A study of titanium release into body organs following the insertion of single threaded screw implants into the mandibles of sheep

Background: Titanium is generally considered a safe metal to use in implantation but some studies have suggested that particulate titanium may cause health problems either at the site overlying the Implant or in distant organs, particularly after frictional wear of a medical prosthesis. It was the purpose of this investigation to study the levels of dissemination of titanium from threaded screw type implants following placement of single implants in sheep mandibles. Method. Twelve sheep were implanted with a single 10x3.75mm self-tapping implant for time intervals of one, four and eight to 12 weeks. Four unoperated sheep served as controls. Regional lymph nodes, lungs, spleens and livers were dissected, frozen and subsequently analysed by Graphite Furnace Atomic Absorption Spectroscopy. Results: Results associated with successful implants showed no statistically significant different levels of titanium in any organ compared to controls, although some minor elevations in titanium levels within the lungs and regional lymph nodes were noted. Two implants failed to integrate and these showed higher levels of titanium in the lungs (2.2-3.8 times the mean of the controls) and regional lymph nodes (7-9.4 times the levels in controls). Conclusions: Debris from a single implant insertion is at such a low level that it is unlikely to pose a health problem. Even though the number of failed implants was low, multiple failed implants may result in considerably more titanium release which can track through the regional lymph nodes. Results suggest that sheep would be an excellent model for following biological changes associated with successful and failed implants and the effect this may have on titanium release.