Cytotoxic effects of dental prosthesis grinding dust on RAW264.7 cells.

Respiratory diseases, including pulmonary fibrosis, silicosis, and allergic pneumonia, can be caused by long-term exposure to dental prosthesis grinding dust. The extent of the toxicity and pathogenicity of exposure to PMMA dust, Vitallium dust, and dentin porcelain dust differs. The dust from grinding dental prosthesis made of these three materials was characterized in terms of morphology, particle size, and elemental composition. The adverse effects of different concentrations of grinding dust (50, 150, 300, 450, and 600 µg ml-l) on RAW264.7 macrophages were evaluated, including changes in cell morphology and the production of lactate dehydrogenase (LDH) and reactive oxygen species (ROS). The dust particles released by grinding dental prosthesis made of these materials had different morphologies, particle sizes, and elemental compositions. They also induced varying degrees of cytotoxicity in RAW264.7 macrophages. A possible cytotoxicity mechanism is the induction of lipid peroxidation and plasma membrane damage as the dust particles penetrate cells. Therefore, clinicians who regularly work with these materials should wear the appropriate personal protection equipment to minimize exposure and reduce the health risks caused by these particulates.

miR-130b participates in wear particle-induced inflammation and osteolysis via FOXF2/NF-κB pathway.

OBJECTIVE: To reveal other miR-130b-mediated signaling pathway in the involvement of wear particle-induced inflammation and osteolysis. MATERIALS AND METHODS: Particle-induced osteolysis (PIO) mice model was established. Secretion levels of TNF-α, IL-1ß, IL-6, and IL-10 were measured by ELISA. miR-130b and forkhead box F2 (FOXF2) mRNA were detected by qRT-PCR. Protein levels of FOXF2, phosphorylation-p65 (p-p65), and p-IκB were observed by Western blot. Luciferase reporter assay was performed to confirm the regulation of miR-130b on FOXF2. RESULTS: Compared with normal mice, secretion levels of TNF-α, IL-1ß, and IL-6 in PIO mice were significantly up-regulated and IL-10 was significantly down-regulated; miR-130b and p-p65 expressions were up-regulated and FOXF2 expression was down-regulated. In addition, the trends of miR-130b, FOXF2, and p-p65 expressions in Co-Cr-Mo treated Raw264.7 cells were the same as that in PIO mice. After transfection with miR-130b inhibitor, secretion levels of TNF-α, IL-1ß, and IL-6 in Raw264.7 cells were significantly decreased and secretion level of IL-10 was significantly increased. We also proved FOXF2 was a target of miR-130b, and FOXF2 siRNA increased secretion levels of TNF-α, IL-1ß, and IL-6 and decreased secretion level of IL-10. Finally, we found nuclear factor-kappa B (NF-κB) inhibitor BAY 11-7082 further decreased secretion levels of TNF-α, IL-1ß, and IL-6 and increased IL-10 level. CONCLUSION: The role of miR-130b/FOXF2/NF-κB pathway in PIO was firstly revealed, which provided new targets for the treatment of periprosthetic osteolysis.

Differential toxicity of processed and non-processed states of CoCrMo degradation products generated from a hip simulator on neural cells.

Physico-chemical characteristics of the CoCrMo degradation products have played an important role in cytotoxicity and clinical complications on the orthopedic patients who have metal implants. Previous studies have limited reflection on the physicochemical characteristics of the degradation products generated in vivo, which are very different from individual metal particles and/or ions obtained from different commercial sources. In this study, we aimed to understand the differences in toxicity induced by the degradation products in as-synthesized form as well as those obtained after post-processing. The degradation products were generated using a hip-simulator by maintaining physiological conditions closer to in vivo and separated into two batches, one with processing by washing and drying called processed degradation products (PDP) and another batch as 'as-synthesized' degradation product (DP). We studied the dose-dependent toxicity response by neural cells derived from induced pluripotent stem cells. The results of the study show that as-synthesized DPs are more toxic to neural cells even at lower concentrations studied with evident low TC50 (1-5 µg/ml) concentrations compared to PDP (25 µg/ml). Flow cytometric analysis showed a significant (p<.01) increase in uptake of the particles after 24 h and corresponding ROS production in DP-treated cells. RT-PCR analysis of oxidative specific gene expression showed, elevated mRNA levels of NADPH oxidase-1, nuclear transcription factor, superoxide dismutase-2 and glutaredoxin-2 in DP-treated cells after 6 h. The results of the study provided a clear evidence of the differential response of neural cells on the degradation products as a function of concentrations and their chemical nature.

