Titanium has been used in dentistry as a restorative material for decades now. Most associate its use with frameworks for partial dentures and dental implants that replace roots. Now it is also being used to restore teeth as a material used in the fabrication of crowns.
The following is taken from a recent publication, the Journal of Prosthodontics, a peer reviewed scientific dental journal. For those with pre-existing sensitivities to metals, including nickle, and auto immune disorders Dr. Valentine-Thon suggests avoiding titanium implants. Testing, as mentioned in the article, is available for those considering titanium implants and restorations. Always discuss material selection with your dentist. Non-metal solutions are now available including ceramic implants. Also, as noted in the following article, if you have titanium implants fluoride should NOT be used.
Titanium and Allergic reactions
New research puts a question mark on conventional thinking that titanium (Ti) is unlikely to cause allergic reactions because of its superior corrosion resistance.
The incidence of allergic reactions attributed to titanium sensitization may increase with its overall medical use, research published in the Feb. 4, 2014 online edition of the Journal of Prosthodontics reported.
Scientists in Japan described the case of a 33-year-old woman referred for treatment following a 10-year history of eczema and itchy redness on her fingers. An allergy clinic conducted lymphocyte stimulation testing (LST), which has been demonstrated in the literature to be a reliable method for detecting metal sensitivity. The patient showed a rare, specific reaction to mercury, nickel and silver, but no reaction to other tested metals, including titanium.
After checking the composition of the patient’s 17 metal restorations, researchers removed all of those containing mercury or silver. The patient’s pruritus improved within two months. After waiting an additional month, researchers replaced the restorations with new ones made of titanium.
Nine months after placement of the Ti restorations, the patient developed cervical eczema. The condition gradually worsened. LST testing revealed a specific reaction to titanium, so the authors removed all titanium containing restorations and replaced them with auto-polymerizing poly (methyl methacrylate) resin. The patient’s eczema resolved within three months and didn’t reoccur over more than five years of observation.
Earlier research uncovered Ti allergy because dermal inflammatory conditions ceased after removal of titanium. This current study, however, described a case of dermatitis associated with a positive LST reaction to titanium after insertion of titanium dental restorations.
In discussion, the authors noted that Ti ions dissolve in artificial bio-liquids more than expected when the surface film is destroyed, and topical fluoride solutions can cause stress corrosion cracking.
“The present findings suggest that the patient had become sensitized by nine months after insertion of Ti, and the fact that complete remission was achieved after removal of the Ti strongly suggests that the cervical eczema was caused by an allergy to intraoral Ti,” the authors said.
They speculated that titanium restorations are likely to increase in frequency as a substitute for precious metal due to the belief that titanium is very stable.
“It seems likely that the incidence of allergic reactions caused by sensitization to titanium will increase in the future as use of medical titanium increases,” authors said. “The rare occurrence of such a response to titanium materials in clinical dentistry should therefore be further discussed and investigated.”