Applications of titanium in medicine

Relevance

Titanium is primarily attractive for medical professionals because of its biological inertness towards the living organism, combined with anticorrosive resistance, high mechanical qualities, affordability and relatively low price. All these advantages have provided enormous interest in titanium and led to numerous clinical trials.

Corrosion resistance

Titanium is in no way inferior to platinum. This metal is resistant in alkaline and acid solutions. In lymph, which is chemically similar to seawater, titanium corrodes at a rate of 0.2 mm per year (0.02 mm per 1000 years). Titanium alloys are resistant to hydrogen peroxide, formaldehyde and gasoline. No corrosion was detected on titanium after repeated boiling and autoclave processing, several months of exposure to 3% chloramine solution, 96 °C ethyl alcohol and bichloride solution. Pitting corrosion was detected in titanium alloys only after keeping them in 10% alcohol tincture of iodine for a few days.

Strength

Another positive property of titanium and its alloys is high fatigue strength under alternating loads. This is especially important in the production of intraosseous fixation devices as well as internal and external prostheses, which are subjected to alternating loads all the time.

Processing

Pure titanium is a sufficiently ductile metal that lends itself to all kinds of mechanical processing: grinding, drilling, milling and cutting. The complexity of production of different constructions from this metal is the same as when working with stainless steel. Besides, titanium is a non-magnetic material. It is a very valuable property. Thanks to it, physical therapy can be used when treating patients who have titanium structures in their bodies. All these qualities make this metal very promising for wide application in the medical sphere.

Biological Inertness

The most important conclusion that came out after years of research was that titanium is an inert metal in relation to biological environments. Titanium structures are perfectly tolerated by the human body and grow into muscle and bone tissue. Titanium hardly corrodes in our body, and the structure of the surrounding tissues does not change over the years. Titanium is chemically indifferent to all stainless steels and the widely used cobalt-based alloy («vitallium»). It is also valuable that technically pure titanium has far fewer impurities than other alloys used in medicine.

Prosthetics

The possibilities of titanium use in medical equipment have been studied especially thoroughly at All-Union Scientific Research Institute of Surgical Equipment and Instruments. Recently specialists of the Titanium Institute and a number of medical associations have joined the research work. For the first time titanium alloys were used for surgical purposes to create an eyeball implant. The long search for the metal led the specialists to the titanium alloy of BT5 grade. Obtained implants were two times lighter than analogous products made of Х18Н9Т steel (taking into account the dimeter of 20mm the weight of steel implant was 3,2 g, but titanium implant weighed 1,6 g). Long-term clinical observations and toxicological studies showed biological inertness of the product. After the successful completion of the titanium eyeball implant, this metal was used in the design of other prostheses, including those with working parts that carry loads.

Surgical instruments

At present more than 200 names of different surgical instruments are used in the clinical institutions. They have been tested at the Moscow Helmholtz Research Institute of Eye Diseases, at the A. Vishnevsky Institute of Surgery, at the Zaporozhye Institute for Advanced Medical Training and at the Ear, Throat and Nose Diseases Clinic of the Central Institute for Advanced Medical Training. All the instruments were positively evaluated by specialists.

Instruments made of titanium alloys, are characterized by biological inertness, high corrosion resistance, durability and plasticity. The task was set before the designers to create the tools superior in their advantages to the ones made of stainless steels. During the researches it has been found out that if for the production of titanium tool to save its functional properties the cross-section should be increased by more than 30% in comparison with the similar product made of steel, the development of this tool becomes unpromising. An exception is when weight is not the dominant characteristic. To preserve the functional properties of metal in the design of non-destructive tools like tweezers and clamps, the sections of individual elements are increased by 10−30%, but the weight of the products is reduced by 30−35% compared to steel specimens. After heat treatment, the hardness of the tools is HRC35−38.

Slat hooks, mirrors and wound spreaders, i.e. tools with a large working area that do not experience high stress during operation, were made with cross-sections reduced by 30%, which in turn reduced the weight of the product by 50%.

Combination tools

For cutting tools, a combined scheme was used: removable working parts were made of appropriate steel and handles were made of titanium alloys. Such products include surgical hooks, scalpels with removable blades, and chisels. Steel was used for fixed cutting tools and handles were made of titanium alloys. All elements were connected using rivets or press fit — rod tools, raspers, scissors.

Tests

In the course of researches it was discovered that titanium alloys should be used where high corrosion resistance at low metal hardness is necessary for medical instruments. The fact that titanium does not have high hardness and cutting properties prevents its wider use in surgical instruments. Therefore, giving titanium its cutting properties and increasing its hardness are tasks of paramount importance. The main difficulty lies in the fact that modern industrial methods of hardening cannot be applied to medical instruments, because there are special requirements for them. In addition, medical instruments and devices work under specific conditions (contact with iodine, physiological solution, sterilization by boiling).