The degree of peri-implant osteolysis induced by PEEK, CoCrMo, and HXLPE wear particles: a study based on a porous Ti6Al4V implant in a rabbit model.

BACKGROUND: Polyether-ether-ketone (PEEK), cobalt-chromium-molybdenum (CoCrMo), and highly cross-linked polyethylene (HXLPE) are biomaterials used in orthopedic implants; their wear particles are considered to induce peri-implant osteolysis. We examined whether different particle types induce the same degree of peri-implant osteolysis. METHODS: Forty female rabbits were randomly divided into four groups-the control group (n = 10), which received implantation operation and sham operation at 1 month postoperation; three experimental groups (n = 10 in each group), which received implantation operation along with administration of 0.1 mL of particle suspension (approximately 1.0 × 108 PEEK, CoCrMo, or HXLPE wear particles) into the knee joint at 1 month postoperation. All rabbits were sacrificed at 2 months postoperation. The synovium was removed and histologically assessed. The distal femurs with the implants were analyzed via micro-computed tomography (CT) and hard tissue biopsy. RESULTS: The average size of almost 90% of the particles was < 5 µm, indicating no significant difference in the three particle types. IL-1ß, IL-8, TNFα, RANKL, and MCP-1 expression in PEEK and CoCrMo groups was high, while that in the HXLPE group was low. The bone density (BD) and bone volume/total volume (BV/TV) of the porous structures (part of the implants in all groups) in experimental groups did not decrease markedly (p > 0.05), while BD in the peripheral regions in experimental groups decreased markedly compared to control groups (p < 0.05). BV/TV in the peripheral regions was significantly decreased in PEEK and CoCrMo groups when compared to control group (p < 0.05), while no significant difference was noted between HXLPE and control groups (p > 0.05). The changes in BV observed in the hard tissue sections were consistent with those noted in the micro-CT findings. CONCLUSION: PEEK, CoCrMo, and HXLPE wear particles (approximately having the same size and doses) induce peri-implant osteolysis to a different degree: HXLPE particles induce peri-implant osteolysis to a mild degree, while PEEK and CoCrMo particles caused significant peri-implant osteolysis. In case of a porous implant, osteolysis occurred primarily in the peripheral region, rather than in the porous structures. Our findings would be helpful for implant designers to choose friction pairs in orthopedic components.

LncRNA TSIX promotes osteoblast apoptosis in particle-induced osteolysis by down-regulating miR-30a-5p.

OBJECTIVE: This study aims to investigate the role of TSIX/miR-30a-5p axis in particle-induced osteolysis (PIO). METHOD: PIO mouse model was established by the implantation of Co-Cr-Mo metal particles (CoPs). MC3T3-E1 cells received CoPs stimulation. Bone mineral density (BMD) in the skull was detected to evaluate PIO development. The expression of TSIX and miR-30a-5p was detected by using qRT-PCR. Osteoblast apoptosis was measured using flow cytometry. RNA pull-down was used to verify the regulatory relationship between TSIX and miR-30a-5p. RESULT: The results showed that BMD of the skull in PIO mice was significantly decreased compared with control mice, which indicated that the PIO model was established successfully. Moreover, CoPs could up-regulate TSIX level, down-regulate miR-30a-5p expression, and promote osteoblast apoptosis in vivo and in vitro. The results also found that TSIX negatively regulated miR-30a-5p expression, and knockdown of TSIX inhibited Runx2 expression. As expected, miR-30a-5p inhibitor could reverse the inhibition of si-TSIX on osteoblast apoptosis. CONCLUSION: TSIX played a pivotal role in PIO development by negatively regulating miR-30a-5p.

