioreactor.

OBJECTIVES: The aim of the present experiment was to test a prototype microsensoric measuring system (micro-bioreactor) for the investigation of the biocompatibility of different titanium surfaces in a cell culture model. METHODS: Osteosarcoma cells of the cell line CAL72 were seeded onto titanium plates (10mm x 10mm x 1mm) and inserted into the culture chamber of the micro-bioreactor. Titanium plates with two different surface topographies (machined and titanium plasma-sprayed [TPS]) were used for this pilot investigation. Plastic plates served as controls. The online-sensoric device of the micro-bioreactor allowed the continuous monitoring of the metabolism of the cells and the control of the culture conditions. Over a period of 17 h changes in O(2)-consumption in the medium were measured by micro-electrodes and registered by the software of the system. The metabolic activity of the cells was calculated from the difference between the bypass and the chamber values. The cell proliferation and vitality were analyzed before and after the perfusion time in the micro-bioreactor. The cell morphology was studied using scanning electron microscopy. RESULTS: The cells on the machined surfaces showed the highest oxygen consumption after 15 h, after that it decreased. The cells on the TPS plates showed a lower oxygen consumption, which remained stable after 17 h. The highest oxygen consumption was seen with the cells on the control plastic plates. Concerning cell proliferation analysis, it could be shown that more vital CAL72 cells seeded onto TPS and plastic could be detected after the passage through the micro-bioreactor. Hence, the number of vital cells on the machined surface was reduced after the passage. SIGNIFICANCE: Within the limits of this experiment, the presented micro-bioreactor system could offer a valuable method to examine the dynamic interactions of cells and materials under defined in vitro experimental conditions. While the presented system is already successfully used in the ecological/ecotoxicological field, its routine use for investigating dental materials on a cellular level has to be evaluated.

Biocompatible Materials↗

Surface modification of titanium by etching in concentrated sulfuric acid.

OBJECTIVE: The purpose of this study was to characterize the etching behavior of titanium in concentrated sulfuric acid and discuss its application on surface modification of titanium for biological use. METHODS: Commercially pure titanium (cpTi) plate was etched in 48% H2SO4 at RT -90 degrees C for 0.25-8 h. The weight loss was derived from the weight differences before and after etching. The surfaces after etching were characterized by surface roughness, X-ray diffractometry, and scannning electron spectroscopy. The apparent activation energy of the dissolution of cpTi into acid was derived from an Arrhenius plot of the rate of weight loss versus the acid temperature. RESULTS: The surface roughness of cpTi increased with the acid temperature and etching time. The surface roughness was strongly related to the weight loss. The weight loss increased drastically with the acid temperature after an initial period, which shortened with increasing acid temperature. The apparent activation energy for the dissolution of cpTi in H2SO4 was derived as 67.8 kJ/mol. SIGNIFICANCE: This study indicates that etching with concentrated sulfuric acid is an effective way to modify the surface of titanium for biological applications.

Acid Etching, Dental↗

Tensile bond strength of dual curing resin-based cements to commercially pure titanium.

OBJECTIVES: The aim of this study was to evaluate the tensile bond strength of dual curing luting resin cements to commercially pure titanium at 10 min and 24h after removal of the oxide layer. METHODS: One hundred and twenty titanium discs were obtained by casting and polishing with silicon carbide papers. The titanium discs were sandblasted with 50 microm aluminum oxide, ultrasonic cleaned and bonded in pairs with the resin-based cements Panavia F and Rely X ARC at 10 min and 24h after the sandblasting. The tensile test was performed with a crosshead speed of 0.5mm/min in an Instron Universal testing machine. RESULTS: The Rely X ARC reached the highest tensile strength value at 24h after sandblasting (18.27 MPa), but there was no statistically significant difference between the two dual curing resin cements for both times tested. All specimens showed a mixture of cohesive fracture in the resin cement and adhesive failure. However, the predominant failure mode for Panavia F was cohesive in resin cement, and the Rely X ARC exhibited a greater proportion of specimens with adhesive failure between the alloy and resin luting cement at 10 min and 24h. SIGNIFICANCE: Both cements had, statistically, the same tensile bond strength. But in the fracture mode analysis, the adhesive predominant fracture mode of Rely X ARC cement indicates a premature clinical adhesive failure. On the other hand, the cohesive predominant fracture mode of Panavia F indicates a longer clinical adhesive bond with titanium.

