The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations

International Journal of Implant Dentistry

Short Report

Sebahat Kaya¹  Peer Wolfgang Kämmerer¹  Bilal Al-Nawas¹  Eik Schiegnitz¹  Lena Katharina Müller-Heupt¹  Elisabeth Jacobi-Gresser² 

[1] Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany;Oral Surgery, Private Practice, Heidesheimer Straße 20, 55124, Mainz, Germany;

关键词: Allergy;    Dental implant;    Ceramic implant;    Epicutaneous test;    German guidelines;    Hypersensitivity;    Titanium implant intolerance;    LTT;    MELISA;    Patch test;    Pro-inflammatory cytokines;    Superstructures;    Titanium;    Titanium dioxide;   

DOI  :  10.1186/s40729-022-00451-1

 received in 2022-10-09, accepted in 2022-10-13,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThere is currently a lack of guidelines for clinicians regarding titanium hypersensitivity in implant dentistry. Diagnostic tests such as the epicutaneous test or the lymphocyte transformation test showed inconsistent results regarding reliability and validity and thus, evidence-based consensus recommendations regarding diagnostic and therapeutic options may be helpful in clinical decision-making. Therefore, the German S3 guideline on titanium hypersensitivity in implant dentistry was developed.FindingsIn the objectives, procedure, voting method and venue were defined and the consensus participants were invited. A systematic literature research was performed, and the overall quality of the evidence was rated according to the GRADE working group. Eight recommendations were formulated within the framework of a structured consensus conference under independent moderation and could be voted on with strong consensus (> 95% agreement). The formulated statements and recommendations were developed in small groups according to the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) and were discussed and agreed upon in the plenum.ConclusionsFor reasonable decision-making, a patient’s clinical symptoms should be regarded as leading parameters, which are usually expressed by a local inflammatory reaction with subsequent disturbed osseous integration. Allergy tests, such as the epicutaneous test or the lymphocyte transformation test are not helpful in titanium intolerance assessments, since these tests indicate T cell-mediated allergies, which are not observed in titanium intolerance reactions. Other metals and impurities that might be present in superstructures or alloys also need to be considered as the cause of an intolerance reaction and a trigger for contact sensitization. In the case of a suspected titanium particle-related, local immunologically induced inflammatory reaction with subsequent impaired osseous integration, dental ceramic implants can be considered as a therapeutic option.Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2022. corrected publication 2023

【 图 表 】

Fig. 5