Palladium-based dental alloys are associated with oral disease and palladium-induced immune responses.
BACKGROUND
Palladium (Pd) and gold (Au) based dental alloys have been associated with oral disease.


OBJECTIVE
This study was designed to explore possible associations between the presence of Au-based and Pd-based dental alloys, and oral lesions, systemic complaints, and specific in vivo and in vitro immune responses.


METHODS
The investigated population consisted of three groups: 26 non-metal-allergic volunteers, 25 metal-allergic patients, and 20 oral disease patients. Medical histories were taken, oral examinations were carried out, and compositions of all dental alloys were determined. Then, Au and Pd patch tests and in vitro assays were performed, revealing cytokine production by peripheral blood mononuclear cells [T helper (Th)1, interferon-γ; Th2, interleukin (IL)-5 and IL-13] and lymphocyte proliferation (LTT-MELISA(®) ).


RESULTS
Non-plaque-related gingivitis was associated with the presence of Pd-based dental alloys, and Pd-positive patch tests and in vitro assays. Collectively, participants with Pd-based dental alloys showed increased Pd patch test reactivity (p < 0.05) and lymphoproliferation (p < 0.05). In contrast, oral lichenoid lesions were associated with Au-based alloys (p < 0.05), but this was not reflected by Au-specific immunoreactivity.


CONCLUSIONS
Oral lesions and Pd-induced immune responses are associated with the presence of dental alloys. However, most oral disease patients did not show positive patch test results or in vitro signs of specific immunoreactivity, suggesting local toxic reactions or the involvement of innate immune responses.
Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam & VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
Joris
J
Muris
Rik J
RJ
Scheper
Cornelis J
CJ
Kleverlaan
Thomas
T
Rustemeyer
Ingrid M W
IM
van Hoogstraten
Mary E
ME
von Blomberg
Albert J
AJ
Feilzer
D000328:Adult; D049109:Cell Proliferation; D003722:Dental Alloys / Q000009:adverse effects* / Q000737:chemistry; D005260:Female; D006046:Gold / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D007113:Immunity, Innate; D007371:Interferon-gamma / Q000096:biosynthesis; D018793:Interleukin-13 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000096:biosynthesis; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D009059:Mouth Diseases / Q000276:immunology*; D010165:Palladium / Q000276:immunology*; D010328:Patch Tests; D018417:Th1 Cells / Q000378:metabolism
D003722:Dental Alloys; D018793:Interleukin-13; D015848:Interleukin-5; D010165:Palladium; D006046:Gold; D007371:Interferon-gamma
Th1; Th2; clinical immunology; dental alloys; gold; oral disease; palladium