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by Robert J Harling
BSc(Hons) CBiol, MIBiol, DipRCPath, MRCPath,
Eurotox Registered Toxicologist; April 2002
The Report is reprinted with permission and
thanks to Danfoss Tantalum Technologies
INTRODUCTION
This document reviews literature that presents
information pertinent to the issue of tantalums
biocompatibility. The information comes from the
scientific literature, from extraction studies
undertaken by Danfoss Technology Centre, and
surface evaluation studies undertaken by The
Danish Polymer Centre, Ris๘ National Laboratory,
Denmark.
SCIENTIFIC LITERATURE
(i) Physical Properties
Tantalum and its alloys retain significant
mechanical properties up to 1000C. Tantalum is
chemically stable, oxidising in air at 300C,
and it has excellent corrosion resistance, being
attacked only by strong acids and alkalis which
hydrolyze to form hydrofluoric acid.
Tantalum symbol Ta
Atomic Number 73
Mean Atomic Weight 180.95
Periodic Table Grouping VB together with
vanadium and niobium
Density 16.6 g.cm3
Melting Point 3000 dg. C
Despite being a reactive metal, (by periodic
table location), tantalum is considered to be a
noble material in practical terms.
(ii) Material Response
There is little published data relative to in
vitro studies to predict in vivo degradation.
Tantalum is covered by a very low solubility
tantalum oxide film, over a wide range of pH and
pO2 combinations which are reflective of
biological situations. The tantalum/tantalum
oxide equilibrium reaction is impossible to
characterise directly due to the protective
power of the oxide. In vivo corrosion release is
very slight, there being no reports indicating
local, systemic or remote site concentrations
related to corrosion release. The most usual
observation in both animals and clinical reports
is the absence of visible corrosion or corrosion
products. In a specific biocompatibility study
Watari et al studied tantalum after implantation
in the subcutaneous tissue of the abdominal
region, and in the femoral bone marrow of rats
for either 2 or 4 weeks.
No dissolution of the metal in soft tissues was
detected using an x-ray scanning analytical
microscope (XSAM), and no dissolution of the
metal was detected in bone using electron probe
microanalyzer elemental (EPMA) mapping
procedures. The study concluded that tantalum
had acceptable biocompatibility for use as a
biomaterial. Where motion between implant and
tissue are possible, then slight discolouration
has been noted on some occasions. This is
similar to the situation which occurs with
titanium and titanium alloys, and is possible
secondary to the removal of oxide particulates.
Intake of tantalum and tantalum oxide produces
very low levels of tantalum absorption from
either the respiratory or gastrointestinal
systems, again a reflection of the low
solubility of the material. Tantalum clears
promptly from lungs, airways and oesophagus in
both animals and humans in the absence of
respiratory disease.
(iii) Host response
Tantalum particles (10 to 50 m) and pure
titanium both cause no growth inhibition in
human dermal fibroblast cultures. Other studies
group tantalum with a number of other metals and
alloys including stainless steel and pure
titanium in relation to lack of biological
effects. It is difficult to find standard data
relating to the toxicological effects of
tantalum. References indicate that there is no
known human disease which is attributable to
tantalum, that systemic poisonings in industrial
situations are unknown, and that tantalum and
tantalum compounds are not listed as presumptive
or possible carcinogens. The oral LD50 for
tantalum pentoxide in rats is quoted in one
reference to be greater than 8 g/kg bodyweight.
Where labelled tantalum has been injected into
animal models only 15% is retained within the
body, the balance being rapidly excreted. Forty
percent of that which is retained within the
body is retained within bone.
When tantalum is implanted as a foil, wire or
mesh in soft tissues in either animals or
humans, the main local tissue reponse is the
formation of a thin, glistening membrane without
any evidence of inflammation. This response has
been characterised by loose and vascularised
fibrous tissue with in some case the presence of
an epithelium in contact with the implant. In
work by Crochet et al an understanding of the
pathological processes following implantation of
tantalum stents into the femoral artery of sheep
provides further evidence of the good
biocompatibility displayed by tantalum based
products. During the first four days after
implantation a covering by non-organised throbi
was noted. By fifteen days neointimal
hyperplasia completely covered the stented
arterial segment. This fibroblastic tissue
showed no foreign body reaction. By 42 days
collagen and myofibroblastic cells had
progressively replaced the fibroblastic tissue
indicative of a healing process. A similar
reponse is seen with pure titanium, titanium
alloys, zirconium, niobium and platinum upon
implantation. In a specific biocompatibility
study Watari et al studied tantalum after
implantation in the subcutaneous tissue of the
abdominal region, and in the femoral bone marrow
of rats for either 2 or 4 weeks. No inflammatory
response was observed around the implants and
all were encapsulated with thin fibrous
connective tissue. The study concluded that
tantalum has sufficient biocompatibility for use
as a biomaterial.