Adhesiveness↗

Reinforcement effect of adhesively luted fiber reinforced composite versus titanium posts.

OBJECTIVE: The aim of the present study was to investigate the influence of the rigidity of different post materials (titanium versus glass fiber reinforced composite [FRC]) on the fracture resistance of endodontically treated teeth (ETT). METHOD: Forty-eight caries-free maxillary central incisors were randomly assigned to six groups (n=8). After endodontic treatment, teeth of four groups were flattened 2mm above and two groups at the cemento-enamel junction (CEJ). As control, specimens of one group received neither composite build-up nor post, and teeth were left empty (E). In another group only a resin composite build-up was placed (C). In two groups, both titanium and FRC posts were inserted. One group with titanium (2/T) and FRC (2/FRC) post received a 2mm deep ferrule preparation. For one group with titanium (0/T) and FRC (0/FRC) post no ferrule design was provided. All-ceramic crowns were adhesively luted on all specimens. Specimens were exposed to thermomechanical loading and finally statically loaded until failure. RESULTS: The median fracture load values (min-max) were: E=317 (242-404); C=387 (335-475); 0/FRC=352 (0-440); 2/FRC=502 (326-561); 0/T=420 (0-548), 2/T=517 (416-653). Statistically significant differences were computed between E, C, 2/FRC, 0/T and 2/T; between C, 2/FRC and 2/T; between 0/FRC, 2/FRC and 2/T; between 0/T and 2/T regarding maximum fracture load. SIGNIFICANCE: Fracture resistance of ETT is not influenced by the rigidity of the post material. The combination of ferrule preparation and endodontic post results in higher load resistance after TML than any other build-up design.

Composite Resins↗

Acoustomechanical properties of open TTP titanium middle ear prostheses.

OBJECTIVE: The purpose of the study was to identify acoustcomechanical properties of various biostable and biocompatible materials to create a middle ear prosthesis with the following properties: (i) improved handling including a good view of the head of the stapes or footplate and adjustable length, (ii) improved acoustical characteristics that are adequate for ossiculoplastic. The identified material should serve to build CE and FDA approved prostheses for clinical use in patients. METHODS: Test models made of Teflon, polyetheretherketone, polyethylenterephtalate, polysulfone, gold, Al2O3 ceramics, carbon and titanium were investigated for their potential to fulfill the requirements. Acoustical properties were investigated by laser Doppler velocimetry (LDV) in mechanical middle ear models (MMM). Measured data were fed in to a recently created computer model of the middle ear (multibody systems approach, MBS). Using computer-aided design (CAD) measured and computed data allowed creation and fine precision of titanium prostheses (Tübingen Titanium Protheses, TTP). Their handling was tested in temporal bones. Acoustomechanical properties were investigated using the MBS and mechanical middle ear models. MAIN OUTCOME MEASURES: Input impedance, mass, stiffness, and geometry of test models and prostheses were determined. Furthermore, their influence on the intraprosthetic transfer functions and on coupling to either tympanic membrane or stapes was investigated. RESULTS: Final results were FDA- and CE-approved filigreed titanium prostheses with an open head that fulfilled the four requirements detailed above. The prostheses (TTP) were developed in defined lengths of between 1.75 and 3.5 mm (partial) and 3.0 and 6.5 mm (total) as well as in adjustable lengths (TTP-Vario). CONCLUSIONS: The results suggest acoustomechanical advantages of TTPs because they combine a significantly low mass with high stiffness. In contrast to closed prostheses, the open head and filigreed design allow an excellent view of the prosthesis foot during coupling to the head or footplate of stapes, contributing to an improved intraoperative reliability of prosthesis coupling.

