CARTA AL DIRECTOR

Titanitis and perititanitis

Titanitis y perititanitis

Dear Director:

Introduction

We would like to make some comments about the terms "Periimplantation osteolysis- periimplatosis- peri…… ….,TITANITIS AND PERITITANITIS"

Nowadays , we believe we could say and write "titanitis" and "perititanitis" with the same rights as Levignac J in the French magazine. . . . . . . . . . . . . . ." Odontoestomatol, 1965 Oct;12(8):1251-60. French mentions the terms in his work "Periimplantation osteolysis- periimplatosis-peri . . . . . . . . . . . . . . ." And in the 12^th National Congress of maxilofacial and oral surgery held in Granada from 23^rd to 25^th June 1993. In a course previous to the congress, which dealt with implantology, and where we heard the terms for the first time; terms that we are not going to write here and are widely introduced in Conferences, courses, books, national and international journals of great impact and modernity, and even some of the terms can be found in dictionaries.² Since then we had the feeling that they had been introduced in a way that was difficult to understand in the medical jargon, as we denounced the same day of the hearing. We are extremely reluctant to use those terms. We haven’t done it so far. And hope it will never happen. It would be like betraying our most basic principles.

For this project we have used and revised books and magazines, exclusively dealing with implantology and that won’t be cited in the bibliography for having used the terms. Even reputed authors that cannot be questioned by any means have not avoided this pitfall. The methodology we have used cannot be simpler , We just had to gather and order articles that accept the terms, that some try to define and even dare to classify but that we are not even going to refer to since any definition from any person, preceeded by the aforementioned subliminal terms in this article, would result "per se" false. It is known that parting from a thought, from a false pretense, makes any attempt at a definition result incorrect and of suspicious consequences. Medicine is already quite inexact to be using inadequate terms like those described in this article. We have not found these terms in the Dictionary of the Real Academia de la Lengua Española,¹ but have in some Medical Dictionaries,² although the shortest was not found in neither. They were neither found in book of Pathologic Anatomy consulted and when we went to speak with anatamopathologists at the Miguel Servet University Hospital in Zaragoza about the terms, I felt and saw that there faces became distorted, and all this without them nothing what I thought. I put, as a form of education since a couple of years ago, when I speak on the subject an example: If the placement of a pacemaker would requiere a process of infection or intolerance in the subcutaneaos pocket created for its location in the days following its placement, maybe we could speak about a peripacemakeritis? Or maybe not, no? Well I speak the same of the . . . . . . . . . . . . . . .and the . . . . . . . . . . . . . . . (fill in by the reader, with the corresponding letters., then maybe you can discover the terms that you should forget.

Conclusion

In conclusion, I´m sure that the terms we propose in the title of our article are inadequate and should not remain in the scientific environment, either spoken or written, nor in our day to day. Just as established terms. If this does not occur, we would proclaim, I think with all rights, those of titanitis and perititanitis.

Of course we do not dare to substitute these unfortunate terms for other concrete ones without having a specific and multidisciplinary scientific team on our side; although they are already in practical use and can be easily recovered to be able to write and talk of the phenomenons that can take place in the perifery of titanium implants installed in live bone both in those covered in fibremucus or with determined skin grafts lubricated with saliva and in contact with the flora and the buccal temperature or with the skin in a dry environment. This may occur in the extraoral and sumergible cases with any relation with the exterior and would be those who truly support a more asceptic environment, like those used to reconstruct small and large articulations, all this without departing of what should be the scientific nomenclature and language both in the medical and veterinary world and always individualized by the medium where the implant is installed.

Metals suffer from oxidation for various reasons and environments, some more sentive than others. Those most resistant to the process would be the noble metals such as gold, platinum, silver, etc., but perhaps we are not authourized to identify such processes as inflamatory phenomenons similar or alike to those that occur in organic tissues.

For those of us who work with implants and try to explain the diverse phenomenons that can occur, both positive and negative for the organisms that support them; it is essential to have the capacity of abstraction neccesary to interpret them outside the context of the speciality in which they are applied and value them with wider perspectives and always inside the canons of a serious investigation, impartial and accustomed to linguistic mimicry, like those that occur to determined groups that use them more frequently than others, which occurs unfortunately in the environment of oral and maxilofacial, stomatology and odontology surgery. It is not the same to say odontitis (term I have not found either) or periodontitis than....., you know what.

Prof. Dr. D. F. Hernández Altemir¹, Susana Hernández Montero², Sofía Hernández Montero³, Elena Hernández Montero⁴

¹ Colaborador Extraordinario de la Universidad de Zaragoza. Facultad de Ciencias de la Salud
y del Deporte. Licenciatura de Odontología, Zaragoza, España
² Médico Odontólogo (Endodoncia) Práctica privada
³ Médico Especialista de Odontología y Cirugía Oral y Maxilofacial-Profesora de la
Universidad Alfonso X el Sabio de Madrid y Directora del Master de Implantología, Madrid, España
⁴Medico Especialista en ORL en el Hospital de Viladecans y del Instituto García-Ibáñez de Otoneurología, Barcelona, España

References

1. Diccionario de la lengua española (Vigésima segunda edición)- 2001.

2. Dorland: Diccionario Enciclopédica Ilustrado de Medicina 30.ª Edición.

3. Más de 100 años de Historia.