I have been doing dental implant surgery for over 37 years. I have spent countless hours in continuing education honing my surgical and restorative skill sets with regards to dental implant. I have always been taught that the overall success of dental implants is based on 3 non-violate factors; Width of bone, Height of bone, and a Wide Zone of Attached gingiva. Deficiency in any one of these three requirements will result in a compromise and hence result in either a short term or a long term dental implant failure.
I recently had an experience with one of my patients where I did a number of implants in both her upper and lower jaws and restored both jaws with implant supported bridgework. 2 years after treatment she started to develop a rash over her torso and legs, had GI issues and felt lethargic. She sought care from traditional and holistic medical professionals with no resolution. After several years of so-so results she was advised that she may have an allergy to her implants.
We discussed this at length, and I told her in my 37 years of doing this and having placed thousands of dental implants I have never seen this cause and effect situation. Long story short, she sought care in Switzerland where they preform Zirconia (Ceramic) implants because they believe there is some sort of reaction between metal dental implants and the body.
They recommended the removal of all her dental implants and the removal of teeth with root canal therapy. She was told there was no guarantees with the ceramic implants but that they believed this would help her.
They removed her titanium implants and the root canal teeth and replaced them with ceramic implants and fabricated temporary bridgework that she will need to wear for the next 8-12 months before the final restoration is made.
She is still a patient of mine and shared this experience with me and revealed since the removal of the implants and root canal teeth all her rashes and other aliments disappeared and she feels much better and has more energy.
This caused me to investigate this and see what the current thought process on titanium implants because now both the dental and medical profession have ceramic alternatives to conventional titanium. Currently there are ceramic dental implants and ceramic hip and knee joint replacements.
So, is there something to an allergic reaction between titanium and the body? The scientific literature reveals the success of titanium implants at 98%. But there is a process called tribocorrosion that dental implants can undergo. Tribocorrosion can be defined as the inter-relationship of wear and chemical and/or electrochemical processes. Metallic biomaterials such as dental implants and its frameworks, abutments, orthodontic devices, and maxillofacial surgical structures are susceptible to tribocorrosion damage, in the oral environment, which is a process where material degradation is caused by the combined effect of corrosion and wear.
This process releases titanium ions into the surrounding tissues, which can trigger a cascade of reactions, localized or at a distance, or even systemic reactions.
Can titanium implants cause neurological problems?
The toxicity of titanium dioxide nanoparticles (NP) in the central nervous system (CNS) has been reviewed by Czajka et al. who cited numerous cases with reported internalization of TiO2 NP into the brain. In most of these cases neurological damage is also reported.
Can titanium cause inflammation in the body?
Multiple investigators have found that titanium implants can induce inflammation in the surrounding tissue over time, leading to the expression of certain mediators known to cause local and systemic health problems.
Can titanium dental implants cause autoimmune disease?
Some research suggests that metal medical and dental implants may cause an autoimmune reaction in people with metal allergies and other genetic predispositions. Some of the diseases researched in connection to metal devices include: Multiple sclerosis and Systemic lupus erythematosus (Lupus).
Can titanium implants cause autoimmune disease?
In one study, prolonged exposure to a prosthesis containing nickel and titanium could have triggered the symptoms of systemic auto inflammation, which responded to corticosteroids. This patient had florid systemic features of inflammation for at least 2.5 years, until the removal of the titanium implant.
Can Dental Implants Make You Sick?
Dental implants are generally safe and do not cause illness in most cases. However, titanium implants can make you sick if you are allergic to the metal. Though only 0.6% of the population has a titanium allergy, it can impact your health and wellness, including your dental implant’s success. Symptoms of a titanium allergy include:
• Acne-like swelling or facial inflammation.
• Wound healing problems.
• Hives or rash.
• Achy joints and muscles.
• Sores and swelling in the mouth’s soft tissues.
If you know or suspect you have a titanium allergy, talk to your dentist about your dental implant options.
Am I Rejecting My Implant?
While titanium generally causes fewer problems than other metals, some people may be allergic to it. The International Journal of Implant Dentistry notes that due to implants' corrosion and wear, titanium alloy particles can get deposited in the surrounding tissues. In some people, this can cause bone loss due to inflammatory reactions or hypersensitivity reactions that cause implant failure.
So how can I recognize if I have a dental implant allergy?
Seminal studies cited by the International Journal of Implant Dentistry report that titanium allergy symptoms include:
• Erythema (skin redness, in this case, in the tissues around the implant)
• Urticaria (hives that may be seen on the skin or gum surface)
• Eczema (itchy inflammation of the skin or gum tissue
• Swelling or pain
• Necrosis (death of cells or tissue, in this case, around the implant)
• Toxic reactions in other tissues, causing yellow nail syndrome (which can also affect the lungs and airways)
• Bone loss
If you notice any of these symptoms, you must contact your dentist immediately.
Diagnosing Titanium Allergy
If medical or dental professionals suspect that you might be allergic to the titanium in your dental implant, the first step is to take diagnostic tests, such as a patch test. Some physicians might also recommend in vitro blood tests to detect metal allergy, including the lymphocyte transformation test, the lymphocyte migration inhibition test, and the commercially available MELISA test.
The International Journal of Implant Dentistry points out that zirconia implants can be an alternative to titanium implants. But there isn’t long-term clinical data associated with their usage, and so your dental professional is the best person to speak to about alternative options.
It can feel both disappointing and overwhelming to learn that you’re not taking to your new implant as well as you'd hoped. But the good news is that there are other options available to you. A dental professional can help you treat your titanium allergy and ensure that you fill the gap in your mouth with a treatment that works for you!
Notably, there are specific oral conditions that include food intake, oral microbiota, fluoridated dentifrices, salivary pH and biomechanical loading that when in-combined, may significantly increase corrosion and speed up the degradation process, and subsequently having a direct influence on the survival of dental implant.
Patients potentially at risk are patients with auto immune issues, demonstrate highly allergic reactions to metals, food, pets and patients with a history of failed implants or peri-implantitis and patients on IV Bisphosphonates
Patients should share with their dentist is they have any allergies or auto immune or medical issues because you may be a candidate for ceramic implants.
Dr. Vito has been placing and restoring dental implants for 37 years. He remains on the forefront of the art and science of dental implants.