Acoustics↗

Changes in condylar long axis and skeletal stability after bilateral sagittal split ramus osteotomy with poly-L-lactic acid or titanium plate fixation.

This study was designed to assess skeletal stability after bilateral sagittal split ramus osteotomy (BSSO) and fixation with a poly-l-lactic acid (PLLA) plate, as compared to that after BSSO and fixation with a titanium plate, and to analyze the change in the condylar long axis after these procedures. The study group comprised 40 patients who had mandibular prognathism (20, titanium group; 20, PLLA group). The groups were randomized to show similar distributions of preoperative SNB. All patients underwent BSSO setback by the Obwegeser method. Fixation was done with bent titanium plates or bent PLLA plates, applied in a similar manner. Lateral, frontal, and submental-vertical cephalograms were analyzed preoperatively and postoperatively. The maximum mouth opening range and the incidence of temporomandibular disorders were also evaluated. There was no significant difference in the right condylar angle or width between the two groups, but the left condylar angle and width, gonial angle, and ramus inclination differed significantly between them (P<0.05). SNA, SNB, and ANB were similar in both groups. There was no significant difference between the groups in maximum mouth opening range or temporomandibular disorders. We conclude that the change in condylar angle after BSSO and fixation with a titanium plate is greater than that after BSSO and fixation with a PLLA plate, but skeletal stability related to the occlusion is similar for the two procedures.

Absorbable Implants↗

Functional reconstruction of maxilla with pedicled buccal fat pad flap, prefabricated titanium mesh and autologous bone grafts.

The aim of this study was to evaluate the use of pedicled buccal fat pad flap (PBFPF), prefabricated titanium mesh and autologous bone graft in maxillary reconstruction. Seventeen patients with a unilateral class I-III maxillary defect were involved. Preoperatively, a solid model was manufactured based on virtual maxillectomy and reconstruction of the abnormal maxilla. Intraoperatively, PBFPF was applied to repair the soft-tissue defect, serving as nasal lining and the receiving bed for bone grafts. Titanium mesh was prefabricated on the solid model and then, together with bone grafts from iliac crest, fixed to residual bones to reconstruct the hard-tissue defect. Postoperative aesthetic appearance and function were followed up. No exposure of titanium mesh, leakage or oronasal regurgitation occurred. Of the patients with a class I or II defect 91% (10/11) and of those with a class III defect 50% (3/6) gained a good appearance. Fifteen patients were articulate. Eleven patients received dental rehabilitation and had a normal diet. PBFPF with prefabricated titanium mesh and autologous bone grafts is a reliable option for reconstruction of unilateral maxillary defects of class I and II, but this method alone should be used cautiously in defects of class III and beyond.

Adipose Tissue↗

Evaluation of five dental silanes on bonding a luting cement onto silica-coated titanium.

OBJECTIVES: Five commercial dental silanes were evaluated in vitro as adhesion promoters bonding a luting cement to silica-coated titanium surfaces. METHODS: Titanium slides (n=20) were cleaned with alumina sand and then silica-coated with a special sand consisting of alumina particles coated with silica. The bonding of a resin composite cement (3M ESPE, Seefeld, Germany) to silica-coated and silanized titanium was evaluated by using the dental silane (RelyX Ceramic Primer) that belongs to the RelyX ARC cementing kit, and comparing it to four other dental silanes (Bisco Porcelain Primer, Cimara, ESPE Sil, and Pulpdent Silane Bond Enhancer). The resin composite cement stubs (n=8) were light-polymerized onto a silanized silica-coated titanium surface. The shear bond strength of the cement stubs was measured after dry storage and thermo-cycling 6000 times between 5 and 55 degrees C. The silanes and their reactions were chemically monitored by using Fourier transform infrared analysis. RESULTS: Statistical analysis using ANOVA revealed that the brand of silanes and the types of storage condition differ significantly (p<0.005). The highest shear bond strength was obtained with RelyX ceramic silane in dry conditions (19.5+/-4.3 MPa), and after thermo-cycling (16.6+/-3.5 MPa). The lowest results were obtained using Pulpdent Silane Bond Enhancer, in dry conditions (7.8+/-2.2 MPa), and after thermocycling (5.3+/-2.4 MPa). The analysis showed that silanes had different pH values. Some differences were detected between the silanes and their reactions. CONCLUSIONS: Dental silanes provide different bonding strengths and have differences in their pH, solvent system and silane concentration.

