Surface analysis of titanium maxillofacial plates and screws retrieved from patients

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Original Article

Author Details : Soumya Allurkar, Satish kumar Patil, Udupikrishna M. Joshi, Kundan Shah, Nitin Thakur, Anand Mangalg

Volume : 4, Issue : 2, Year : 2016

Article Page : 167-173

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Abstract

Introduction: Miniplate fixation and screws is the method of choice for many surgeons to obtain rigid fixation and promote osteosynthesis within the maxillofacial region. The most common commercially used plates and screws are made up of pure titanium. The popularity of biocompatible devices containing titanium is due to its high resistance to corrosion in physiologic body fluids.
Generally titanium fixation plates are not removed after osteosynthesis because they have high biocompatibility. This study was done to analyze the surface characteristics and changes in retrieved titanium plates and screws by scanning electron microscope (SEM) and stereomicroscope.
Materials and Methods: A total of 20 plates were retrieved from 12 patients visiting the department of oral and maxillofacial surgery at our institution over a period of 18months. These samples were studied by stereomicroscopy and scanning electron microscopy. Each plate and one of its screws were examined for evidence of manufacturing defects, surgical damage and corrosion. Particular attention was focused on countersink area of plate and taper of the screw head as these regions were particularly prone to micro movements and subsequent corrosion.
Results: Surface contamination was detected both on retrieved and control plates. Manufacturing defects comprising of rough metal edges and protuberances were identified on the unused controls and surgical damage was evident on retrieved specimens. Two of the retrieved plates and screw showed the presence of corrosion and metal release which had been in the tissues for 14 to 20 months. Rest of the retrieved plates and screws, which had been in the tissues, between 6 months to 48 months showed no signs of corrosion or surface deterioration.
Conclusion: The present study showed that 2 plates and its associated screws had signs of corrosion and metal release; but further long-term follow-up studies are desirable to assess the clinical and toxicological effects of the retention of titanium plates, especially in relation to release of particles to the surrounding tissues. The source of metal release has to be further confirmed by EDX analysis. There was no evidence from this study to support the routine removal of titanium maxillofacial miniplates.

Keywords: Titanium Plates, Corrosion, Metal Release, Retrieved Plates

How to cite : Allurkar S, Patil S K, Joshi U M, Shah K, Thakur N, Mangalg A, Surface analysis of titanium maxillofacial plates and screws retrieved from patients. J Dent Spec 2016;4(2):167-173

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