Metallic plates and screws made of stainless steel, pure titanium, titanium alloy and titanium nitride were implanted in the dorsal subcutaneous tissue and femur of 64 rabbits, and elution of metallic elements and tissue reaction in surrounding tissues were comparatively investigated at the 2nd, 4th, 8th, and 12th weeks after implantation. Using an inductively coupled plasma spectrometer, the metallic elements eluted in the subcutaneous tissues were quantitatively analyzed. The amount of iron from the stainless steel decreased with time. The amount of titanium eluted from pure titanium, titanium alloy and titanium nitride, increased with time, although only slightly in all cases. However, the amount of aluminum eluted from the implanted titanium alloy was considerably higher than that of titanium. Histological examination of the reaction of subcutaneous tissue, revealed encapsulation of pure titanium, titanium alloy and titanium nitride plates by dense fibrous connective tissues from the 2nd week after implantation, whereas the stainless steel plate was encapsulated by thin fibrous tissue. Using an energy dispersed X-ray microanalysis on the metal-bone interface, it was found that the element of titanium accumulated in the bone area about 5μm from the metallic screw, but there was no such finding for titanium alloy and titanium nitride. From stainless steel, no elution of iron, chromium and nickel was detected. Histological examination of the reactions of bone tissue to pure titanium, titanium alloy and titanium nitride, showed the formation of new bone between the metallic screw and bone tissue from the 4th week, and it gained a close and dense contact with normal bone at the 12th week after implantation, All experimental materials used in this study exhibited excellent resistance to corrosion and materials of titanium had better biocompatibility compared with stainless steel. Above all, the results of this study suggest that titanium nitride is useful as a biomaterial the same as pure titanium and titanium alloy.
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