Ruling out Titanium Toxicity in Implant Case?

This is the million dollar question very tough to prove and titanium allergy is rare but it exists. If it were me I would find a good allergist. The patient's history very important any new food, environment of meds? It looks suspicious for a titanium allergy but I would want to be sure prior to removal. The only case I found by the orthopedic literature involved the gradual bone loss around a knee implant. I think an allergist would be the way to go. Could you post your findings on this very rare sequela? Thanks.

In our work, we have seen an occasional titanium sensitivity (less than 1% of the population of 57,000 patients tested). In the case of the zirconium, sensitivity in the European community runs just below 1%. However, in North America, we see zirconium sensitivity in 5% to 8% of the population with regional variation. We believe the difference lies in social customs. Most of our European neighbors wear a deodorant or nothing at all under arm. Within North America, the predominant choice of underarm protection is usually an antiperspirant. The anti-wetting agent is often aluminum-zirconoim chlorhydrate. Patients may become zirconium sensitive under such conditions. A useful and non-offensive way to check this is to simply ask the patient in a pretreatment questionnaire if they experience reddening or soreness underarm when using an antiperspirant. A positive response may suggest greater care if zirconia is proposed for the patient.

Today the most reliable test is the MELISA test. Titanium allergy is rare but a reaction to other metals that are in the implant is possible for example nickel. The results of the MELISA test can confirm or rule out many metal sensitivities. If it idiocy may want to consider ceramic implants ;).

P.S. The aluminum and zirconium in deodorants is not the oxide it's aluminium chlorohydrate the metal derivatives. The ceramic used in technical ceramics I.e zirconia is the oxide which does not induce any biological reactions, in the literature there is no zirconia oxide sensitivity or toxicity.

Since 15 years I use dental implants made of zirkondioxide (Incermed, Z-Look, Zeramex). I have never seen a reaction of the immunsystem or a periimplantitis.

Most people don't know the word URITICARIA....... I first learned about it 28 years ago when my eldest daughter, six at the time,while sitting beside the swimming pool, was licking a Popsicle ( a fruit drink frozen into ice and mounted on a wooden stick).... and unbeknownst to her, as she was licking away and enjoying the tasty frozen stick....her lips began to swell up, and then small hives began to develop.......luckily, there was a pediatrician closeby who recognized the symptoms, and suggested we go immediately to the emergency at the hospital. This is a rare condition, and as CRS mentioned above , your patient should be tested for allergies......my daughter, now 34 , told me that the best way to test for Cold Uriticaria, is to have the person put an ice cube on her arm, and leave it there for a few minutes.......after removing it, if the skin shows the pattern of the ice cube embossed by hives.....then this is very well the problem...easy to treat..... stay away from ice and any food or drink too cold.

Awfully difficult to test without being able to remove the implants and of course if you do and they weren't at fault... big decision time. Pre-treatment advice for patients who fear a possible titanium allergy is to request a titanium slug or disc from your preferred implant manufacturer and tape it to the patient for three days, then look for allergic skin reaction.

Yes but I believe the MELISA test gives us better data as to the nature and presence as well as objective measurement of any metal reactivity. Have a look at Melisa.org for more info.

Thanks to all who have enlightened with imformation. At present Patient is under care of Allegy Specialist.will request her to do MELISA test and get the results.I have to remove one more fixed bridge which is of metal ceramics (nickel cromium and ceramic)to rule out of nickel allergy.but it of 10 years old.get in touch with further details later.

To get an answer, you could use a blood test, the titansimulation-test (LLT). Titanimplants are often not only pure titanium. A test by putting samples of titan on the skin does not work.

I would suggest you read the following paper: Does the urticaria look similar to the picture presented in this case (assumed Ti allergy) on Medhelp?

titanium sensitivity is rare but would recommend she be referred to an allergist to test for titanium allergy and also he can address other possible causes

MELISA test. I've submitted a few. V. interesting about the zirconia allergy. Thanks for the anti-perspirant tip!

Hello. This is a long-shot I know, but my 24 yr old son has been experiencing an undiagnosed, reoccurring illness ever since having a Dornhopper porp implant. I've read your string on comments and wonder if the implant could be causing his troubles. He received the implant in Oct 2011 and in Aug 2012 was admitted to ER for what docs suspected was meningitis. His spinal tap came back negative, however given his symptoms several docs later suggested he may have had either meningitis or encephalitis but was tested too soon for the bacteria to show in test. Since this episode, he's experienced reoccurring bouts of extreme 'brain fog'. He describes it as not being able to connect his thoughts, bad memory, lack of emotion. He had to drop out of college twice, and now as an adult is struggling with his career when these episodes happen. I'm wondering if he could have a sensitivity to the implant and/or the implant has caused a metal toxicity. I'm trying to get the safety data sheet for the implant and wondering what tests we should request. THANK YOU for any suggestions you may have.