[Preclinical evaluation of coated knee implants for allergic patients]. / Präklinische Ergebnisse beschichteter Knieimplantate für Allergiker.

BACKGROUND: 10-15% of the population show allergic reactions against skin contact to metals as nickel, cobalt or chromium and have thus a risk of not tolerating implants containing those materials. The relationship between periimplantary hypersensivity reaction and given cutaneous contact allergy is currently unknown. A new developed multilayer coating system is supposed to prevent long-term allergic reactions that may result from uncoated implants. METHODS: Stability and function (concerning bonding durability, wear and ion release to the serum) of the multilayer coating system has been examined in a test series. RESULTS: The specific architecture of the multilayer coating system evidences a very good bonding durability. The results of the test in the simulator show a reduction of wear of approximately 60% compared to the uncoated implants. Ion concentrations within the serum of the wear tests were by magnitudes lower than those measured in reference tests on uncoated components. CONCLUSION: The results of the preclinical evaluation prove that the durability and function of the multilayer coating system are as intended.

[In vitro toxicity and mutagenicity of CoCrMo and TiAl wear particles]. / In-vitro-Toxizität und Mutagenität von CoCrMound TiAl-Abriebpartikeln.

Contact of wear particles with body fluids can result in widespread dissemination of extractable constituents from joint implants. The aim of this in vitro study is to clarify whether there is a mutagenic and/or carcinogenic risk from Co(28)Cr(6)Mo and Ti(6)Al(4)V wear particles. Particles of a representative size were produced by fretting; toxicity and mutagenicity were investigated using the Ames Salmonella/microsome test and the V79-HGPRT Test (Chinese hamster fibroblasts). To obtain the greatest possible elution of all constituents, the metallic wear particles were extracted with DMSO and water and the resulting eluates mixed together. After repeated test series under standardized conditions, neither the bacterial nor the mammalian cell assays produced evidence of toxic or mutagenic effects in the concentration range under study. It is therefore not to be expected that CoCrMo or TiAl alloys initiate carcinogenesis in the human organism.

In vitro toxicity and mutagenicity of CoCrMo and Ti6Al wear particles.

Contact of wear particles with body fluids can result in widespread dissemination of extractable constituents from joint implants. The aim of this in vitro study is to clarify whether there is a mutagenic and/or carcinogenic risk from CoCrMo and Ti6Al wear particles. Particles of a representative size were produced by fretting; toxicity and mutagenicity were investigated using the salmonella/microsome test according to AMES and the V79-HGPRT Test (Chinese Hamster Fibroblasts). To obtain the greatest possible elution of all constituents the metallic wear particles were extracted with dimethylsulfoxyd and water and the resulting eluates mixed together. Neither the bacterial assay nor the mammalian cell system after repeated test series under standardised conditions produced evidence of a toxic or mutagenic effect in the concentration range under study. It is therefore not to be expected that CoCrMo or Ti6Al alloys initiate carcinogenesis in the human organism.

Orthopaedic implant related metal toxicity in terms of human lymphocyte reactivity to metal-protein complexes produced from cobalt-base and titanium-base implant alloy degradation.

Metal toxicity from sources such as orthopaedic implants was investigated in terms of immune system hyper-reactivity to metal implant alloy degradation products. Lymphocyte response to serum protein complexed with metal from implant alloy degradation was investigated in this in vitro study using primary human lymphocytes from healthy volunteers (n = 10). Cobalt chromium molybdenum alloy (Co-Cr-Mo, ASTM F-75) and titanium alloy (Ti-6Al-4V, ASTM F-136) beads (70 microm) were incubated in agitated human serum at 37 degrees Celsius to simulate naturally occurring metal implant alloy degradation processes. Particulate free serum samples, which were incubated with metal, were then separated into molecular weight based fractions. The amounts of soluble Cr and Ti within each serum fraction were measured and correlated with lymphocyte proliferation response to the individual serum fractions. Lymphocytes from each subject were cultured with 11 autologous molecular weight based serum fractions either with or without added metal. Two molecular weight ranges of human serum proteins were associated with the binding of Cr and Ti from Co-Cr-Mo and Ti implant alloy degradation (at < 30 and 180-330 kDa). High molecular weight serum proteins (approximately 180 kDa) demonstrated greater lymphocyte reactivity when complexed with metal released from Co-Cr-Mo alloy and Ti alloy than with low (5-30 kDa) and midrange (30-77 kDa) serum proteins. When the amount of lymphocyte stimulation was normalized to both the moles of metal and the moles of protein within each fraction (Metal-Protein Complex Reactivity Index, MPCRI), Cr from Co-Cr-Mo alloy degradation demonstrated approximately 10 fold greater reactivity than Ti in the higher molecular weight serum proteins (approximately 180-250 kDa). This in vitro study demonstrated a lymphocyte proliferative response to both Co-Cr-Mo and Ti alloy metalloprotein degradation products. This response was greatest when the metals were complexed with high molecular weight proteins, and with metal-protein complexes formed from Co-Cr-Mo alloy degradation.

