Titanium: a review on exposure, release, penetration, allergy, epidemiology, and clinical reactivity

Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental a...

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Vydáno v:Contact dermatitis Ročník 74; číslo 6; s. 323 - 345
Hlavní autoři: Fage, Simon W., Muris, Joris, Jakobsen, Stig S., Thyssen, Jacob P.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Oxford, UK Blackwell Publishing Ltd 01.06.2016
Wiley Subscription Services, Inc
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ISSN:0105-1873, 1600-0536
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Abstract Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs. However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
AbstractList Exposure to titanium (Ti) from implants and from personal care products as nanoparticles ( NPs ) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs . However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs. However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs. However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs. However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
Author Muris, Joris
Fage, Simon W.
Jakobsen, Stig S.
Thyssen, Jacob P.
Author_xml – sequence: 1
  givenname: Simon W.
  surname: Fage
  fullname: Fage, Simon W.
  organization: Department of Dermato-Venereology, Aarhus University Hospital, 8000 Aarhus, Denmark
– sequence: 2
  givenname: Joris
  surname: Muris
  fullname: Muris, Joris
  organization: Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, 1081 LA, Gustav Mahlerlaan 3004, Amsterdam, The Netherlands
– sequence: 3
  givenname: Stig S.
  surname: Jakobsen
  fullname: Jakobsen, Stig S.
  organization: Department of Orthopaedic Surgery, Aarhus University Hospital, 8000 Aarhus, Denmark
– sequence: 4
  givenname: Jacob P.
  surname: Thyssen
  fullname: Thyssen, Jacob P.
  email: jacob.p.thyssen@regionh.dk
  organization: National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Herlev-Gentofte, 2900 Hellerup, Denmark
BackLink https://www.ncbi.nlm.nih.gov/pubmed/27027398$$D View this record in MEDLINE/PubMed
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Issue 6
Keywords contact allergy
toxicity
corrosion
dermatitis
hypersensitivity
penetration
release
titanium
patch test
lymphocyte transformation test
Language English
License http://onlinelibrary.wiley.com/termsAndConditions#vor
2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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PublicationTitle Contact dermatitis
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Snippet Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion...
Exposure to titanium (Ti) from implants and from personal care products as nanoparticles ( NPs ) is common. This article reviews exposure sources, ion release,...
Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release,...
Summary Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion...
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SubjectTerms Alloys
Bone Plates
Bone Screws
contact allergy
corrosion
Cosmetics
Cosmetics industry
Dental Implants
dermatitis
Dermatitis, Allergic Contact - epidemiology
Dermatitis, Allergic Contact - etiology
Food
Humans
hypersensitivity
Jewelry
lymphocyte transformation test
Mucous Membrane - metabolism
Pacemaker, Artificial
patch test
Patch Tests
penetration
Personal care industry
Prostheses and Implants
release
Skin - metabolism
Stents
titanium
Titanium - adverse effects
Titanium - metabolism
toxicity
Title Titanium: a review on exposure, release, penetration, allergy, epidemiology, and clinical reactivity
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fcod.12565
https://www.ncbi.nlm.nih.gov/pubmed/27027398
https://www.proquest.com/docview/1785682014
https://www.proquest.com/docview/1786524825
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