This article was originally published here
Acta Biomater. 2021 Oct 6:S1742-7061(21)00659-0. doi: 10.1016/j.actbio.2021.10.002. Online ahead of print.
Titanium and alloys thereof are widely utilized for biomedical applications in the fields of orthopedics and dentistry. The corrosion resistance and perceived biocompatibility of such materials are essentially related to the presence of a thin passive oxide layer on the surface. However, during inflammation phases, the immune system and its leukocytic cells generate highly aggressive molecules, such as hydrogen peroxide and radicals, that can significantly alter the passive film resulting in the degradation of the titanium implants. In combination with mechanical factors, this can lead to the release of metal ions, nanoparticles or microscaled debris in the surrounding tissues (which may sustain chronic inflammation), bring about relevant health issues and contribute to implant loss or failure. After briefly presenting the context of inflammation, this review article analyses the state-of-the-art knowledge of the in vitro corrosion of titanium, titanium alloys and coated titanium by reactive oxygen species and by living cells with an emphasis on electrochemical and microstructural aspects. STATEMENT OF SIGNIFICANCE: Inflammation involves the production of reactive oxygen species that are known to alter the passive layer protecting titanium implants against the aggressive environment of the human body. Inflammatory processes therefore contribute to the deterioration of biomedical devices. Although review articles on biomaterials for implant applications are regularly published in the literature, none has ever focused specifically on the topic of inflammation. After briefly recalling the clinical context, this review analyses the in vitro studies on titanium corrosion under simulated inflammation conditions from the pioneer works of the 80s and the 90s till the most recent investigations. It reports about the status of this research area for a multidisciplinary readership covering the fields of materials science, corrosion and implantology.