title: A comparative analysis of metal allergens associated with dental alloy prostheses and the expression of HLA-DR in gingival tissue.
abstract: The present study aimed to provide guidance for the selection of prosthodontic materials and the management of patients with a suspected metal allergy. This included a comparison of the sensitivity of patients to alloys used in prescribed metal‑containing prostheses, and correlation analysis between metal allergy and accompanying clinical symptoms of sensitized patients using a patch test. The results from the patch test and metal component analyses were processed to reach a final diagnosis. In the present study, four dental alloys were assessed. Subsequent to polishing the surface of a metal restoration, the components were analyzed using an X‑ray fluorescence microscopy and spectrometry. Immunohistochemical analysis, reverse transcription‑polymerase chain reaction and western blotting were used to detect the expression levels of human leukocyte antigen (HLA)‑DR in gingival tissues affected by alloy restoration, and in normal gingival tissue samples. Positive allergens identified in the patch test were consistent with the components of the metal prostheses. The prevalence of nickel (Ni) allergy was highest (22.8%), and women were significantly more allergic to palladium and Ni than men (P<0.05). The protein and gene expression levels of HLA‑DR in the Ni‑chromium (Cr) prosthesis group were significantly higher, compared with those in the other groups (P<0.01); followed by cobalt‑Cr alloy, gold alloy and titanium alloy. In conclusion, dentists require an understanding of the corrosion and allergy rates of prescribed alloys, in order to reduce the risk of allergic reactions. Patch testing for hypersensitive patients is recommended and caution is required when planning to use different alloys in the mouth.
authors.affiliation: Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, P.R. China.
authors.forename: Li-Cheng
authors.initials: LC
authors.lastname: Wei
authors.affiliation: Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Yu
authors.affiliation: Department of Stomatology, Yuhuangding Hospital, Yantai, Shandong 264000, P.R. China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Wang
authors.affiliation: Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000485:Allergens / Q000009:adverse effects*; D003722:Dental Alloys / Q000009:adverse effects*; D017266:Dental Prosthesis / Q000009:adverse effects; D003793:Dental Restoration, Permanent; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000276:immunology*; D006684:HLA-DR Antigens / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects*; D010328:Patch Tests
chemical_list: D000485:Allergens; D003722:Dental Alloys; D006684:HLA-DR Antigens; D008670:Metals