Metal ion release of titanium and titanium alloy dental implants with dissimilar abutment materials: A systematic review of <i>in vitro</i> studies.

Abstract

The emerging concept of tribocorrosion including metal ion release and wear at the implant-abutment interface remains a challenge. This systematic review aims to investigate the differences in metal ion release at implant abutment interface when titanium/titanium alloy implants are coupled with dissimilar abutment materials as compared to titanium/titanium alloy abutments. A comprehensive search relevant to the predefined key terms was conducted across five databases (PubMed, Scopus, Web of Science, Embase, and Google Scholar) up to March, 2024 using the PECO framework. Inclusion criteria focused on <i>in vitro</i> studies on metal ion release at the implant-abutment interface. The eligibility and risk of bias of study was assessed using the QUIN tool. The data were extracted and based on the observed heterogeneity; only qualitative synthesis was performed. A total of 17 studies (477 specimens) were included for data analysis. The findings revealed significant variations in ion release depending on material combinations. Titanium implants paired with dissimilar abutment materials showed increased ion release over time, especially from days 43 to 84 as compared to Ti/Ti alloy abutment. Greater wear was also observed with dissimilar materials as compared to similar abutment material. Within the limitations of the analysis, metal ion release was substantially variable for Ti/Ti alloy abutments compared to other metal abutment materials coupled with Ti/Ti alloy implant and was found to be increased over time. Further clinical studies are needed to standardize metal ion detection and wear measurement methods and extend implant longevity.