Dictionary of Allergies .. Dental alloys

Dental alloys

Nickel, chromium and cobalt alloys are frequently used in the frames of removable partial dentures. Allergic reactions to wires for intermaxillary fixation and to the buckle on a headgear (an orthodontic appliance) have been reported, as well as reacting to metals in partial dentures (Schriver et al 1976, Blanco-Dalman 1982).

There have also been a few cases of allergic contact stomatitis from a gold alloy used in crowns and bridges. Exposure to nickel-containing orthodontic appliances may cause intra- or extraoral allergic reactions. Nickel is the most typical antigen implicated in causing allergic contact dermatitis, which is a Type IV delayed hypersensitivity immune response. All dental cast alloys release metal ions into the oral environment which have the potential to interact with the oral tissues[3]. Amount and type of metal elements released are varying and not directly related to the composition of the alloy.

Patients relating oral symptoms to metal restorations should be subjected to a thorough dental and general medical examination in order to exclude non-material related diseases being the cause for their complaints/symptoms. These cases are a challenge for the collaboration between the medical and dental professions [4].

References

1. Schriver, W.R. et al: Oral surg. 42, 578. (1976).

2. Blanco-Dalman, L.: J. Pros. Dent. 48, 99. (1979).

3. Kolokitha OE, Chatzistavrou E. A severe reaction to ni-containing orthodontic appliances. Angle Orthod. 2009 Jan;79(1):186-92.

4. Schmalz G, Garhammer P. Biological interactions of dental cast alloys with oral tissues. Dent Mater. 2002 Jul;18(5):396-406