Cytotoxic effects of submicron- and nano-scale titanium debris released from dental implants: an integrative review

This integrative review aimed to report the toxic effect of submicron and nano-scale commercially pure titanium (cp Ti) debris on cells peri-implant tissues. A systematic search was carried out PubMed electronic platform using following key terms: Ti “OR” “AND” dental implants nanoparticles nanometric osteoblasts “OR “cytotoxicity” OR “macrophage” “mutagenic” “peri-implantitis”. The inclusion criteria involved articles published in English language, until December 26, 2020, reporting particles as released from toxicity damage osteoblasts. Of 258 identified, 14 were selected for this review. Submicron cp altered behavior culture medium. An inflammatory response triggered by macrophages, fibroblasts, osteoblasts, mesenchymal cells, odontoblasts indicated detection several mediators such IL-6, IL-1?, TNF-?, PGE2. formation a bioactive complex composed calcium phosphorus allowed their binding proteins leading cell internalization phenomenon. induced mutagenic carcinogenic effects into cells. cytotoxic depends size, concentration, chemical composition particles. high concentration scale intensifies responses with potential surrounding Titanium ions have been detected tissues different forms. presence metallic at also stimulates migration immune reactions. Cp TiO2 micro- can reach bloodstream, accumulating lungs, liver, spleen, bone marrow.