Biodegradation of titanium implants after long-time insertion used for thetreatment of fractured upper and lower jaws through osteosynthesis: Element analysis by electron microscopy and EDX or EELS

Twelve patients underwent an osteosynthesis with titanium to treat upper an d lower jaw fractures. Six to 12 months later, the miniplates were removed. Tissue samples were analyzed by light and electron microscopy for detectio n of a metallosis. The analysis showed new bone formation like callus tissu e around the miniplates. In some cases small, rounded deposits and accumula tion of colloid-like particles located next to bigger titanium artifacts we re detected in the cytoplasm of histiocytes and in the matrix of connective tissue. The titanium was identified by elemental analysis using EDX in SEM as well as by EELS and electron diffraction in TEM. Both kinds of particle s contain titanium, but they seem to be different in composition and deriva tion. The bigger particles seem to consist of metallic titanium and sourced by working on the metallic implants during the implantation itself. On the other hand, the colloidal-like, small, rounded particles in tissue macroph ages and outside the cells in the matrix of connective tissue are presumabl y of other origin; for example, they could be derived from biodegradation a nd chemical conversion of the metallic implants. The titanium miniplates we re examined before and after implantation by using ESCA technique and revea led metallic titanium and different compositions with other elements. The a mount of titanium load of the tissue was very low in most cases and presuma bly not of biomedical relevance.