Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices-A systematic review

Objective: To systematically review the allergic reactions associated with metal alloys in porcelain-fused-to-metal (PFM) fixed prosthetic devices. Method and Materials: After reviewing the titles and abstracts of the articles as well as removing duplicates, 22 articles were considered relevant. PubMed, Web of Science, ScienceDirect, and Google Scholar from 1970 to 2012 were evaluated, and randomized studies, review articles, case reports, cross-sectional surveys, and abstracts were included. Conference papers and posters were excluded. Results: Although reported, allergic reactions to metallic alloys in the context of PFM devices are not well documented. Allergic reactions to high noble and noble metal alloy cores of palladium and gold and to base metal alloys nickel and cobalt in the context of PFM fixed partial dentures (FPDs) are reported. Each type of metal is associated with a different rate of allergic reactions, which may be attributed to the extent of corrosion of the alloy, population exposure, and the biologic environment. Because few studies document allergic reactions to metals that comprise PFM crowns and partial dentures, further research in this field is necessary to determine the frequency and type of reactions elicited. Conclusion: Though allergic reactions to metal alloys used in dentistry are well documented, only few articles focus on the correlation between FPDs and metal allergies. Thus, this paper surveys case reports of hypersensitivity reactions linked to FPDs and reviews the current literature on allergic reactions to the metallic elements comprising those devices. Keywords: dentistry, fixed partial denture, metal allergy, systematic review