Treatment

At the All-Union Scientific Research Institute of Surgical Instruments and Instruments, chemical-thermal and thermal treatments (i.e. alphidation and nitriding) were performed to increase metal hardness, wear resistance and reduce the friction coefficient. Using anodizing, the products received a color film of different shades (purple, green, purple, and gold). All samples were sterilized through an autoclave at 180 °C. After each cycle, the color change of the coating and the appearance of corrosion spots were studied. The strongest and most corrosion-resistant film was the oxide film in gold, purple and violet.

Sets

Titanium medical instruments are 20−30% lighter than steel items, yet they are more comfortable and durable as well as having better corrosion resistance. Employees of the All-Union Scientific Research Institute on the basis of the obtained data have developed and produced the experimental sets of the instruments from titanium alloys for dentistry, otorhinolaryngology and general surgery. The set for general surgery included styptic clamps, plate forceps and double-sided hooks, V-shaped wire hook, scalpel with detachable blades, liver mirrors and other articles — a total of 27 items (the weight of all tools is 1.59 kilograms). The ENT kit for otorhinolaryngologic operations included a tracheotomy dilator with a spring, a «Lira» wound spreader, ear forceps, a tracheotomy hook, ear funnels, and tampon forceps (total weight 235 grams). The set of dental instruments has passed all tests at the Central Research Institute of Dentistry.

Orthopedics

Currently, bone fractures are often treated with metal osteosynthesis. It uses rods, which provide immobility to the fragments, contributing to the process of consolidation of the fracture. But many patients subsequently experience various complications associated with the use of stainless steel structures. The inhomogeneity of the steel, both chemical and structural, often causes the fixators to fail, and this leads to fractures of the entire structure. Bone tissue is damaged by corrosion products, and electrical conductivity and ionization phenomena are observed. Iron ions begin to interact with the physiological salts of the body, which causes inflammation and severe pain. Therefore, even the highest quality stainless steel is not the best material for osteosynthesis.

The use of titanium for the production of bone fixation devices has made it possible to avoid the complications described above due to the biological neutrality of this metal. Thus, titanium structures can be used for long-term (or even permanent) stay in the human body. This is especially important if osteosynthesis is performed on elderly people, because the use of titanium can save the patient from having to undergo surgery to remove the fixation.

Titanium Constructions

Thanks to titanium, complex shapes can be used in the treatment of periarticular fractures. In the past, such structures were not used because of the difficulty in removing them. Nowadays, terminals (titanium staples) are used in skeletal traction techniques. In the Soviet Union, N.K. Mitunin and G.M. Frolov (in Leningrad), S.I. Kutnovsky (in Novosibirsk), G.I. Tateosov (in Monchegorsk), B.S. Gavrilenko and V. В. Volkova (Zaporozhye).

Arthroplasty

Joint prostheses and various other titanium constructions are successfully developed by the staff of the Moscow Central Institute of Traumatology and Orthopedics under the guidance of Professor K.M. Sivash. Titanium is favorably distinguished from competing metals by its biological inertness and valuable mechanical properties. A titanium rod with a diameter of 10 mm has the same tensile strength as an iron rod with a diameter of 14 mm. Titanium is a structural material that makes it possible to make a product stronger while maintaining its dimensions, or to gain up to 40% in weight without losing strength and reducing the volume of the structure. That is why titanium remains the best metal for internal prostheses. Titanium is most effective in hip arthroplasty.

Dentistry

In the manufacture of plastic dentures, a white crystalline substance, which is titanium dioxide, is used in domestic dentistry in order to obtain a cosmetic effect. But for dental prostheses it is possible to use both compounds of titanium with oxygen and structural titanium — it is biologically inert, strong, light enough and well machinable metal.

Clinic of Oral and Maxillofacial Surgery headed by Associate Professor K.I. Tatarintsev (Zaporozhye) offered a new method of treating fractures of the lower jaw with the help of U-shaped staples made of titanium BT1−00. Expanding legs of these brackets ensure reliable fixation of all fractures of the jaw in the correct position. About fifty patients with unilateral or bilateral mandibular fractures were treated with this method between 1971 and 1973. The results prove that the new technology shortens the wound healing time and thereby the ability to work much faster.

Buy, price

Evek GmbH sells rolled metal products at an optimal price. It is formed taking into account LME rates (Londonmetal exchange) and depends on the technological features of production without additional costs. We supply a wide range of products made of titanium and its alloys. All batches have quality certificate for compliance with standards requirements. With us you can buy in bulk the most various products for large-scale productions. The wide choice, exhaustive consulting of our managers, reasonable prices and timely delivery determine the face of our company. There is a system of discounts for wholesale purchases

Relevance

Titanium is primarily attractive for medical professionals because of its biological inertness towards the living organism, combined with anticorrosive resistance, high mechanical qualities, affordability and relatively low price. All these advantages have provided enormous interest in titanium and led to numerous clinical trials.

