Lamia NAJAFOVA, Hüseyin Mehmet KURTULMUŞ

PROTETİK DİŞ TEDAVİSİNDE TİTANYUM ALERJİSİ

ÖZ Günümüzde diş eksikliğinin tedavisinde en güncel ve biyomimetrik tedavi seçeneklerinden biri implant tedavisidir. Çoğu zaman bu tür tedavilerin başarı oranları çok yüksektir. Diş hekimliğinde kullanılan implantlar titanyum veya titanyum ve diğer alaşımlarının kombinasyonlarından üretilmektedir. Ağız boşluğundan titanyum biyoinert malzeme olarak kabul edilmektedir. Bundan dolayı vücut herhangi bir yabancı cisim reaksiyonunu göstermeden implantları “kabul etmektedir”. Lakin bu konu son zamanlar hastaların titanyuma karşı alerji göstermelerinden kaynaklı tartışma konusu olmuştur. Araştırmacılar son zamanlarda herhangi bir biyolojik ve teknik komplikasyon nedeni olmayan implant kayıplarının titanyuma karşı alerjiden kaynaklandığından şüphe etmektedirler. Bu derlemenin amacı diş hekimliğinde kullanılan titanyuma karşı alerji vakalarını incelemektir.

Anahtar Kelimeler:

İmplant, titanyum, alerji

TITANIUM ALLERGY IN PROSTHODONTICS

Today, implant therapy is one of the most current and biomimetric treatment options in the treatment of tooth deficiency. Often, the success rates of such treatments are very high. The implants used in dentistry are manufactured from titanium or a combination of titanium and other alloys. Titanium from the oral cavity is considered as bioinert material. Therefore, the body accepts implants without showing any foreign body reactions. However, this issue has recently been the subject of controversy due to patients’ allergies to titanium. Researchers have recently suspected implant losses that do not cause any biological and technical complications as they are caused by allergies to titanium. The aim of this review is to investigate allergy cases against titanium used in dentistry.

Keywords:

