Diagnosis of Sensitization to Dental Restorative Metals

Objectives: In dentistry and medicine many materials are used which are ‘medical devices' and aimed to stay in the human body. Within the aggressive oral environment metal components may dissolve, resulting in exposure of the human interior to these metals. Sensitive persons may develop toxic and/or immunologic reactions.

Aim: To develop a diagnostic system to reveal T-cell sensitization to metal components to enable an evaluation of health side-effects of metal-based dental devices.

Methods: A test methodology was developed which consisted of a sampling method for EDAX analysis of the metal based restoratives present of the patient, a special questionnaire to reveal metal exposures of other origin and a specific lymphocyte transformation test (LTT), MELISA® (MEmory Lymphocyte ImmunoStimulation Assay) to evaluate T-cell sensitization to metals. With this system a non-randomized group of 140 patients was screened. All patients were referred to our oral diagnostic clinic for the evaluation of possible intra-oral sources of their metal allergy.

Results:

In this non-randomized group a significant relation between patients that showed a T-cell sensitization to one ore more metals of which their dental restorations were composed and the occurrence of health side-effects was found.

Conclusions: The diagnostic system developed in this study offers a tool to reveal sensitization to dental metal restoration components. Our results strongly support the need of controlled randomized clinical trials into the relation between metal-based medical devices and health side-effects.