From the Guidelines
Titanium dental implants are not a contraindication for MRI, and patients with these implants can safely undergo MRI procedures without concern. The most recent and highest quality study, 1, published in 2024, supports this recommendation, as it mentions that titanium is a non-ferromagnetic metal that does not interfere with MRI scanning. Although this study focuses on PET/MRI scans, its findings on titanium's compatibility with MRI technology are relevant to our question.
Key Points to Consider
- Titanium is a non-ferromagnetic metal, which means it is not attracted to the magnetic field generated by an MRI machine, as noted in 1.
- Titanium dental implants are MRI-compatible and will not move, heat up significantly, or cause image distortions during scanning, as supported by the general principles outlined in 1 regarding MRI safety.
- While some minimal artifacts (small areas of image distortion) may occur in images of the oral region, these typically do not interfere with the diagnostic quality of MRI scans of other body parts, a point that can be inferred from the discussion on MRI attenuation correction in 1.
- The safety of titanium implants in MRI environments is well-established in clinical practice, and patients generally do not need to inform MRI technicians about their titanium dental implants before undergoing scans, a conclusion that can be drawn from the overall context of MRI compatibility discussed across the provided studies.
Clinical Implications
- Patients with titanium dental implants should not be excluded from undergoing MRI procedures based on the presence of these implants.
- Clinicians should be aware of the MRI compatibility of titanium dental implants to ensure that patients are not unnecessarily denied MRI scans, which are crucial for diagnosing and monitoring various medical conditions.
- The focus should be on the clinical judgment of the need for an MRI rather than the presence of titanium dental implants, as emphasized by the principles of using the latest technology and techniques to minimize artifacts and ensure accurate imaging, as discussed in 1.
From the Research
Titanium Dental Implants and MRI
- Titanium dental implants can cause extensive signal voids and artifacts in MRI due to their strong susceptibility 2, 3, 4
- The artifacts caused by titanium implants can lead to inaccurate size determination and limited image contrast in MRI 2, 3
- Zirconium implants, on the other hand, produce minor distortion artifacts and can be clearly defined with MRI 2, 4
- The choice of MRI sequence and imaging protocol can affect the severity of artifacts caused by titanium implants 3, 5
Comparison of Imaging Modalities
- CT and CBCT examinations are less affected by artifacts from titanium and titanium-zirconium alloy implants compared to MRI 2, 4
- MRI allows for excellent image contrast and limited artifacts in patients with zirconium implants, but is not suitable for titanium implants 2, 3
- The use of lower field strength MRI (0.55T) can reduce metal artifacts and improve diagnostic confidence compared to higher field strength MRI (3T) 6
Implications for Clinical Practice
- The knowledge of differences in artifacts between various implant materials and imaging modalities can help support clinical decisions for the choice of implant material or imaging device 2
- MRI technology is not suitable for imaging titanium implants, but can be used for ceramic implants 3
- The selection of appropriate imaging protocols and sequences can help minimize artifacts and improve image quality in patients with dental implants 3, 5