Increased levels of dissolved titanium are associated with peri-implantitis-a cross-sectional study

Luciana M. Safioti, Georgios A. Kotsakis, Alex E. Pozhitkov, Whasun O. Chung, Diane M. Daubert

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Background: Peri-implantitis represents a disruption of the biocompatible interface between the titanium dioxide layer of the implant surface and the peri-implant tissues. Increasing preclinical data suggest that peri-implantitis microbiota not only triggers an inflammatory immune response but also causes electrochemical alterations of the titanium surfaces, i.e., corrosion, that aggravate this inflammatory response. Thus, it was hypothesized that there is an association between dissolution of titanium from dental implants, which suggests corrosion, and peri-implantitis in humans. The objective of this study is to compare levels of dissolved titanium in submucosal plaque collected from healthy implants and implants with peri-implantitis. Methods: Submucosal plaque from 20 implants with periimplantitis and 20 healthy implants was collected with sterile curets from 30 participants. Levels of titanium were quantified using inductively coupled plasma mass spectrometry and normalized for mass of bacterial DNA per sample to exclude confounding by varying amounts of plaque per site. Statistical analysis was performed using generalized estimated equations to adjust for clustering of implants per participant. Results: Implants with peri-implantitis harbored significantly higher mean levels of titanium (0.85-2.47) versus healthy implants (0.07-0.19) after adjusting for amount of plaque collected per site (P = 0.033). Conclusions: Greater levels of dissolved titanium were detected in submucosal plaque around implants with periimplantitis compared with healthy implants, indicating an association between titanium dissolution and peri-implantitis. Factors triggering titanium dissolution, as well as the role of titanium corrosion in the peri-implant inflammatory process, warrant further investigation. J Periodontol 2017;88:436-442.

Original languageEnglish (US)
Pages (from-to)436-442
Number of pages7
JournalJournal of periodontology
Issue number5
StatePublished - May 2017
Externally publishedYes


  • Biofilms
  • Corrosion
  • Dental implants
  • Peri-implantitis
  • Titanium

ASJC Scopus subject areas

  • Periodontics


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