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Titanium allergy: could it affect dental implant integration?

Allauddin Siddiqi¹, Alan G T Payne¹, Rohana Kumara De Silva¹

¹Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand.

Clinical Oral Implants Research

|January 22, 2011

Summary

Titanium hypersensitivity reactions can cause implant failure, though data on their incidence is limited. Further research is needed to understand this growing concern in metallic biomaterials.

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Area of Science:

Biomaterials Science
Immunology
Orthopedic Surgery

Background:

Metallic biomaterials, particularly titanium, can degrade, potentially leading to metal hypersensitivity reactions.
Symptoms of hypersensitivity include pain, rashes, fatigue, and implant loss, with titanium hypersensitivity increasingly implicated in implant failure.

Purpose of the Study:

To review the existing literature on titanium hypersensitivity and its role in implant failure.
To highlight the lack of epidemiological data on titanium-related allergic reactions.

Main Methods:

A comprehensive literature search was conducted using MEDLINE and PubMed with keywords such as 'titanium hypersensitivity,' 'titanium allergy,' and 'titanium release.'
Manual bibliographical searches and complementary hand searches were performed to identify relevant articles and case reports.

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Main Results:

The review encompassed 127 publications, predominantly case reports and in vivo/in vitro trials.
Literature originated mainly from orthopedics (knee/hip arthroplasties, osteosynthesis) but also included dental implants, cardiac devices, and other applications.
Wear debris from orthopedic implants was a significant focus.

Conclusions:

Titanium can induce hypersensitivity in susceptible individuals, potentially contributing to implant failure.
There is a need for long-term clinical and radiographic follow-up for implant patients sensitive to metals.
While understanding of titanium hypersensitivity is limited, it should not be excluded as a cause of implant failure.