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When Titanium Becomes Toxic

When Titanium Becomes Toxic

2/27/2019 10:03:03 PM   |   Comments: 0   |   Views: 251

There is a current debate in the dental community about the long-term effects of dental implant materials on the body.  While no clinician would ever want to cause harm to a patient, many doctors ignore some of the research showing that titanium and titanium alloys may have some negative impacts to the body, as a whole.  Dr. William Locante recently gave an outstanding lecture addressing this topic at The International Academy of Ceramic Implantology in Tampa, FL. This is a short summary of Dr. Locante’s eye-opening lecture.


Titanium has long set the standard in all implantology to judge the performance of all other bio-materials and has been used successfully for decades.  The reason titanium is used for implants of all kinds is due to 5 factors: 

  1. Titanium is biocompatible
  3. Corrosion resistant (not corrosion free)
  5. Light weight
  7. Strength
  9. Malleability 

Interestingly, titanium in and of itself is not bi-compatible, it is the titanium dioxide layer that forms on the surface of an implant when inserted into the body that makes it bio-compatible.  If issues arise, it is years later when this titanium dioxide layer begins to break down or corrode.  This breakdown can result in the formation of a metal protein complex.  Titanium compounds can be cytotoxic locally and systematically.  Meaning, it can destroy cells right where the implant is located, but also in other areas of the body.

A very common problem with titanium dental implants is peri-implantitis or mucositis, which is an inflammatory issue that negatively affects the soft tissue and/or bone around an implant. This inflammation can cause irritation, soft tissue loss, bone loss and even cause the implant to fail. And, this inflammation is simply a warning and defense of the body against a foreign body.  Dr. Locante says the literature shows that up to 23% of metal implants are affected by this disease.

The lecture also discussed osteolysis, which is the pathological destruction around a titanium implant, because of titanium corrosion.  This would cause the metal dental implant to loosen and even come out completely.  Moreover, what is left is a large area of missing bone and a bone graft may be needed to fill that space.  

Other problems with the dissolution of titanium, and materials like vanadium, aluminum and other materials used to make titanium alloys, come from leached ions.  These ions can induce osteolysis, allergic reactions or hypersensitivity.  There is even some isolated incidence of tumors associatedwith titanium implants.  Almost all the problems associated with titanium implants are inflammatory in nature, which is the bodies indication that something seriously wrong is happening.  

Dr. Locante mentions that titanium implants are still a very viable option in manydental implant surgeries, and we will not see the material disappear anytime soon. But he adds, that newer materials like zirconia are an ideal substitute for titanium in creating implants.  Zirconia dental implants, commonly referred to as, ceramic implants, are ideal because they do not corrode in the oral environment and share many of the same positive characteristics of titanium.  

Ceramic dental implants are extremely tissue friendly, meaning that it is rare to see a peri-implantitis associated with these metal-free implants.  For those looking for very natural looking and highly aesthetic tooth replacement.  For those patients with metal allergies or seeking a holistic option for tooth replacement, ceramic implants are the ideal choice.  Moreover, the holistic population is growing, and doctors should offer a metal-free options for their patients from a clinical perspective and from a business perspective. 

William Locante, DDS has been practicing dentistry for over 30 years and works in private practice in   Dr. Locante is an Assistant Clinical Professor in the Dept. of Periodontics and Restorative Dentistry at the University of Tennessee. He is an Honored Fellow of The American Academy of Implant Dentistry, an Honored Fellow and a Diplomat of the International Congress of Oral Implantology and a Diplomat of The American Board of Oral Implantology.  Dr. Locante as been published in multiple peer reviewed journals and is an examiner for the American Academy of Implant Dentistry. He also sits as a key opinion leader for several implant companies worldwide and a Ceramic Implant Expert for Z-SYSTEMS.  He has also done research on Bio Protein and Bone Cell research, which helped identify healing mechanisms with bone augmentation materials. Dr. Locante lectures nationally and internationally and has been involved in dental education for over 25 years.

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