Corrosion resistance

Titanium is in no way inferior to platinum. This metal is resistant in alkaline and acid solutions. In lymph, which is chemically similar to seawater, titanium corrodes at a rate of 0.2 mm per year (0.02 mm per 1000 years). Titanium alloys are resistant to hydrogen peroxide, formaldehyde and gasoline. No corrosion was detected on titanium after repeated boiling and autoclave processing, several months of exposure to 3% chloramine solution, 96 °C ethyl alcohol and bichloride solution. Pitting corrosion was detected in titanium alloys only after keeping them in 10% alcohol tincture of iodine for a few days.

Strength

Another positive property of titanium and its alloys is their high fatigue strength under alternating loads. This is especially important in the production of intraosseous fixation devices as well as internal and external prostheses, which are constantly subjected to alternating loads.

Processing

Pure titanium is a sufficiently ductile metal that lends itself to all kinds of mechanical processing: grinding, drilling, milling and cutting. The complexity of production of different constructions from this metal is the same as when working with stainless steel. Besides, titanium is a non-magnetic material. It is a very valuable property. Thanks to it, physical therapy can be used when treating patients who have titanium structures in their bodies. All these qualities make this metal very promising for wide application in the medical sphere.

Biological Inertness

The most important conclusion that came out after years of research was that titanium is an inert metal in relation to biological environments. Titanium structures are perfectly tolerated by the human body and grow into muscle and bone tissue. Titanium hardly corrodes in our body, and the structure of the surrounding tissues does not change over the years. Titanium is chemically indifferent to all stainless steels and the widely used cobalt-based alloy («vitallium»). It is also valuable that technically pure titanium has far fewer impurities than other alloys used in medicine.

Prosthetics

The possibilities of titanium use in medical equipment have been studied especially thoroughly at All-Union Scientific Research Institute of Surgical Equipment and Instruments. Recently specialists of the Titanium Institute and a number of medical associations have joined the research work. For the first time titanium alloys were used for surgical purposes to create an eyeball implant. The long search for the metal led the specialists to the titanium alloy of BT5 grade. Obtained implants were two times lighter than analogous products made of Х18Н9Т steel (taking into account the dimeter of 20mm the weight of steel implant was 3,2 g, but titanium implant weighed 1,6 g). Long-term clinical observations and toxicological studies showed biological inertness of the product. After the successful completion of the titanium eyeball implant, this metal was used in the design of other prostheses, including those with load-bearing working parts.

Surgical instruments

At present more than 200 names of different surgical instruments are used in the clinical institutions. They have been tested at the Moscow Helmholtz Research Institute of Eye Diseases, at the A. Vishnevsky Institute of Surgery, at the Zaporozhye Institute for Advanced Medical Training and at the Ear, Throat and Nose Diseases Clinic of the Central Institute for Advanced Medical Training. All the instruments were positively evaluated by specialists.

Instruments made of titanium alloys, are characterized by biological inertness, high corrosion resistance, durability and plasticity. The task was set before the designers to create the tools superior in their advantages to the ones made of stainless steels. During the researches it has been found out that if for the production of titanium tool to save its functional properties the cross-section should be increased by more than 30% in comparison with the similar product made of steel, the development of this tool becomes unpromising. An exception is when weight is not the dominant characteristic. To preserve the functional properties of metal in the design of non-destructive tools like tweezers and clamps, the sections of individual elements are increased by 10−30%, but the weight of the products is reduced by 30−35% compared to steel specimens. After heat treatment, the hardness of the tools is HRC35−38.

Slat hooks, mirrors and wound spreaders, i.e. tools with a large working area that do not experience high stress during operation, were made with cross-sections reduced by 30%, which in turn reduced the weight of the product by 50%.

Combination tools

For cutting tools, a combined scheme was used: removable working parts were made of appropriate steel and handles were made of titanium alloys. Such products include surgical hooks, scalpels with removable blades, and chisels. Steel was used for fixed cutting tools and handles were made of titanium alloys. All elements were connected using rivets or press fit — rod tools, raspers, scissors.

Tests

In the course of researches it was discovered that titanium alloys should be used where high corrosion resistance at low metal hardness is necessary for medical instruments. The fact that titanium does not have high hardness and cutting properties prevents its wider use in surgical instruments. Therefore, giving titanium its cutting properties and increasing its hardness are tasks of paramount importance. The main difficulty lies in the fact that modern industrial methods of hardening cannot be applied to medical instruments, because there are special requirements for them. In addition, medical instruments and devices work under specific conditions (contact with iodine, physiological solution, sterilization by boiling).