Early studies did report abscesses following
cerebral apposition of tantalum in humans,
however, infection has to considered as a
potential reason rather than a tissue reponse to
the implanted material. In addition some of the
early clinical studies have to be questioned due
to the source, purity, pre-operative cleaning
and sterilisation processes used for the
implanted tantalum. When implanted as foil,
wire, rod or ball there are several reports that
tantalum can be osteo-integrated. That is,
direct apposition of bone is seen against the
implant without an intervening soft tissue layer
or capsule. It has been suggested that the
reason for this is that, like titanium, tantalum
has an electrically non-conductive surface oxide
which does not denature proteins and thus
permits osteo-integration. Work supporting this
concept is presented by Zitter et al who
describe an in vitro system for measuring
current densities of metals used in implants.
These measurements produce results which are in
good agreement with results from in vivo
biocompatibility studies. In their studies pure
metals like titanium, niobium and tantalum
showed the lowest current density values which
correlates with these materials having high
biocompatibility. The reason quoted for these
materials having low current densities is the
presence of a stable oxide layer on the base
metals. The stable oxide layer prevents an
exchange of electrons and thus any redox
reaction. Hence the materials are bio-inert.
Bobyn et al (1) utilised cylindrical implants of
tantalum which were 75 to 80% porous, in a 52
week dog study where they were implanted into
the femur. Bone ingrowth was clearly
demonstrated in the study with high fixation
strength occurring at an earlier time point with
the porous tantalum implants. The report
provides no indication of any adverse reactions
during the procedures utilised. Work with alkali
and heat treated tantalum by Kato et al
describes the bone-bonding ability of tantalum
in rabbit studies, and no histological effects
indicative of an adverse reaction to the
implants were noted in their study. Bobyn et al
(2) studies the osseous tissue reponse to an
implanted tantalum biomaterial in dogs with
bilateral hip arthroplasties. Good bone growth
was seen with the porous tantalum and
histopathological examination confirmed the
biocompatibility of the implants. In vitro work
by Sharma et al demonstrated that the presence
of the oxide layer on tantalum enhances the
adsorption of protein at the interface. A
mixture of proteins was used in the studies and
these included albumin, globulin and fibrinogen.
Adsorption of proteins onto the surface, rather
than protein denaturation, will be one of the
reasons for good biocompatibility results with
tantalum implants.
In several studies tantalum has been
acknowledged as being bio-inert and as such has
been selected as a negative control in certain
experimental situations. For example, Miller et
al utilised tantalum as a negative control in a
study where rats with tantalum implants were
sampled for urine and plasma, and the samples
tested for mutagenic activity using the Ames
test. All results were negative. Chronically
implanted stimulating electrodes for neural
prostheses are being developed to alleviate
neural deficits. In comparative work by Johnson
et al the use of tantalum-tantalum oxide
electrodes was investigated in brain
implantation studies with cats. When removed at
the end of the study all electrodes were loosely
encapsulated by a fibrous sheath of
dura-archnoid connective tissue. There was no
tissue adhering to the electrode surface.
Histologically there was a slightly thickened
pia with a slight reaction of the subpial
neuroglia and no neuronal reaction or
inflammatory reaction in the cortex. The study
concluded that the tantalum-tantalum oxide
electrodes resulted in less tissue damage than
with electrodes made from rhodium, platinum or
carbon, and tantalum-tantalum oxide electrodes
did not result in neurotoxic effects.
