Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
Humans ; Peri-Implantitis/pathology* ; Titanium/pharmacology* ; Dental Implants/adverse effects* ; Osteolysis/pathology* ; Inflammation/chemically induced*

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ² test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,P<0.01). There were no significant differences in coronal, sagittal parameters, VAS and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2(t=-3.203, P=0.046). PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.
Male ; Female ; Animals ; Humans ; Adult ; Retrospective Studies ; Titanium ; Kyphosis/etiology* ; Sacrum ; Osteotomy/adverse effects* ; Spinal Fusion/methods* ; Lumbar Vertebrae ; Treatment Outcome ; Postoperative Complications/epidemiology*

Objective: To study the changes of serum metabolic profile of occupational people exposed with nanometer titanium dioxide particles (TiO(2)-NPs), and to explore the biomarkers and injury mechanism of TiO(2)-NPs health effects. Methods: From June 2020 to June 2021, a TiO(2)-NPs production enterprise was selected as the research site by a typical sampling method, 64 people in the TiO(2)-NPs exposure group were selected from the enterprise, and 62 people of the logistics administrative staff in the same enterprise were selected as the control group, and blood samples were collected using non-anticoagulant blood collection tubes. After the samples were methanol-precipitated, the untargeted metabolomic data was collected by ultra-high performance liquid chromatography time-of-flight mass spectrometry, and biomarkers were screened and metabolic pathway analysis was performed. Results: 46 different metabolites were screened out by P<0.05 and variable importance projection index (VIP) value >1, mainly including glycerides, sphingomyelin, glycerophospholipid, fatty acyl, etc.; By ROC analysis to determine 3-hydroxy-4, 5-dimethyl-2 (5H) - furanone, 4-aminobiphenyl, heptanoylcarnitine, Hexadecanedioic acid mono-L-carnitine ester, Ibutilide, LysoPA (18∶1 (9Z) /0∶0), LysoPC (18∶0), PC (16∶0/16∶0), PC (16∶0/20: 4 (5Z, 8Z, 11Z, 14Z) ), PC (P-18∶1 (9Z) /P-18∶1 (9Z) ) 10 candidate biomarkers; involving changes in 4 metabolic pathways, namely glycerophospholipid metabolism, sphingolipid metabolism, phenylalanine, tyrosine and tryptophan acid biosynthesis, linoleic acid metabolism. Conclusion: Occupational exposure to TiO(2)-NPs has a significant impact on serum metabolic profiles.
Humans ; Metabolomics ; Metabolome ; Titanium/adverse effects* ; Chromatography, High Pressure Liquid/methods* ; Biomarkers

OBJECTIVE: This paper is aimed at investigating the efficacy of combining internal fixation using prefabricated rib-locking titanium plate with ultrasound-guided thoracic paravertebral nerve blockade in treating multiple rib fractures among the elderly. METHODS: Retrospective analysis of 221 elderly patients with multiple rib fractures treated from February 2016 to November 2020. According to whether surgery was performed, they were divided into the plate-blockage combination group (surgical group, 102 cases) and conservative treatment group (non-surgical group, 119 cases). The surgical group consisted of 58 males and 44 females aged from 60 to 85 years old, with an average of (67.2±3.6 ) years old, who suffered from 3 to 12 rib fractures with an average of (5.3±2.1) fractures. The non-surgical group consisted of 66 males and 53 females aged from 60 to 84 years old with an average of (66.8±3.2) years old, who suffered from 2 to 11 rib fractures with an average of(6.1±2.3) fractures. The clinical data, efficacies observed, and complications associated with both groups were compared and analyzed. RESULTS: There was no significant difference in preoperative clinical data between two groups (P>0.05), and all patients were discharged smoothly. Pulmonary infection (P=0.028), atelectasis (P=0.032), respiratory failure (P=0.026), time to get out of bed (P=0.040), time to fracture healing (P=0.035), length of hospital stay in the operation group (P=0.043), visual analogue scale (VAS) at 3 days (P=0.028), 5 days(P=0.032), and 7 days(P=0.019), maximal voluntary ventilation (MVV) at 3 months after surgery (P=0.042), forced expiratory volume in one second (FEV1)(P=0.035), and maximal voluntary ventilation at 6 months, the maximal voluntary ventilation(MVV)(P=0.021) and forced FEV1(P=0.026) were all significantly better than those in non-surgical treatment group. CONCLUSION For elderly patients with severe multiple rib fractures, the proposed plate-blockade combination can timely and effectively relieve pain, restore thoracic stability, shorten hospital stay, and reduce the incidence of complications such as pulmonary infections and acute respiratory distress syndrome(ARDS) compared with non-surgical treatments. Prefabricated rib-locking titanium plates have proved to demonstrate high clinical efficacy in treating multiple rib fractures among the elderly.
Male ; Female ; Humans ; Aged ; Middle Aged ; Aged, 80 and over ; Rib Fractures/etiology* ; Titanium ; Retrospective Studies ; Bone Plates/adverse effects* ; Fracture Fixation, Internal/adverse effects* ; Treatment Outcome ; Ultrasonography, Interventional/adverse effects* ; Nerve Block/adverse effects* ; Ribs