Treatment

At the All-Union Scientific Research Institute of Surgical Instruments and Instruments, chemical-thermal and thermal treatments (i.e. alphidation and nitriding) were performed to increase metal hardness, wear resistance and reduce the friction coefficient. Using anodizing, the products received a color film of different shades (purple, green, purple, and gold). All samples were sterilized through an autoclave at 180 °C. After each cycle, the color change of the coating and the appearance of corrosion spots were studied. The strongest and most corrosion-resistant film was the oxide film in gold, purple and violet.

Sets

Titanium medical instruments are 20−30% lighter than steel items, yet they are more comfortable and durable as well as having better corrosion resistance. Employees of the All-Union Scientific Research Institute on the basis of the obtained data have developed and produced the experimental sets of the instruments from titanium alloys for dentistry, otorhinolaryngology and general surgery. The set for general surgery included styptic clamps, plate forceps and double-sided hooks, V-shaped wire hook, scalpel with detachable blades, liver mirrors and other items — a total of 27 items (the weight of all tools is 1.59 kilograms). The ENT kit for otorhinolaryngologic operations included a tracheotomy dilator with a spring, a «Lira» wound spreader, ear forceps, a tracheotomy hook, ear funnels, and tampon forceps (total weight 235 grams). The set of dental instruments has passed all tests at the Central Research Institute of Dentistry.

Orthopedics

Currently, bone fractures are often treated with metal osteosynthesis. It uses rods, which provide immobility to the fragments, contributing to the process of consolidation of the fracture. But many patients subsequently experience various complications associated with the use of stainless steel structures. The inhomogeneity of the steel, both chemical and structural, often causes the fixators to fail, and this leads to fractures of the entire structure. Bone tissue is damaged by corrosion products, and electrical conductivity and ionization phenomena are observed. Iron ions begin to interact with the physiological salts of the body, which causes inflammation and severe pain. Therefore, even the highest quality stainless steel is not the best material for osteosynthesis.

The use of titanium for the production of bone fixation devices has made it possible to avoid the complications described above due to the biological neutrality of this metal. Thus, titanium structures can be used for long-term (or even permanent) stay in the human body. This is especially important if osteosynthesis is performed on elderly people, because the use of titanium can save the patient from having to undergo surgery to remove the fixation.

Titanium Constructions

Thanks to titanium, complex shapes can be used in the treatment of periarticular fractures. In the past, such structures were not used because of the difficulty in removing them. Nowadays, terminals (titanium staples) are used in skeletal traction techniques. In the Soviet Union, N.K. Mitunin and G.M. Frolov (in Leningrad), S.I. Kutnovsky (in Novosibirsk), G.I. Tateosov (in Monchegorsk), B.S. Gavrilenko and V. В. Volkova (Zaporozhye).

Arthroplasty

Joint prostheses and various other titanium constructions are successfully developed by the staff of the Moscow Central Institute of Traumatology and Orthopedics under the guidance of Professor K.M. Sivash. Titanium is favorably distinguished from competing metals by its biological inertness and valuable mechanical properties. A titanium rod with a diameter of 10 mm has the same tensile strength as an iron rod with a diameter of 14 mm. Titanium is a structural material that makes it possible to make a product stronger while maintaining its dimensions, or to gain up to 40% in weight without losing strength and reducing the volume of the structure. That is why titanium remains the best metal for internal prostheses. Titanium is most effective in hip arthroplasty.

Dentistry

In the manufacture of plastic dentures, a white crystalline substance, which is titanium dioxide, is used in domestic dentistry in order to obtain a cosmetic effect. But for dental prostheses it is possible to use both compounds of titanium with oxygen and structural titanium — it is biologically inert, strong, light enough and well machinable metal.

Clinic of Oral and Maxillofacial Surgery headed by Associate Professor K.I. Tatarintsev (Zaporozhye) offered a new method of treating fractures of the lower jaw with the help of U-shaped staples made of titanium BT1−00. Expanding legs of these brackets ensure reliable fixation of all fractures of the jaw in the correct position. About fifty patients with unilateral or bilateral mandibular fractures were treated with this method between 1971 and 1973. The results prove that the new technology shortens the wound healing time and thereby the ability to work much faster.

Buy, price

Evek GmbH sells rolled metal products at an optimal price. It is formed taking into account LME rates (Londonmetal exchange) and depends on the technological features of production without additional costs. We supply a wide range of products made of titanium and its alloys. All batches have quality certificate for compliance with standards requirements. With us you can buy in bulk the most various products for large-scale productions. The wide choice, exhaustive consulting of our managers, reasonable prices and timely delivery determine the face of our company. There is a system of discounts for wholesale purchases