Titanium-silver alloys miniplates for mandibular fixation-In vitro and in vivo study

Publication date: Available online 23 April 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jung-Hwan Lee, Jae-Sung Kwon, Seung-Kyun Moon, Soo-Hyuk Uhm, Byung-Ho Choi, Uk-Hyon Joo, Kwang-Mahn Kim, Kyoung-Nam Kim
PurposeTitanium (Ti) alloys have received significant attention as materials for oral and maxillofacial surgery, which requires high mechanical strength, osteosynthesis and biocompatibility. The objective was to implant miniplates fabricated from commercially pure Ti (CP Ti) and newly developed Ti-Ag alloy in fractured mandibles of adult dogs after preliminary mechanical and biological characterization.MethodsThe surface characteristics, biocompatibility, and pre-osteoblast adhesion and proliferation of CP Ti (grade 3) and Ti-Ag (2 at% of Ag) alloys were evaluated. Next, the bending strength of six- and eight-hole miniplates fabricated from CP Ti and Ti-Ag was compared according to ISO 9585. Six-hole miniplates were implanted for 12 weeks in fractured mandibles of adult dogs. The silver ion concentration in each alloy and implanted bone block with soft tissue was measured by inductively coupled plasma mass spectroscopy after euthanasia according to ISO 10993-12.ResultsPrecipitated Ag was detected in Ti-Ag by alpha- and beta-phase Ti in X-ray powder diffraction. The biocompatibility with pre-osteoblasts of Ti-Ag and CP Ti was comparable in terms of cytotoxicity, cell adhesion and proliferation (P > .05). Ti-Ag miniplates had up to threefold greater bending strength than CP Ti miniplates (P < .05). An in vivo study showed that CP Ti and Ti-Ag miniplates had comparable soft and hard tissue regeneration ability (P > .05). Silver ions were detected in Ti-Ag alloys and applied mandible blocks.ConclusionThe results of this study suggest that Ti-Ag alloys can be used to produce miniplates with high mechanical properties, considerable biocompatibility and osteosynthesis ability and silver ion-release properties. Further studies, including preclinical investigations, are required to enable clinical usage of Ti-Ag bone plates.

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