OBJECTIVETo evaluate the clinical results of using end plate rings in preventing subsidence of titanium cage in anterior cervical corpectomy and fusion (ACCF) surgery.

METHODSThe clinical data of 71 patients with cervical spondylotic myelopathy underwent ACCF in single segment from February 2008 to February 2011 were retrospectively analyzed. There were 38 males and 33 females, aged from 39 to 74 years old with a mean of 53.8 years. Thirty-three were used end plate rings and thirty-eight were not used (end plate rings group and no end plate ring group, respectively). The Japanese Orthopaedic Association (JOA) score, Odom's scale, imaging data were used to evaluate the clinical effects. Imaging data including Cobb angle of fusion segment, intervertebral height of anterior border (Da) and posterior border (Dp), the mean intervertebral height (Dm).

RESULTSAll patients were followed up from 13 to 34 months with an average of 19.5 months. Between two groups, there was no significant difference in Cobb angle of fusion segment and the mean intervertebral height (Dm) before surgery and one week after surgery. Whereas, one year after surgery, the Cobb angle of end plate ring group was (9.4 ± 3.8) degrees, and contral group was (7.5 ± 3.9) degrees, which was significantly lower than that of end plate ring group. Meanwhile, the Dm of end plate ring group was (57.3 ± 2.2) mm, and no end ring group was (55.2 ± 2.6) mm which was significantly lower than that of end plate ring group. The subsidence in end plate ring group was 57.6%, and was 78.9% in no end plate ring group. There was no significant difference in JOA score before and after surgery between two groups. At 1 year after operation, 90.9% (30/33) got excellent or good results in end plate ring group, 89.5% (33/38) got excellent or good results in contral group.

CONCLUSIONThe use of end plate rings could not completely prevent the subsidence of titanium cage, however, which can decrease the occurrence rate of the subsidence and lessen its degree.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Fixation Devices ; adverse effects ; Spinal Fusion ; instrumentation ; methods ; Spondylosis ; pathology ; surgery ; Titanium

Bone Plates ; Female ; Fracture Fixation, Internal ; adverse effects ; Humans ; Hypersensitivity ; etiology ; Middle Aged ; Tibial Fractures ; surgery ; Titanium ; adverse effects

OBJECTIVETo investigate the internal fixation of sternum with titanium plate for the treatment of sternal wound infection after cardiac surgery.

METHODSA retrospective study of 26 patients from Jan 2009 to Dec 2011 was carried out. All the 26 cases with sternal wounds infection after cardiac surgery, were treated by internal fixation with titanium plates.

RESULTSAll the patients had chronic infection, lasting for more than 3 months. 3 patients received vacuum-assisted closure treatment after complete debridement. All the wounds were covered with pectoral major muscle flap. All the wounds healed completely with no recurrence of infection.

CONCLUSIONSInternal fixation of sternum with titanium plate can increase the stability. It helps to improve the treatment efficacy of sternal wound infection after cardiac surgery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Wound Infection ; surgery ; Thoracic Surgical Procedures ; adverse effects ; Thoracic Wall ; surgery ; Titanium

This paper is aimed to investigate the effect of titanium (Ti) particles and tumor necrosis factor alpha (TNF-alpha) on the expressions of MMP-1, 2, 3 in human synovial cells, so as to explore the possible mechanism of osteolysis post-operation of metal-on-metal total joint arthroplasty in human synovial cells induced by Ti particles. In vitro cell cultures, human synovial cells were treated by Ti particles and/or TNF-alpha. The total RNA was isolated at 2 hours after the treatment. The gene expression of MMP-1, 2, 3 was analyzed by Semi-quantitative Reverse-transcriptional PCR and quantitative real-time PCR. Cell supernatant was collected at 12, 24, 48 hours after the treatment and Gelatin zymography was performed to detect the activity of MMP-2. Compared to those in the control group (untreated), Ti particles and TNF-alpha increased the gene expression of MMP-1, 2, 3 respectively (P < 0.05), and the effect of combination of the two was even more significant (P < 0.01). The trend of activities of MMP-2 is similar with gene expression. Ti particles and TNF-alpha increased MMP-2 activities by 1.3 times and 1.5 times respectively (P < 0.05), and the combination of the two increased by 1.7 times (P < 0.01). Ti particles and TNF-alpha-induced the stimulation of MMP-1, 2, 3 expressions and MMP-2 activities in human knee joint synovial cells may be involved in aseptic loosening after metal-on-metal arthroplasty through increasing the degradation of bone matrix and declining of osseous support structure mechanics.
Cells, Cultured ; Humans ; Joint Prosthesis ; Knee Joint ; cytology ; Matrix Metalloproteinase 1 ; genetics ; metabolism ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Matrix Metalloproteinase 3 ; genetics ; metabolism ; Matrix Metalloproteinases ; genetics ; metabolism ; Particle Size ; Prosthesis Failure ; adverse effects ; RNA ; genetics ; metabolism ; Synovial Membrane ; cytology ; enzymology ; Titanium ; pharmacology ; Tumor Necrosis Factor-alpha ; pharmacology

