Contact stomatitis and dermatitis to nickel and palladium

Abstract

17 subjects were tested epicutaneously with 22 materials, including Ni, Pd, Cr and Co. 5 subjects with a positive allergic skin reaction to Ni were tested with a pure metallic nickel plate 3 X 5 mm, which was attached to the buccal side of one lower premolar. These 5 subjects all developed local allergic contact stomatitis on the mucosa of the cheek adjacent to the metal plate. This was confirmed histologically. The same oral test with pure metallic palladium gave no reaction in subjects with a positive patch test. A control group gave no reactions to the metal plates. Allergic contact stomatitis was diagnosed with the help of both clinical and histological examinations.

Casting Alloys: Side-Effects

“…Palladium allergy seems to occur in patients who are also sensitive to nickel (van Ketel and Niebber, 1981;Nakayama, 1982;van Loon et al, 1984van Loon et al, , 1986Stenman and Bergman, 1989;Augthun et al, 1990), but not consistently (Castelain and Castelain, 1987). All casting alloys, except unalloyed titanium, seem to have a potential for eliciting adverse reactions in individual, hypersensitive patients.…”

Nickel‐induced angular cheilitis due to orthodontic braces

“…Even though nickel and other metals used in dentistry have been known to cause oral lichenoid reactions (3), nickel sensitivity is more commonly associated with a generalized skin eruption including urticaria and eczema (4). Contact cheilitis and stomatitis have been reported from nickel (5, 6). However, the occurrence of angular cheilitis following contact sensitivity to nickel in braces has not been reported.…”

Palladium alloys for biomedical devices

“…Limitations of these studies included a lack of knowledge of the composition of the alloy used, sketchy patient histories and uncontrolled conditions or confounding variables. In one interesting study, individuals with Ni and Pd allergy were not allergic to pure Pd metal placed intraorally [49]; this result has been attributed to intraoral corrosion resistance to Pd [1]. Yet, other studies suggest that some Pd-based alloys gradually experience intraoral corrosion of base metal elements, leading to Pd enrichment at the alloy surface and more Pd release over time because of the enrichment [34].…”

“…Controversy persists and, to date, no prospective, randomized, appropriately controlled studies have been performed to establish the prevalence of allergic responses to Pd dental alloys. However, several reports have concluded that even in patients with documented Pd allergy, the risk of allergic reaction to Pd alloy is relatively low because of the low corrosion rate of Pd from these alloys [1,42,[49][50][51].…”

“…However, prevalence of allergy in the general population is unclear because most studies have evaluated populations that had some other immunological sign or symptom. For example, patients who have eczema [41], a history of allergic reaction [49], Ni allergy or allergy to other metals [50,52] or who work in metal refineries [51,53] have been used as cohorts for assessing allergy to Pd ions. A more recent retrospective study used a cohort of dental patients who had received a metallic prosthesis, and found the prevalence of PdCl 2 sensitivity to be 3.8%, based on a patch test [54].…”