For several years now scientific and medical sLaff have recognised the risks of toxicity of certain metals contained in alloys used in Lhe manufacture of biomaterials protheses, implants, and artificial organs. A number or scientific and industrial research centres have focussed their investigations in this direction and international societies and commissions have organised meetings with specialists from complementary disciplines in attendance in attempts to guage the importance of biological risks and to determine the toxicity of certain metals, with the aim of establishing preventive measures and guidelines. In the last century great efforts have been made to reduce unwanted biological effects caused by orthopaedic implants. The problems of pain and infection were overcome and the development of modern technology has resulted in a convincing decrease in corrosion problems and mechanical failure, such that ostosynthesis and endoprosthesis have rapidly progressed beyond the level of tentative investingation.llowever, a number of problems still remain to be solved, such as the influence of the material type on the healing process and its relative speed. The increasing use of cobalt-,chromium-and nickel-containing alloys in surgical and dental implants has raised various questions concerning the biological consequences of chronic internal release of these elements in the human body. A total of 55 delegates representing 16 countries heard presentations of fundamental aspects, local and remote tissue response, immunopathology, clinical aspects, and manufacturing qual ity control issues.

Inhalt

The International Standards Organization Technical Committee on Surgical Implants.- Fundamental Aspects.- Carcinogenic Risks of Metal Implants and Prostheses.- The Toxicity of Chromium in the Zero and Trivalent Form.- Measurement of the Uptake of Chromium.- Analysis of Cobalt, Chromium and Nickel in Biological Materials State of the Art.- Phenomenology of the Trace Element Burdening of the Human Organism by the In-Body Corrosion of Co-Cr-Ni-Alloys as Revealed by Neutron Activation Analysis.- Chairmen Summary: Fundamental Aspects.- Tissue Response.- In vivo Corrosion of a Cobalt-Base Alloy and its Biological Consequences.- Relation between Metal Corrosion and Electrical Polarization.- In vitro and in vivo Cellular Response to Semi-Precious and Amorphous Alloys.- Nickel and Chromium in the Human Body A Review and a Research Proposal.- Orthopaedic Implants and Corrosion Products Ultrastructural and Analytical Studies of 65 Patients.- Histochemical, Electron Microscopic and Microanalytic Investigations of Tissue Surrounding Ni-Cr-Allenthesis in Maxillo-Facial Surgery.- Measurement of Nickel and Chromium at the Site of Metallic Dental Implants.- In vitro Evaluation of the Biocompatibility of a Ni-Cr-Alloy (Wiron 88) An Ultrastructural Study.- Chairmen Summary: Tissue Response.- Immunopathology.- Fundamental Aspects of Contact Sensitivity to Nickel.- Total Hip Arthroplasties and Allergy to Metals.- Nickel, Chromium, Cobalt Dental Alloys and Allergic Reactions An Overview.- Allergic Contact Stomatitis from Ni-Alloys A Histological, Immunohistological and Electrochemical Relation.- Immunological Aspects of Contact Hypersensitivity to Nickel and Chromium in Dental Alloys.- Chairmen Summary: Immunopathology.- Clinical Aspects.- Analysis of Total Joint Replacements (Hip and Knee).- Aspects of the Failure of the Implanted Systems in Orthopedicsand Traumatology.- Clinical Intolerance to Prosthesis Material Including Metallic Implants.- Clinical Aspects on the Corrosion of Dental Alloys.- The Influence of Intraoperative Forming Procedures on Corrosion of Ni-Cr Alloys.- Pilot Study of Allergic Effects of Co-Cr-Ni Alloys among Dental Technicians.- Chairmen Summary: Clinical Aspects.- Quality Control.- The Corrosion of Dental Ni-Cr Alloys An in vitro Evaluation.- Austenitic Stainless Steel S350 for Surgical Implants?.- Corrosion and Bioelectrochemistry.- Micro-Analysis of the Composition of Dental Implants before and after Implantation.- Surface Treatment of Metallic Biomaterials to Improve Biological and Economical Compatibility.- Corrosion and Protection of Surgical and Dental Metallic Implants.- Chairman Summary: Quality Control.- Conclusions and Recommendations.- Conclusions and Recommendations.- Contributors.