Biocompatibility of fixation materials in the brain.

Recent clinical reports documenting passive intracranial translocation of microplates and microscrews have prompted concerns regarding brain biocompatibility and neurotoxicity of fixation hardware used in craniofacial surgery. Although the effects of commercially pure titanium. Vitallium (cobalt-chromium-molybdenum), stainless steel, and various alloys have been well assessed in bone and soft tissues, there are no comprehensive studies of these materials in the brain. To investigate this, the biocompatibility of titanium, vitallium, and 316L stainless steel was evaluated in the rabbit brain and compared with silicone elastomer shunt tubing, a material that is used commonly as a neurosurgical implant material with well-established brain biocompatibility. Forty-eight juvenile New Zealand White rabbits were randomly assigned to one of three groups and underwent placement of either commercially pure titanium microscrews, vitallium microscrews, or 316L monofilament stainless steel wire into the parietal region. Silicone elastomer strips of similar size were implanted in the contralateral hemisphere of each rabbit. Animals were assessed daily for signs of neurotoxicity. Rabbits in each group were sacrificed at 2, 4, 8, and 26 weeks following implantation. Brains were sectioned at the implantation site and were examined by means of standard hematoxylin and eosin stains and with immunohistochemical markers sensitive to inflammatory changes in the brain. None of the animals showed any behavioral changes or neurologic deficits suggestive of either systemic or localized toxicity from the implant materials. Silicone clastomer was found to cause the least amount of inflammation relative to other materials tested at all sacrifice points, suggesting that as a standard neurosurgical implant material, it is an appropriate control for studies of brain biocompatibility. At 2 weeks, titanium was found to cause the largest inflammatory response in surrounding brain parenchyma based on analysis of markers for microglial proliferation, gliosis, and leukocyte infiltration. At the 26-week endpoint of our study, the biocompatibility of titanium was nearly equal to the biocompatibility of vitallium based on all studied markers of inflammation. A progressive increase in the inflammatory response surrounding stainless steel implants was noted at 8 and 26 weeks. Relative to all materials studied, at 26 weeks the greatest leukocyte response was found with stainless steel implants. Our results indicate that at the 26-week end-point of our study, titanium and vitallium incited a similar inflammatory response in the rabbit brain that was greater than the response found with silicone elastomer, a standard neurosurgical implant material, but less than that found with stainless steel wire, which is commonly recommended as an alternative fixation material.

Cobalt-chromium-molybdenum but not titanium-6aluminium-4vanadium alloy discs inhibit human T cell activation in vitro.

This study describes the effect of the presence of cobalt-chromium-molybdenum (CoCrMo) and titanium-6aluminium-4vanadium (Ti6AL4V) disc samples on the CD3-mediated in vitro response of human peripheral blood T lymphocytes. Lymphocyte proliferation in the presence and absence of these metal alloy discs was measured by [3H]thymidine incorporation. Inhibition of lymphocyte proliferation was observed in the presence of CoCrMo disc samples. In contrast, the presence of the Ti6AL4V metal alloy discs had no effect on T cell proliferation. Ultrastructural studies using scanning electron microscopy revealed that the differences in the number of blast cells on uncoated CoCrMo and Ti6AL4V discs from a 4 day culture were consistent with the results observed in the proliferation experiments, i.e. fewer blast cells were seen on the CoCrMo than on the Ti6AL4V discs. In addition, a quantitative analysis of trace elements using total reflection X-ray fluorescence spectrometry in supernatants from 68 h in vitro cultures containing Ti6AL4V or CoCrMo disc samples was performed, revealing differences in the relative metal concentrations in the culture conditions tested. These differences point to the presence of cobalt in the supernatants as a possible determining factor of the inhibition observed. Because cell viability did not appear to change, a more complex mechanism involving the interaction of metals with T lymphocytes may account for the results obtained.

