What to do about dental restorations in consideration of potential immune hypersensitivity to titanium? Ask your dental specialist about zirconia ceramic implants. As the author of this paper published in the Journal of the American Dental Association when comparing porcelain fused to metal with all zirconia ceramic states: “it is assumed that the well-known objectionable gingival reactions often observed with PFM restorations probably will be reduced or eliminated. After having placed hundreds of restorations, I have found these reactions to be reduced with the use of all-ceramic materials.” The authors of this study published in Neuro Endocrinology Letters make the compelling statement: “This clinical study shows that dental implants made from zirconia are a feasible alternative to titanium dental implants. In addition to excellent cosmetic results, zirconia implants allow a degree of osseointegration and soft tissue response that is superior to titanium dental implants.”

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Whenever metals are implanted in the human body there is a possibility that hypersensitivity will develop which can evolve into autoimmune disease. Two interesting papers in the Neuro Endocrinology Letter investigate the evidence. The authors of Hypersensitivity to titanium: Clinical and laboratory evidence conclude: “These data clearly demonstrate that titanium can induce clinically-relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants.” The study Diagnosis and treatment of metal-induced side-effects documents diagnosis by the lymphocyte transformation test and observes that, “The removal of incompatible dental material (RID) resulted in long-term health improvement in the majority of patients.” Yet another paper in the same journal concludes, “The optimized LTT-MELISA® test is a clinically useful and reliable tool for identifying and monitoring metal sensitization in symptomatic metal-exposed individuals.” Bear in mind that this applies to all kinds of metal implants, including replacement joints.

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