Abstract
Background:
Polymethyl methacrylate (PMMA) is a commonly used biomaterial in orthopedic and dental applications, especially as bone cement and in prosthetic implants.

Aim:
This research aims to examine the inflammatory outcomes of Titanium Dioxide Nanoparticles (TiO₂NPs) on Polymethyl Methacrylate (PMMA) as it pertains to cellular interactions. Additionally, the study assessed the possibilities that TiO₂-PMMA composites can afford to the longevity of an implant and reduced reactivity from the TiO₂NP materials introduced into the body.

Methods:
A controlled randomized study was completed using twenty male New Zealand rabbits in order to evaluate tissue responses to histopathological evaluations of specimens of PMMA acrylic resin and TiO₂NPs at NPs at 0% wt., 0.5% wt., 1% wt., and 2% wt.. A total of eighteen PMMA implants (3 cm length × 3 mm diameter) were divided into groups based on the wt.% of TiO₂NPs in the PMMA acrylic resin (n = 20/group). The PMMA implants were surgically placed in the dorsal subcutaneous tissues of the rabbits. The inflammatory response was evaluated post-14 days of implantation using histopathological evaluation techniques.

Results:
The study demonstrated lower inflammation and better tissue integration with the TiO₂-PMMA composite groups compared to pure PMMA. While there were adverse reactions noted among the TiO₂NP with 0.5% wt. (likely very minor) concentrations, the large amounts of TiO₂NP 1% wt. and 2% wt. composites showed greater biocompatibility.

Conclusion:
TiO₂ nanoparticles enhance PMMA biological performance (e.g., lower inflammatory responses, better tissue integration) in this model system. The findings of this study illustrate the promise of TiO₂-PMMA composites in extending the longevity and success of biomedical implants.

Key words: Polymethyl methacrylate; Titanium dioxide nanoparticles; Inflammation; Histopathology.