Intraarticular carcinogenesis bioassays of CoCrMo and TiAlV alloys in rats.

Wear-debris powders of cobalt-chromium-molybdenum (CoCrMo) and titanium-aluminum-vanadium (TiAlV) alloys, which are widely used for orthopedic implants (eg, hip and knee prostheses), were tested for carcinogenic activity following intraarticular administration (20 mg/rat) to groups of 44 male Fischer-344 rats (Charles River Breeding Laboratories, North Wilmington, MA). Control groups received similar intraarticular injections of either a noncarcinogen (manganese powder, negative control rats) or a potent carcinogen (nickel subsulfide powder, positive control rats). The experimental groups of 8-12 rats were observed for 24 months after injection. No local tumors developed at the injection site in the negative control rats or in rats that received the CoCrMo or TiAlV powders; poorly differentiated or pleomorphic sarcomas developed at the injection site in 10 of the 12 positive control rats that were treated with nickel subsulfide. Incidences of primary tumors distant from the injection site did not differ significantly among the experimental groups. This study shows that, under experimental conditions, any carcinogenic activity of CoCrMo or TiAlV wear-debris powders is weak in comparison to nickel subsulfide. Based on this study and observations in other laboratories, intraarticular administration of test materials to rats provides a practical, reliable, and biologically relevant method for carcinogenesis testing of biomaterials used for orthopedic implants.

Cell damage in vitro following direct contact with fine particles of titanium, titanium alloy and cobalt-chrome-molybdenum alloy.

Fibroblastic cells in vitro were exposed to powders of titanium, titanium-aluminium-vanadium alloy and cobalt-chrome-molybdenum (Co-Cr-Mo) alloy, either in direct contact with the cells or separated from the cells by a microporous membrane. Fine particles of all the materials reduced cell growth when in direct contact with cells, but only the finest particles of Co-Cr-Mo alloy caused cell damage through the microporous membrane. This provides further evidence that there is a mechanism of cell damage in vitro which depends on a direct interaction between cells and particles and is largely independent of the chemical nature of the particle.

[Morphologic and toxicologic evaluation of response to subcutaneous para-osseous implants Medpol-1 and Medpol-2 in rats]. / Ocena morfologiczna i toksykologiczna wplywu podskórnych przykostnych wszczepów Medpol-1 i Medpol-2 na organizm szczura.

Cobalt alloys produced in Poland and meant for orthopedic implants were morphologically and toxicologically evaluated. They were implanted subcutaneously in the para-osseous region of rats' heads. The results of the experimental tests strongly suggest the advisability of a clinical research project (study) on the examined cobalt alloys: Medpol-1 and Medpol-2.

Release of corrosion products by F-75 cobalt base alloy in the rat. II: Morbidity apparently associated with chromium release in vivo: a 120-day rat study.

There is concern whether in vivo corrosion of chromium-cobalt alloys releases ions containing trivalent [Cr(III)] or hexavalent [Cr(VI)] chromium. The question arises from indications that Cr(VI) is far more biologically active than Cr(III). Using a previously developed microsphere implant model, specimens of F-75 chromium-cobalt-molybdenum alloy were implanted in rats for periods up to 120 days. Blood and urine were collected at intervals during the study. Significant postoperative serum and urine chromium concentration elevations were observed. In addition, weight gain inhibition, lung morbidity, and animal mortality, related to the implant surface area to animal body weight ratio (SA/BW), were observed. Comparison of measured chromium serum concentrations with those concentrations found by others to be biologically active in tissue culture studies strongly suggests the release of Cr(VI) in this study.