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Sensitization to palladium and nickel in Europe and the relationship with oral disease and dental alloys.

AbstractBACKGROUND:
The role of palladium and nickel sensitization in oral disease and dermatitis is not fully understood.
OBJECTIVES:
To investigate whether sensitization to these metals was associated with exposure to dental alloys and oral and skin complaints/symptoms in a European multicentre study.
METHODS:
In six dermatology clinics, patch tests with palladium (3% Na2 PdCl4 ; Pd = 102.0 µmol/g) and nickel (5% NiSO4 .6H2 O; Ni = 190.2 µmol/g) were performed in consecutive patients, and patients' characteristics were collected with a questionnaire and a clinical investigation.
RESULTS:
In total, 906 patients were included, of whom 24.3% reacted to palladium and 25.2% to nickel. The rate of monosensitization was 6-7% for both metals. Palladium sensitization (as opposed to no sensitization to both metals) was associated with exposure to dental crowns [odds ratio (OR) 2.0], skin reactivity to metals (OR 2.8), oral lichenoid lesions (OR 4.7), xerostomia (OR 7.3), and metal taste (OR 20.7), but not with eczema, stomatitis, or oral burning sensation. Additionally, xerostomia (OR 8.7) and metal taste (OR 4.6) were associated with sensitization to both metals.
CONCLUSIONS:
Clinically, it is important for palladium-sensitized patients to undergo an oral examination, with particular attention to the presence of/exposure to dental crowns. In the case of metal contact allergy, exposure to dental crowns could play a role.
AuthorsJoris Muris, An Goossens, Margarida Gonçalo, Andreas J Bircher, Ana Giménez-Arnau, Caterina Foti, Thomas Rustemeyer, Albert J Feilzer, Cornelis J Kleverlaan
JournalContact dermatitis (Contact Dermatitis) Vol. 72 Issue 5 Pg. 286-96 (May 2015) ISSN: 1600-0536 [Electronic] England
PMID25580524 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Copyright© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chemical References
  • Dental Alloys
  • Palladium
  • Nickel
Topics
  • Cross-Sectional Studies
  • Crowns (adverse effects)
  • Dental Alloys (adverse effects)
  • Dermatitis, Allergic Contact (diagnosis, epidemiology, etiology)
  • Europe
  • Female
  • Humans
  • Lichen Planus, Oral (epidemiology)
  • Male
  • Multiple Chemical Sensitivity (epidemiology)
  • Nickel (adverse effects)
  • Palladium (adverse effects)
  • Patch Tests
  • Prevalence
  • Surveys and Questionnaires
  • Taste Disorders (epidemiology)
  • Xerostomia (epidemiology)

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