Author: Pigatto PDM, Brambilla L, Ferrucci S, Guzzi G.
Source: Skin Allergy Meeting
Year: 2010
Comment:
This study finds that dental amalgam mercury and titanium implants can interact and cause dematitis.
Abstract / Excerpt:
“Background Systemic allergic contact dermatitis has been reported in patients with adverse health effects linked to dental alloy restorations. Here we report a case of severe systemic allergic contact dermatitis caused by allergy to metals released by galvanic corrosion between mercury dental amalgam and a titanium dental implant. Methods A 36-year-old woman reporting severe systemic dermatitis with intractable pruritus was examined in April 2002. The rapid onset of dermatitis began several months after she received 2 titanium screws which were implanted in her maxilla and jaw. Examination showed extensive dermatitis with erythema, dry skin with scaling and crusting on face, neck, and inguinal area (Fig.1). She had 2 titanium endosseous implants (on 1.6 and 3.6 area) and 1 mercury amalgam filling on the mandibular left first molar (3.7). We suspected an high rate of intraoral metal ions release due to galvanic corrosion between mercury amalgam filling on 3.7 and the titanium implant-supported gold-alloy crown in 3.6 area. Amalgam tattoo was present on 1.6 gingival area. Results She was patch-tested with general and dental series. We observed very strong positive allergic reactions to nickel sulfate 5% (+++) and potassium dichromate 0.5% (+++), gold sodium thiosulfate 0.5% (++), all in petrolatum. Lymphocyte stimulation test confirmed nickel allergy (stimulation index: 6.7). Dental amalgam as well as metal ceramic crown on implant were removed to eliminate the oral galvanism corrosion. The systemic contact dermatitis resolved completely within 8 months after the removal of mercury amalgam. There have been reports of skin disorders associated with mercury amalgam such as nummular dermatitis, eczema, urticaria, pink exanthem, cutaneous lichen planus, orofacial granulomatosis. Adverse events associated with titanium implants are yellow nail syndrome, sinusitis, neuropathy, implant-related immune activation, arthritis, and leukopenia. Conclusions Clinicians should consider allergy to metal ions released from galvanic couple between mercury amalgam and titanium implant in patients with systemic dermatitis.”
Citation:
Pigatto PDM, Brambilla L, Ferrucci S, Guzzi G. Systemic allergic contact dermatitis due to galvanic couple between mercury amalgam and titanium implant. Skin Allergy Meeting. 2010.