Abstract
Objectives: Titanium miniplates and screws are commonly used in the surgical management of dentofacial deformities. Despite the opinion of the biocompatibility of these bone fixations, some patients experience symptoms of chronic inflammation around titanium implants even many years after their application. The aim of this study was to examine the levels of cytokines, chemokines, and growth factors released from the maxilla and mandible periosteum surrounding titanium fixations 11 months after the implantation procedure. Methods: From the study group (n = 20) consisting of patients with maxillofacial defects who underwent bimaxillary osteotomy, fragments of the periosteum of the maxilla and mandible adjacent to the titanium miniplates and screws were taken during routine bone fixation removal procedures. From the control group subjects (n = 20), fragments of healthy maxillary and mandibular periosteum were taken prior to surgical treatment of dentofacial deformities. The examination of cytokines, chemokines, and growth factors levels released from the periosteum of jaws was performed using the Bio-Plex Pro Human Cytokine Screening Panel (48-Plex). Results: The study group was characterized by a significant increase in the concentration of most of the tested-for proinflammatory cytokines/chemokines/growth factors compared to the control group, with greater amounts of inflammatory factors released from the periosteum covering the titanium implants in the mandible than from the periosteal cells surrounding the titanium implants in the maxilla. Conclusions: Prolonged exposure to titanium miniplates and screws leads to a disturbance of immune homeostasis in the periosteal cells of the maxilla and mandible. The data obtained indicate the need to remove fixations after the bone fragments have healed.