Immune markers in oral discomfort patients before and after elimination of oral galvanism.

BACKGROUND: An enhanced release of metals in the mouth due to galvanic cell formation is considered to be one of the causes of oral discomfort. The aim of this study was to investigate the influence of galvanic cell on salivary immune defense factors. MATERIAL AND METHODS: The levels of IgA1, IgA2, sIgA, lysozyme and antiIgA/HSP60 were evaluated in representative samples from 159 patients with galvanism, from 177 patients without galvanism and in two control groups. All the participants underwent personal history taking, clinical examination, galvanic currents measurement and saliva collection. RESULTS: Electro active dental materials were removed in 30 patients. There was a significant increase in IgA2 level, a significant decrease in antiIgA/HSP60 levels and an increase in IgA1, sIgA and lysozyme levels found after the removal of electro active restorations. Morphological symptoms disappeared in 70% of the treated patients. CONCLUSION: The study confirmed that pathologic galvanic phenomena influences the immune defense reactions in the oral cavity and thus may cause the symptoms of oral discomfort. A measurement of the galvanism and a subsequent removal of electro active restorations should become a common therapeutic procedure in the patients with oral discomfort.

Orofacial granulomatosis associated with hypersensitivity to dental amalgam.

Orofacial granulomatosis is a clinicopathologic entity characterized by chronic swelling of the lip and possible soft tissues in the orofacial region owing to granulomatous inflammation of unknown cause. We present 3 cases of orofacial granulomatosis associated with allergic contact dermatitis to dental materials. Previous treatment with corticosteroids did not have any therapeutic effect. Patch testing revealed a positive reaction to several allergens, including dental amalgam and mercury in 2 cases. A lymphocyte transformation test modified for metals was used to evaluate lymphocyte reactivity. After the removal of the suspected allergens, all patients experienced recovery within 1 month, with the exception of the lip swelling, which gradually subsided over several months.

Influence of metals on cytokines production in connection with successful implantation therapy in dentistry.

OBJECTIVES: In most of patients in need of implantation treatment in the oral cavity, implants heal well, nevertheless, there are some individuals, in whom titanium implants fail for reasons, which remain unclear. DESIGN: The aim of our study was to determine if there is a difference between metal influenced IL-1ß, IL-4, IL-6, TNF-α and IFN-γ cytokines production in patients with successfully healed implants compared to those, whose implant therapy was unsuccessful. SETTING: The two study groups included 12 patients with failed dental titanium implants and 9 patients with successfully healed implants. In the subjects, cytokine production was established after lymphocyte cultivation with mercury, nickel and titanium antigens. RESULTS: IL-1ß levels were significantly increased in all patients after stimulation with titanium and in patients with accepted implants compared to patients with failed implants after the stimulation with mercury and titanium. Titanium caused significantly increased IL-6 production in all patients. TNF-α and IFN-γ levels were also significantly increased after the stimulation with titanium. Significantly increased TNF-α levels were found in patients with accepted implants as compared to patients with failed implants. CONCLUSIONS: Increased production of IL-1ß a IL-6 cytokines in reaction to titanium and increased production of TNF-α and IFN-γ cytokines in reaction to mercury, which is very often present in the form of amalgam in the oral cavity of persons in need of implant therapy, can play an important role in immune reactions during implant healing process. In patients with failed titanium implants, decreased production of these cytokines may participate in implant failure.

Metal alloys in the oral cavity as a cause of oral discomfort in sensitive patients.

OBJECTIVE OF THE STUDY: The occurrence of galvanism with its heterogeneous symptomatology is often the source of considerable problems. Abrasion and corrosion not only damage dental alloys but also burden the organism by release of metallic particles. The objective of this study is to evaluate the hypothesis that measurement of galvanic currents could be a useful diagnostic method. PATIENT GROUPS AND METHODOLOGY: Three hundred fifty-seven persons with dental metal restorations were divided into groups according to abnormal values of galvanic currents and by oral discomfort. In all persons a detailed examination of the oral cavity was performed, and galvanic currents were measured. In one hundred fifty-nine patients abnormal galvanic currents were found. Measurement of metallic elements in saliva was performed in these patients and in a group of 21 healthy volunteers without any metals in the oral cavity. Thirty-three patients agreed to treatment which involved removal of the causative alloys and their replacement by non-metallic restorations. RESULTS: No correlation was found between the values of measured currents and the number of teeth treated by metal restorations. However, patients with metal restorations had significantly higher contents not only of mercury, but also of tin, silver, copper, and gold in the saliva than patients without metallic restorations. After removal of the electro-active restorations, both the contents of metals in saliva and galvanic currents decreased in comparison with the levels before the treatment. CONCLUSIONS: Galvanic effects as well as metal particles may induce a series of local or systemic pathological phenomena in sensitive individuals. The occurrence of pathologically acting galvanic effects is influenced not only by the composition and combination of different dental alloys, but to a significant degree also by the quality of used materials and processing.