Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand.
Clin Oral Implants Res. 2011 Jul;22(7):673-680. doi: 10.1111/j.1600-0501.2010.02081.x. Epub 2011 Jan 20.
Degradation products of metallic biomaterials including titanium may result in metal hypersensitivity reaction. Hypersensitivity to biomaterials is often described in terms of vague pain, skin rashes, fatigue and malaise and in some cases implant loss. Recently, titanium hypersensitivity has been suggested as one of the factors responsible for implant failure. Although titanium hypersensitivity is a growing concern, epidemiological data on incidence of titanium-related allergic reactions are still lacking.
A computer search of electronic databases primarily MEDLINE and PUBMED was performed with the following key words: 'titanium hypersensitivity', 'titanium allergy', 'titanium release' without any language restriction. Manual searches of the bibliographies of all the retrieved articles were also performed. In addition, a complementary hand search was also conducted to identify recent articles and case reports.
Most of the literature comprised case reports and prospective in vivo/in vitro trials. One hundred and twenty-seven publications were selected for full text reading. The bulk of the literature originated from the orthopaedic discipline, reporting wear debris following knee/hip arthroplasties. The rest comprised osteosynthesis (plates/screws), oral implant/dental materials, dermatology/cardiac-pacemaker, pathology/cancer, biomaterials and general reports.
This review of the literature indicates that titanium can induce hypersensitivity in susceptible patients and could play a critical role in implant failure. Furthermore, this review supports the need for long-term clinical and radiographic follow-up of all implant patients who are sensitive to metals. At present, we know little about titanium hypersensitivity, but it cannot be excluded as a reason for implant failure.
金属生物材料（包括钛）的降解产物可能导致金属过敏反应。生物材料过敏通常表现为模糊的疼痛、皮疹、疲劳和不适，在某些情况下还会导致植入物丢失。最近，钛过敏被认为是导致植入物失败的因素之一。尽管钛过敏是一个日益受到关注的问题，但关于与钛相关的过敏反应发生率的流行病学数据仍然缺乏。
通过计算机在电子数据库（主要是 MEDLINE 和 PUBMED）中进行了检索，使用了以下关键词：“钛过敏”、“钛过敏症”、“钛释放”，没有任何语言限制。还对所有检索到的文章的参考文献进行了手工检索。此外，还进行了补充的手动搜索，以确定最近的文章和病例报告。
大多数文献包括病例报告和前瞻性体内/体外试验。选择了 127 篇文献进行全文阅读。大部分文献来自矫形科，报告了膝关节/髋关节置换术后的磨损碎片。其余的包括骨固定术（板/螺钉）、口腔植入物/牙科材料、皮肤病/心脏起搏器、病理学/癌症、生物材料和一般报告。
对文献的回顾表明，钛可以在易感患者中引起过敏反应，并可能在植入物失败中起关键作用。此外，这篇综述支持对所有对金属敏感的植入物患者进行长期的临床和影像学随访的必要性。目前，我们对钛过敏知之甚少，但不能排除其是植入物失败的原因。
