Dental Tribune Indian Edition

The World’s Dental Newspaper • Indian Edition Published in India www.dental-tribune.com Vol. 1 No. 1 Page 3 Endodontic retreatment Achieving success the second time around Panoramic dental X-ray showing several fixed tooth replacements. Microscopic particles of titanium have been found in the surroun- ding tissue of medical implants. (DTI/Photo Natasha Spiridonova, Ukraine) Titanium implants may carry risk of corrosion, study finds DTI BIRMINGHAM, UK: Titanium me- dical implants used in dental prosthe- ses and bone-anchored hearing aids may be less robust than commonly believed. Researchers from the UK have recently discovered evidence to suggest that in environments where there is no significant wear process, microscopic particles of titanium can be found in the surrounding tissue, which may have a negative impact on the devices. For the study, Dr Owen Addison in the Biomaterials unit of the Uni- versity of Birmingham’s School of Dentistry and his team obtained tis- sue from patients undergoing schedu- led revision surgery associated with bone-anchored hearing aids (BAHA) at University Hospitals Birmingham NHS Foundation Trust. Soft tissue surrounding commercially pure tita- nium anchorage devices was exami- ned using micro-focus synchrotron X-ray spectroscopy at the Diamond Light Source, Oxford, UK. “The results showed, for the first time, a scattered and heterogeneous distribution of titanium in inflamed tissue taken from around failing skin- penetrating titanium implants,” the authors reported. “Wear processes and implant debris were unlikely to be ma- jor contributors to the problem. In the absence of obvious macroscopic wear or loading processes, we propose that the titanium in the tissue results from micro-motion and localised corrosion in surface crevices.” Globally, more than 1,000 tonnes of titanium are implanted into patients in the form of biomedical devices every year. Metallic prostheses, fixation and anchoring devices are used exten- sively for dental, orthopaedic, and craniofacial rehabilitation and their effects on the body are widely percei- ved to be predictable following initial implantation. The development of peri-implant inflammation may result in the pre- mature loss of the implanted device or the requirement for revision/rescue surgery, which are scenarios that can “impact on patients’ well-being and economically on the health service provider,” the authors concluded in the study. “Our results emphasise the need to understand further both the physical and chemical mechanisms leading to the dispersal of titanium species in tissue around implants and their potential to exacerbate inflam- mation.” Addison commented that while the findings pose no alarm to those with BAHA implants or similar de- vices, they demonstrate that impro- vements in materials like titanium can be sought. Research is currently being conducted to look at the biolo- gical consequences and to understand the mechanisms by which the debris is produced.DT Osteonecrosis of the jaw is associated with bisphosphonate therapy, required in some cancer and bone disorder treatments. (DTI/Photo courtesy of Masashi Yamori, Department of Oral and Maxillofacial Surgery, Kyoto University, Japan) Study links bisphosphonates to osteonecrosis of the jaw Cumulative incidence of ONJ significantly higher among patients who had received BP DT Asia Pacific KYOTO, Japan: A new study has shown that bisphosphonates (BP), a class of drugs commonly used to tre- at bone diseases such as osteoporosis, is associated with an increased risk of developing severe bone disease of the maxilla and the mandible. The rese- archers found that especially elderly patients who had received intravenous BP had an increased risk of osteone- crosis of the jaw (ONJ). The study was conducted among 3,216 male and female patients aged 20 or older mostly diagnosed with osteoporosis and various types of cancer. They had undergone tooth extraction at the Kyoto University Hospital’s Department of Oral and Maxillofacial Surgery between April 2006 and June 2009. About 4 per cent (126) had received either oral BP (99) or intravenous BP (27), while 96 per cent (3,090) had not received such treatment. Researchers from the institute found that at 42 months following tooth extraction the cumulative inci- dence of ONJ was significantly higher among patients who had received BP. According to the study, five patients to whom BP had been administered developed ONJ, compared with only one patient in the control group. They observed a significant diffe- rence with regard to age and prevalen- ce of cancer or osteoporosis between the two groups. The risk ratio for ONJ was particularly elevated in patients aged over 65 who had received intrave- nous BP, according to the researchers. In addition, they found that alveolar bone loss could be a risk factor for BP- induced ONJ after tooth extraction. Thus, they suggested that inflamma- tion of the periodontal tissue might predispose people to the condition, and preventive treatment of oral bacte- ria might be essential for a favourable outcome of tooth extraction. BP is usually administered to pre- vent further bone loss, reduce pain and increase bone mineral density in patients with bone disorders. A study published in the September 2003 issue of the International Journal of Oral and Maxillofacial Surgery was the first to suggest osteonecrosis as a side effect of bisphosphonate treatment. In the current literature, the estimated incidence of BP-induced ONJ ranges from 8.3 per cent to 40 per cent.DT Page 22 Business EAO celebrates successful anniversary event in Copenhagen Page 18 World News British researchers discover the origin of teeth in fish INDBCZ2213029 Trends & Applications