Our previous investigations demonstrated that varying sizes of loaded titanium particles could inhibit proliferaion, adhension and osteoblastic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs). The present study aims to validate the hypothesis that particled-shaped wear debris from prosthetic implants influence the adipocytic differentiation of rBMSCs. The effects of different sizes of loaded titanium particles (6.9 microm, 2.7 microm and 0.9 microm) on the adipocytic differentiation of rBMSCs were studied by observing lipid droplet formation, assaying the expression of lipoprotein lipase (LPL) mRNA by RT-PCR and Triglycerides (TG) secretion. The loaded titanium particles were found to influence adipogenesis of rBMSCs, but had different effects, depending upon particle size, concentration and loading time duration. 2.7 microm and 0.9 microm titanium particles promoted lipid droplet formation, LPL mRNA expression and TG secretion, while at a higher concentration of titanium particles and a longer loading duration, 6.9 microm titanium particles gradually inhibited adipogenic differentiation of rBMSCs. Three sizes of loading titanium particles obviously disturbed the adipocytic differentiation capability of rBMSCs: the smaller particles promoted but the larger inhibited the adipogenic differentiation of rBMSCs.
Adipocytes ; cytology ; Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; drug effects ; Cells, Cultured ; Joint Prosthesis ; Male ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Particle Size ; Prosthesis Failure ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Titanium ; pharmacology

OBJECTIVETo investigate the effect of alloy leaching liquor of four different types of base metal alloy on the expression of prostaglandin E(2) (PGE(2)) and cyclo-oxygenase-2(COX-2) by human gingival fibroblast(HGF) in vitro.

METHODSNi-Cr, Co-Cr, pure Ti and Au ceramic alloys were incubated in Dulbecco's modified Eagle's medium (DMEM) to prepare alloy leaching liquor, and then added in HGF medium. DMEM was prepared as negative control. Aliquots were taken from exposed media after 1, 6, 12, 24 h. Assays for PGE(2) were carried out by enzyme-linked immunosorbent assay (ELISA).

RESULTSIn 6, 12, 24 h, the expression of PGE(2) in Ni-Cr and Co-Cr alloy groups (Ni-Cr: 45.568 ± 0.926, 60.538 ± 0.988, 73.754 ± 0.507; Co-Cr: 40.496 ± 0.693, 53.216 ± 0.327, 65.470 ± 1.086) were significantly higher than those in other experimental groups (Ti: 31.564 ± 0.719, 31.998 ± 0.856, 32.066 ± 0.513; Au alloy: 31.540 ± 0.821, 31.136 ± 0.518, 31.340 ± 0.443) and control group (31.122 ± 0.642, 31.230 ± 0.634, 30.980 ± 0.746) (P < 0.05). No significant difference were found in the expression of PGE(2) among pure Ti, Au alloy groups and the control group (P > 0.05). Immunofluorescence showed dark and uniform COX-2 stain in Ni-Cr and Co-Cr alloy groups, while in pure Ti group, Au alloy group, and negative control group shallow and uneven distribution of COX-2 stain were observed.

CONCLUSIONSOur findings suggested that pure Ti and Au alloy did not cause elevated PGE(2) and COX-2 release from HGF. However, Ni-Cr and Co-Cr alloy caused increase in PGE(2) and COX-2 levels.

Cells, Cultured ; Chromium Alloys ; adverse effects ; Cyclooxygenase 2 ; metabolism ; Dental Alloys ; adverse effects ; Dinoprostone ; metabolism ; Fibroblasts ; cytology ; metabolism ; Gingiva ; cytology ; Gold Alloys ; adverse effects ; Humans ; Titanium ; adverse effects