Adhesiveness↗

Radiographic evaluation of osseointegration and loosening of titanium implants in the MCP and PIP joints.

PURPOSE: Good to excellent clinical results have been shown in the initial studies on osseointegrated metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint implants that consist of a flexible silicone spacer connected to osseointegrated titanium fixtures. A high fracture rate of the silicone spacer, however, has been reported, diminishing the value of this implant system. The purpose of this study was to evaluate the osseointegration of the titanium fixture itself in a large study group and compare patients with rheumatoid arthritis with those with osteoarthrosis as a base for further development of the implant concept. METHODS: Two hundred thirty-nine implants (27 PIP, 212 MCP) in 86 patients were retrospectively evaluated radiographically. Two hundred implants were in patients with rheumatoid arthritis. Radiographic evaluation included measuring the length and width of resorption zones around the titanium fixtures. A scoring system was used that grouped observations in 4 groups, from 0 (little or no change) to 3 (loosening). Status of the silicone spacer was also noted. RESULTS: At follow-up evaluation an average of 41 months (range, 12-103 months) after surgery, complete osseointegration was found in 450 of 478 fixtures (94%). Loosening was found in 10 proximal and 18 distal fixtures. The proximal fixtures showed loosening mainly during the first 3 years after surgery and the distal fixtures also had loosening. In the 31 MCP joint implants that were evaluated for more than 5 years, the osseointegration rate was 97%. CONCLUSIONS: Implant stem fixation with osseointegrated titanium fixtures is a valuable method that works well in rheumatoid arthritis patients. Further development will focus on a more durable constrained joint mechanism.

Adolescent↗

A histologic analysis of the effects of stainless steel and titanium implants adjacent to tendons: an experimental rabbit study.

PURPOSE: The current trend is to treat distal radius fractures with open reduction and internal fixation with either titanium or stainless steel plates. Both provide stable fixation; however, there is minimal evidence concerning the soft-tissue response to these materials. Our objective was to evaluate the response of adjacent extensor tendons to titanium and stainless steel in a rabbit in vivo model and to evaluate the influence of time. METHODS: Forty rabbits were divided into 5 groups of 8 rabbits each. Groups I and II had unilateral osteotomy of the distal radius followed by dorsal fixation with titanium and stainless steel plates, respectively. Groups III and IV had fixation with titanium and stainless steel, respectively, but without osteotomy. Group V had surgical dissection without osteotomy or plates. Two animals per group were killed at 1, 4, 12, and 24 weeks. The specimens (distal radius, plate, overlying soft tissue, and extensor tendon) were harvested en bloc for histologic analysis. For interface preservation between implant and tissues the specimens were embedded in methylmethacrylate, sectioned, and stained with hematoxylin-eosin. RESULTS: Histologic analysis showed a fibrous tissue layer formed over both implants between the plate and the overlying extensor tendons in the groups treated with plating independently of the material and the presence or absence of osteotomy. This fibrous layer contained the majority of debris. Metallic particles were not observed in the tendon or muscle substance of any animals; however, they were visualized in the tenosynovium. Hematoxylin-eosin-stained sections of groups I through IV showed proliferative fibroblasts and metallic particles; however, this layer was not observed in group V. Statistical analysis did not show differences between the groups regarding the number of cells or metallic particles. CONCLUSIONS: Our results indicate that both implants generated adjacent reactive inflammatory tissue and particulate debris. There was no difference in cell or particle number produced by both materials. There is a statistically significant increase in inflammatory cells with increasing time of implantation.

Animals↗