Nickel hypersensitivity-related periodontitis

As the cost of providing dental care escalates, there has been a substantial increase in the substitution of nonprecious alloys for gold and precious metals found in porcelain-fused-to-metal crowns. These alloys are frequently 69% to 81% nickel. Nickel hypersensitivity is quite common in the general population and periodontal responses have been associated with nickel-containing crowns in nickel-sensitive individuals. In this article, the authors report the case of a nickel-sensitive patient who demonstrated loss of alveolar bone after the placement of crowns with a high nickel content. Nonprecious alloy crowns can be well tolerated in most cases, however, a history of metal sensitivity should be evaluated.