Reinventing implants

A few days after the lead researcher, Dr.Terry Lowe, was the US guinea-pig for the new nanotitanium dental implant, Implant Practice US caught up with him to find out more about the super-strong alloy, its applications, and what might come next

Implant Practice: How did you get involved in this field of dentistry?
Terry Lowe: Dental implants were the most obvious first application for nanostructured titanium. So, we focused on learning about this medical technology area from the outset.

What expertise did you and your partners bring to the table for this project?
Our team has a broad range of expertise, including materials science, bio-engineering, structural mechanics, metal forming, dentistry, oral surgery, high-precision medical device manufacturing, and quality management.

Where did the idea for a super-strong alloy for dental implants come from?
The idea for making super-strong metals through nanostructuring originated in Russia. Manhattan Scientifics co-developed the technology in collaboration with scientists at the Institute of Physics of Advanced Materials in Ufa, Russia, and Los Alamos National Laboratory in the United States.

What is nanotitanium?
Nanotitanium, also called nanostructured titanium, is solid titanium metal that has internal structures that are 1,000 times smaller than the comparable structures in conventional titanium. This gives nanostructured titanium its enhanced strength and biocompatibility.

The launch of this new product is attracting a great deal of attention. What makes it special?
Nanostructured-titanium bone implants or replacements are special because of their remarkable ability to integrate quickly with human bone and their very high strength. Studies have consistently shown that the growth of bone cells on nanostructured titanium occurs at a rate that can be as much as 20 times faster than cell growth on conventional titanium. Also, nanostructured pure titanium can have a strength of more than 1,400 Mpa, which is approximately twice as strong as conventional pure titanium. This super-high strength makes orthopedic implants made from nanostructured titanium able to sustain higher loads without risk of breaking.

How does it work?
Nanostructuring is accomplished entirely by deforming metal in a way that causes very small structures to form inside. This mechanical treatment can be applied indefinitely to reduce the scale of internal microstructures by a factor of 1,000 or more.
The small-scale features exist throughout an entire solid piece of nanostructured metal. The features that happen to be on the surface present a million times more surface regions to which bone cells can attach.

How has its effectiveness been proven?
The virtues of nanostructured titanium have been studied and published in hundreds of technical papers by scientists from around the world. Multiple studies of the superior bio-integration of nanostructured titanium have been published since 2004. Medical trials with more than 2,000 patients conducted in Eastern Europe and Canada have demonstrated the effectiveness of nanostructured titanium in dental implants.

What are the future plans for the implants?
The launch of the Biotanium™ (Basic Dental Implants) is only the first of many products we expect to see developed using nanostructured titanium. We expect that this remarkable metal will be adopted by many medical device companies.

To whom and where will it initially be available?
The initial availability of nanostructured titanium is through our partner company NanoMet in Ufa, Russia. Now, nanostructured titanium is available only to a few specific dental implant and orthopedic device companies, including Basic Dental in Albuquerque.

What are the plans to get this into the global dental implant market?
We expect that nanostructured titanium will be extensively available in the UK, Europe, Asia, North America, South America, and Australia today through the Basic Dental implant system, then later in the products of other companies.

What other equipment or training, if any, is required for the system?
In general, no special equipment or training is required by surgeons or their assistants to use medical devices made from nanostructured titanium. The Basic Dental implant system relies on the use of a very simple surgical technique that requires minimal training, and a self-study DVD is available to help learn the technique.

The first nanotitanium dental implant operation took place on October 14, 2010, with you as the patient. How did that go?
The placement in my mouth of the first Biotanium™ implant in the United States was quick and completely painless. I went out for dinner 2 hours after the surgery. There wasn’t even any need for any pain medication. The surgical procedure for placing Basic Dental implants is particularly simple for the dentist, and comfortable for the patient.

How did the clinician find the surgery?
Quoting the surgeon, Dr. Steven Holbrook: “The procedure was simple. The placement took only 10 minutes.”

What did you find most challenging about the project?
The greatest challenge in this project has been choosing the appropriate strategy for introducing the nanostructured metals technology. We chose dental implants over other orthopedic devices such as spinal rods or hip stems, even though these other target markets are much larger.

What’s next for you?
I will work with our manufacturing partners in the United States and Russia to optimize the technology for a growing number of medical and other applications. We are really just at the beginning of unfolding the potential of nanostructured metals.

Nanotitanium—the new supermetal
Former Russian and US weapons scientists have developed nanotitanium, a supermetal that is now being used for dental implants.
The new, stronger alloy allows the implant to bond more quickly to human bone.
Created under a 3-year partnership between Los Alamos National Laboratory (LANL), several Russian institutes, and New Mexico-based Manhattan Scientifics, the new implant material is reliable and long lasting, and should result in faster post-surgery healing.
It is the first dental implant made with nanotitanium that has been approved by the Food and Drug Administration (FDA).
Nanotitanium is part of the National Nuclear Security Administration’s (NNSA) Global Initiatives for Proliferation Prevention (GIPP) program, which helps to advance the expertise of former weapons of mass destruction personnel in the development of civil-use technologies.
Under the program, partners provide financial or in-kind contributions equal in value to the funds NNSA commits to each project.
Manhattan Scientifics owns the US licence to a family of patents that will enable the manufacture and marketing of super-strong, ultra-lightweight “nanostructured” metals that have been developed.
Available from Basic Dental Implants under the name Biotanium™ since mid-December 2010. Visit www.basicdentalimplants.com for further information.

Terry Lowe, BS, PhD, is the chief scientist at Manhattan Scientifics. Over the past 12 years, Dr. Lowe has been passionately engaged in the emergence of nanoscience and nanoscale technology, with special focus on nanomaterials and commercialization of the benefits they offer. In relation to this focus, he has over 80 technical papers, 3 patents and 5 edited books to his credit. He has also served as a member/advisor of multiple national, and international companies, boards, and technical committees, including his former role leading the nanotechnology subcommittee of the National Materials Advisory Board of the National Research Council. He is an adjunct professor at Clemson University and at the New Mexico Institute of Mining and Technology.