Table 2.
Various toxic effects of titanium particles.
| Authors | Type of study | Influence on oral cavity |
|---|---|---|
| Correa et al. 2009 [26] | In vitro | (i) Greater S. mutans adherence |
| Makihira et al. 2010 [27] | In vitro | (i) Increased cytotoxicity and inflammation |
| Olmedo et al. 2012 [28] | Ex-vivo | (i) Increased number of macrophages and T lymphocytes cause bone loss and implant failure |
| Barao et al. 2013 [29] | In vitro | (i) Increased LPS adherence |
| Olmedo et al. 2013 [5] | Ex-vivo | (i) Metal particles exfoliated in peri-implant mucosa trigger inflammatory reactions |
| Barao et al. 2014 [30] | In vitro | (i) Increased P. gingivalis attachment on implant surface |
| Safioti et al. 2017 [31] | Observational study | (i) Peri-implantitis |
| Chandar et al. 2017 [32] | In vitro | (i) Greater cell viability of CpTi than Ti6Al4V (ii) Aluminum and vanadium in Ti6Al4V induce cytotoxicity (iii) Cytotoxicity decreases due to the formation of TiO2 |
| Pettersson et al. 2017 [33] | In vitro | (i) Increased Ti ions near Ti implants stimulate human macrophages to release IL-1β specifically from LPS stimulated macrophages |
| Daubert et al. 2018 [34] | Observational study | (i) Ti ions modify peri-implant microbiome structure and diversity (ii) Increased Peri-implantitis |
| Zhu et al. 2018 [35] | In vitro | (i) Ti ions (10 ppm) suppressed osteoblasts and trigger nuclear expression of YAP pathway (ii) Its activation suppresses osteogenic differentiation |
| Hosoki et al. 2018 [36] | Observational study | (i) Ti allergy occurred in 6.3% of all cases |
| Daubert et al. 2019 [37] | Case control study | (i) Increased methylated DNA cytosine in peri-implantitis due to epigenetic alterations in the tissues (ii) Increased association between Ti concentration and global methylation levels independent of peri-implantitis (iii) Methylation of DNA influenced by Ti dissolution |
| Berryman et al. 2020 [38] | Ex-vivo | (i) Increased bone loss and peri-implantitis |
| Kotsakis et al. 2020 [39] | In vitro | (i) Cytotoxic effects of Ti on fibroblasts |
| De Lima-Souza et al. 2021 [40] | Case report | (i) Erythematous-papular-nodular lesions in mandibular and submandibular region (ii) Histopathologically chronic fistula with foreign body reaction and Ti ions along fistula wall |