Implant, titanium, allergy,

PDF

___

1. Council, N.R., Biologic markers in immunotoxicology. 1992: National Academies Press.
2. Mösges, R., The increasing prevalence of allergy: a challenge for the physician. Clinical & Experimental Allergy Reviews, 2002. 2(1): p. 13-17.
3. Muller, K. and E. Valentine-Thon, Hypersensitivity to titanium: clinical and laboratory evidence. Neuroendocrinology Letters, 2006. 27(1): p. 31-35.
4. Frisken, K., et al., A study of titanium release into body organs following the insertion of single threaded screw implants into the mandibles of sheep. Australian dental journal, 2002. 47(3): p. 214-217.
5. Okamura, T., A skin patch test for the diagnosis of titanium allergy. J Dent res, 1999. 78: p. 1135.
6. Thomas, P., et al., Hypersensitivity to titanium osteosynthesis with impaired fracture healing, eczema, and T-cell hyperresponsiveness in vitro: case report and review of the literature. Contact Dermatitis, 2006. 55(4): p. 199-202.
7. Siddiqi, A., et al., Titanium allergy: could it affect dental implant integration? Clinical Oral Implants Research, 2011. 22(7): p. 673-680.
8. Delves, P.J., et al., Essential immunology. 2017: John Wiley & Sons.
9. Hallab, N., K. Merritt, and J.J. Jacobs, Metal sensitivity in patients with orthopaedic implants. JBJS, 2001. 83(3): p. 428-436.
10. Venugopal, B. and T.D. Luckey, Metal toxicity in mammals. Volume 2. Chemical toxicity of metals and metalloids. 1978: Plenum Press.
11. Forte, G., F. Petrucci, and B. Bocca, Metal allergens of growing significance: epidemiology, immunotoxicology, strategies for testing and prevention. Inflammation & Allergy-Drug Targets (Formerly Current Drug Targets-Inflammation & Allergy), 2008. 7(3): p. 145-162.
12. Smith, D.C., et al., Systemic metal ion levels in dental implant patients. International Journal of Oral & Maxillofacial Implants, 1997. 12(6).
13. Sykaras, N., et al., Implant materials, designs, and surface topographies: their effect on osseointegration. A literature review. International Journal of Oral & Maxillofacial Implants, 2000. 15(5).
14. Nakagawa, M., S. Matsuya, and K. Udoh, Corrosion behavior of pure titanium and titanium alloys in fluoride-containing solutions. Dental materials journal, 2001. 20(4): p. 305-314.
15. Holgers, K., et al., Clinical, immunological and bacteriological evaluation of adverse reactions to skin-penetrating titanium implants in the head and neck region. Contact Dermatitis, 1992. 27(1): p. 1-7.
16. Kruger, J., Fundamental aspects of the corrosion of metallic implants, in Corrosion and degradation of implant materials. 1979, ASTM International.
17. Kamachimudali, U., T. Sridhar, and B. Raj, Corrosion of bio implants. Sadhana, 2003. 28(3-4): p. 601-637.
18. RAVNHOLT, G., Corrosion current and pH rise around titanium coupled to dental alloys. European Journal of Oral Sciences, 1988. 96(5): p. 466-472.
19. Cadosch, D., et al., Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening—current concepts. Journal of Biomedical Materials Research Part A: An Official Journal of The Society for Biomaterials, The Japanese Society for Biomaterials, and The Australian Society for Biomaterials and the Korean Society for Biomaterials, 2009. 91(4): p. 1252-1262.
20. Okazaki, Y., et al., Comparison of metal concentrations in rat tibia tissues with various metallic implants. Biomaterials, 2004. 25(28): p. 5913-5920.
21. Urban, R.M., et al., Dissemination of wear particles to the liver, spleen, and abdominal lymph nodes of patients with hip or knee replacement. JBJS, 2000. 82(4): p. 457- 477.
22. Merritt, K. and S.A. Brown, Distribution of cobalt chromium wear and corrosion products and biologic reactions. Clinical Orthopaedics and Related Research®, 1996. 329: p. S233-S243.
23. Merritt, K. and J.J. Rodrigo, Immune response to synthetic materials: sensitization of patients receiving orthopaedic implants. Clinical Orthopaedics and Related Research®, 1996. 326: p. 71-79.
24. Büdinger, L., M. Hertl, and L. Büdinger, Immunologic mechanisms in hypersensitivity reactions to metal ions: an overview. Allergy, 2000. 55(2): p. 108-115.
25. Frigerio, E., et al., Metal sensitivity in patients with orthopaedic implants: a prospective study. Contact Dermatitis, 2011. 64(5): p. 273-279.
26. Nasser, S., Orthopedic metal immune hypersensitivity. Orthopedics, 2007. 30(8): p. 89.
27. Koch, P., Kontaktallergien bei Metallarbeitern: Berufliche und allergologische Relevanz der Epikutantestung bei 17 Patienten. Dermatosen in Beruf und Umwelt, 1996. 44(2): p. 62-67.
28. Abdallah, H.I., R.K. Balsara, and A.C. O’Riordan, Pacemaker contact sensitivity: clinical recognition and management. The Annals of thoracic surgery, 1994. 57(4): p. 1017-1018.
29. Lalor, P., et al., Sensitivity to titanium. A cause of implant failure? The Journal of bone and joint surgery. British volume, 1991. 73(1): p. 25-28.
30. Peters, M.S., et al., Pacemaker contact sensitivity. Contact dermatitis, 1984. 11(4): p. 214-218.
31. Halpern, B. and N. Amache, Diagnosis of drug allergy in vitro with the lymphocyte transformation test. Journal of Allergy, 1967. 40(3): p. 168-181.
32. Müller, K.E., Zwei Episoden eines Guillain- Barré-Syndrom (GBS) nach Roxithromycin und Mercurius solubilis. Umwelt Medizin Gesell, 2003. 16: p. 101-102.
33. Stejskal, V.D., M. Forsbeck, and R. Nilsson, Lymphocyte transformation test for diagnosis of isothiazolinone allergy in man. Journal of investigative dermatology, 1990. 94(6): p. 798-802.
34. Warrington, R. and K. Tse, Lymphocyte transformation studies in drug hypersensitivity. Canadian Medical
35. Carroll, K.G. and J.L. TULLIS, Observations on the presence of titanium and zinc in human leucocytes. Nature, 1968. 217(5134): p. 1172.
36. Du Preez, L., K.-W. Butow, and T.J. Swart, Implant failure due to titanium hypersensitivity/allergy?-Report of a case: implantology corner. South African Dental Journal, 2007. 62(1): p. 22-25.
37. Weingart, D., et al., Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region. International journal of oral and maxillofacial surgery, 1994. 23(6): p. 450- 452.
38. Mitchell, D.L., S.A. Synnott, and J.A. VanDercreek, Tissue reaction involving an intraoral skin graft and CP titanium abutments: a clinical report. International Journal of Oral & Maxillofacial Implants, 1990. 5(1).