(iv) Clinical responses
Tantalum has been widely used in clinical
applications for more than 50 years:
as a radiographic marker for diagnostic
purposes, due its high density
as the material of choice for permanent
implantation in bone, as osteomigration prevents
migration
as vascular clips, with the particular
advantage that since tantalum is not
ferromagnetic it is highly suited to MRI
scanning
in the repair of cranial defects - a United
States of America medical material standard
exists for tantalum in this application
as a flexible stent to prevent arterial
collapse
as a stent to treat biliary and arteriovenous
(haemodialyzer) fistular stenosis
in fracture repair
in dental applications
in other miscellaneous applications
Aronson et al undertook a specific study of
tantalum markers in radiography with pin and
spherical markers being implanted into bony and
soft tissues of rabbits and children. No
macroscopic reaction was noted around the
markers, those implanted into bone were firmly
fixed exhibiting close contact with adjacent
bone lamellae. Microscopic examination in
rabbits showed no reaction or slight fibrosis in
bone, and slight fibrosis, but no or only a
minimal inflammatory response after 6 weeks. In
the children, no inflammatory reaction and only
slight fibrosis was present up to 48 weeks after
insertion. The bio-inertness of tantalum was
commented on in the conclusion of the paper.
(v) Extraction data
Extraction studies undertaken within the Danfoss
technology Centre followed standard procedures
(EN ISO 10993-12) to make extracts from various
metals or metal combinations. Extracts were made
utilising physiological saline and peanut oil at
a temperature of 121C for one hour. Analysis of
the extracts using ICP is presented below. The
materials of particular interest are AISI 316 +
Ta and Vitalium + Ta.
Results of analysis from physiological saline
extracts
Co Cr Cu Fe Mn Mo Ni Pb Si V
ppm ppm ppm ppm ppm ppm ppm ppm ppm ppm
Blank <0,05 <0,05 <0,05 <0,05 <0,05 <0,05 <0,05
<0,1 0,94 <0,1
Ta <0,05 <0,05 <0,05 <0,05 <0,05 <0,05 <0,05
<0,1 0,57 <0,1
Vi 0,24 <0,05 <0,05 <0,05 <0,05 <0,05 <0,05 <0,1
0,82 <0,1
AISI 316 <0,05 <0,05 <0,05 2,36 0,18 <0,05 0,06
<0,1 3,05 <0,1
AISI 316+Ta <0,05 <0,05 <0,05 <0,05 <0,05 <0,05
<0,05 <0,1 2,80 <0,1
V + Ta <0,05 <0,05 <0,05 <0,05 <0,05 <0,05 <0,05
<0,1 3,64 <0,1
The report states that extraction of silicon
from the glass experiment (as demonstrated by
the blank value) means that data from this
column is representative of extracted Si from
the metals.
Results of analysis from peanut oil
Co Cr Cu Fe Mn Mo Ni Pb V
ppm ppm ppm ppm ppm ppm ppm ppm ppm
Blank <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0 <2,0
<0,5
Ta <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0 <2,0 <0,5
Vi <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0 <2,0 <0,5
AISI 316 <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0 <2,0
<0,5
AISI 316+Ta <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0
<2,0 <0,5
Vi + Ta <0,5 <0,5 <0,5 <0,5 <0,5 <3,0 <2,0 <2,0
<0,5
The results of these studies show that for the
AISI 316 + tantalum and the vitalium + tantalum
none of the values from either the physiological
saline or the peanut oil extractions exceeded
the detection limits.
(vi) Surface analysis studies
In work undertaken at the Danish Polymer centre
(part of the Ris๘ National laboratory) studies
were undertaken to analyse qualitatively the
composition of both the outer surface and bulk
material of tantalum coatings which had been
applied to different substrates. Since the
impurity levels in tantalum are so low, ToF-SIMS
(Time-of-Flight Secondary Ion Mass Spectrometry)
was utilised to analyse the samples. The results
demonstrated that tantalum oxide was detected
with similar or slightly higher intensity than
tantalum during the initial part of the analysis,
indicating that a thin layer of tantalum oxide
exists. The results also demonstrate that the
CVD-Ta coating on stainless steel has the lowest
amount of impurities present, and this
combination has an even better impurity profile
than the tantalum reference.
CONCLUSION
Information available indicates tantalum is
highly resistant to chemical attack and arouses
very little adverse biological response in
either the reduced or oxidised forms. Many
studies demonstrate excellent biocompatibility
in a variety of situations including, those
applications involving bone surgery. Metals
coated with tantalum and tantalum itself release
nothing into extraction media during
standardised procedures, and the surface
analysis shows low impurity profiles.
Providing the tantalum used in the manufacture
of the proposed medical devices meets the purity
criteria there is no reason to undertake further
biocompatibility studies in animals.
This report prepared by: Date: April 2002
Robert J Harling
BSc(Hons) CBiol, MIBiol, DipRCPath, MRCPath,
Eurotox Registered Toxicologist
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