Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.
Department of Clinical Pathophysiology, Tokyo Dental College, Tokyo, Japan.
J Prosthodont Res. 2019 Jul;63(3):309-312. doi: 10.1016/j.jpor.2019.01.003. Epub 2019 Feb 7.
To assess the current status of patients with dental metal allergies in Japan.
This study analyzed dental metal allergy in 1225 patients (1:3 male to female ratio; average age 53.0 ±16.5 years), including 300 who were scheduled to undergo dental implant surgery, between 2006 and 2016. For diagnosis of metal allergy, patch tests using metal allergens were performed. Additionally, when necessary, metal element analysis of dental alloys was performed in the mouths of some patients using an X-ray fluorescence analyzer for those who exhibited positive reactions.
Among 925 patients (i.e., excluding those scheduled to undergo dental implant surgery [n=300]), nearly one-half (44.0%) exhibited a positive response to any metal element in the patch test. The positivity rates were as follows: nickel (22.5%); palladium (14.8%); and zinc (11.5%). Almost one-half (42.3%) of the patients had diseases associated with metal allergy. Among patients who exhibited a positive reaction to any metal element in the patch test, more than two-thirds (67.9%) had dental alloys containing the positive metal element(s). One-half (55.6%) of the patients who underwent treatment to remove the metal experienced improvement in symptoms. In patients who underwent patch testing as an implant preoperative examination, several (2.7%) exhibited a positive reaction to titanium.
Dental metals, including nickel, palladium and zinc, which are indispensable to dental treatment in Japan, had high positivity rates in patch testing, and one-half of the patients improved following removal of the metal. Additionally, there were several patients with allergy to titanium.
评估日本牙科金属过敏患者的现状。
本研究分析了 2006 年至 2016 年间 1225 名（男女比例 1:3；平均年龄 53.0±16.5 岁）计划接受牙种植手术的患者的牙科金属过敏情况。为诊断金属过敏，对这些患者进行了金属过敏原斑贴试验。此外，对于那些出现阳性反应的患者，当需要时，使用 X 射线荧光分析仪对其口腔中的牙科合金进行金属元素分析。
在 925 名（即不包括计划接受牙种植手术的患者[n=300]）患者中，近一半（44.0%）对斑贴试验中的任何金属元素呈阳性反应。阳性率如下：镍（22.5%）；钯（14.8%）；锌（11.5%）。几乎一半（42.3%）的患者患有与金属过敏相关的疾病。在对斑贴试验中任何金属元素呈阳性反应的患者中，超过三分之二（67.9%）的患者使用含有阳性金属元素的牙科合金。一半（55.6%）接受去除金属治疗的患者症状得到改善。在接受作为植入术前检查的斑贴试验的患者中，有几例（2.7%）对钛呈阳性反应。
日本牙科治疗中不可或缺的牙科金属（包括镍、钯和锌）在斑贴试验中阳性率较高，一半的患者在去除金属后症状得到改善。此外，还有几例对钛过敏的患者。
