Aukštėja | Metal Allergy Testing

Worth knowing:

Although titanium, commonly found in dental implants, is generally considered a “biocompatible” metal and widely used in oral surgery and orthopedics, a significant portion of individuals may experience Type IV delayed allergic reactions to titanium or its impurities.
Pure titanium, consisting of approximately 99% of the metal, still contains traces of nickel, chromium, cobalt, and aluminum due to the manufacturing process, which can potentially trigger allergic reactions.
Symptoms of allergies to titanium or other metal impurities can vary, including muscle and joint pain, chronic fatigue syndrome, neurological problems, depression, sensitivity to various chemicals, dermatitis, acne-like facial skin inflammation, and headaches. These symptoms may not immediately manifest after implantation but may develop within a few months.
At our clinic, we perform the “Melisa” metal allergy test, an optimized, clinically validated lymphocyte transformation test (LTT) widely used to detect Type IV allergic reactions to metals.
Before choosing metal dental implants, we recommend conducting a test for allergies to the five most commonly used metals in dental implants: aluminum, titanium, vanadium, nickel, and chromium. People who are allergic to metals or jewellery are likely to be overly sensitive to metal implants, making the “Melisa” test essential for them.
The “Melisa” metal allergy test is also necessary when considering metal braces in orthodontics or when mercury fillings are present. We recommend using zirconium dioxide ceramic dental implants for patients who exhibit allergic reactions to metals.

FREQUENTLY ASKED QUESTIONS

Do I need the "Melisa" metal allergy test?

The “Melisa” test is necessary if you are planning to choose metal dental implants, metal braces, or prosthetics with metal-ceramic crowns. It is also recommended if you have a chronic illness, experience muscle and joint pain, chronic fatigue syndrome, neurological problems, depression, sensitivity to various chemicals, dermatitis, acne-like facial skin inflammation, headaches, and have any of the aforementioned metal objects in your body.

What are the possible causes of allergic reactions to titanium?

While titanium forms a stable oxide layer that protects against metal contact with body tissues, studies have shown that metal ions from implants can still enter body fluids and tissues. Factors such as infections, bacteria (lipopolysaccharides), toothpaste with fluoride, and acidic food in the oral cavity contribute to this. Some researchers suggest that it is challenging to identify allergic reactions to titanium implants because patients may be sensitive not only to titanium but also to impurities such as nickel, chromium, and cadmium in the metal.

How do the "Melisa" and skin patch tests differ in evaluating metal allergies?

Research has shown that lymphocyte transformation tests are more suitable than skin patch tests for assessing metal sensitivity. It should be noted that T cells, which are triggered in cases of hypersensitivity reactions related to implants, are examined in the “Melisa” test. The skin patch test lacks standardization, affecting its reliability. Opinions on the accuracy of the skin patch test for detecting titanium allergies vary greatly. Over the course of a decade, specialists at the Mayo Clinic were unable to confirm titanium allergies using this method, even after reports of such cases were published. It has been proven that titanium causes clinically significant hypersensitivity reactions that can be detected by the “Melisa” test. Some surgeons recommend using the “Melisa” test before operating on patients who may develop metal allergies, helping select the most suitable dental implants.

What are the alternatives for patients with metal hypersensitivity?

Zirconium dioxide (zirconia) dental implants can be used for patients with allergic reactions to metals.

What are the symptoms of metal allergies, and when do they occur?

Symptoms of titanium allergy can vary, and not all of them occur in every patient. The following partial list of symptoms was reported by patients allergic to titanium in the article “Hypersensitivity to titanium: Clinical and laboratory evidence“:

Muscle, joint, and nerve pain
Chronic fatigue syndrome
Neurological problems
Depression
Sensitivity to various chemicals
Dermatitis
Acne-like facial skin inflammation
Headaches

These symptoms may start to manifest within several months after implantation.