The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations
Abstract Background There is currently a lack of guidelines for clinicians regarding titanium hypersensitivity in implant dentistry. Diagnostic tests such as the epicutaneous test or the lymphocyte transformation test showed inconsistent results regarding reliability and validity and thus, evidence-...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-11-01
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| Series: | International Journal of Implant Dentistry |
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| Online Access: | https://doi.org/10.1186/s40729-022-00451-1 |
| _version_ | 1811223832418058240 |
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| author | Lena Katharina Müller-Heupt Eik Schiegnitz Sebahat Kaya Elisabeth Jacobi-Gresser Peer Wolfgang Kämmerer Bilal Al-Nawas |
| author_facet | Lena Katharina Müller-Heupt Eik Schiegnitz Sebahat Kaya Elisabeth Jacobi-Gresser Peer Wolfgang Kämmerer Bilal Al-Nawas |
| author_sort | Lena Katharina Müller-Heupt |
| collection | DOAJ |
| description | Abstract Background There is currently a lack of guidelines for clinicians regarding titanium hypersensitivity in implant dentistry. Diagnostic tests such as the epicutaneous test or the lymphocyte transformation test showed inconsistent results regarding reliability and validity and thus, evidence-based consensus recommendations regarding diagnostic and therapeutic options may be helpful in clinical decision-making. Therefore, the German S3 guideline on titanium hypersensitivity in implant dentistry was developed. Findings In the objectives, procedure, voting method and venue were defined and the consensus participants were invited. A systematic literature research was performed, and the overall quality of the evidence was rated according to the GRADE working group. Eight recommendations were formulated within the framework of a structured consensus conference under independent moderation and could be voted on with strong consensus (> 95% agreement). The formulated statements and recommendations were developed in small groups according to the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) and were discussed and agreed upon in the plenum. Conclusions For reasonable decision-making, a patient’s clinical symptoms should be regarded as leading parameters, which are usually expressed by a local inflammatory reaction with subsequent disturbed osseous integration. Allergy tests, such as the epicutaneous test or the lymphocyte transformation test are not helpful in titanium intolerance assessments, since these tests indicate T cell-mediated allergies, which are not observed in titanium intolerance reactions. Other metals and impurities that might be present in superstructures or alloys also need to be considered as the cause of an intolerance reaction and a trigger for contact sensitization. In the case of a suspected titanium particle-related, local immunologically induced inflammatory reaction with subsequent impaired osseous integration, dental ceramic implants can be considered as a therapeutic option. Graphical Abstract |
| first_indexed | 2024-04-12T08:39:11Z |
| format | Article |
| id | doaj.art-1339fa4ce6194f49891d89302c53db25 |
| institution | Directory Open Access Journal |
| issn | 2198-4034 |
| language | English |
| last_indexed | 2024-04-12T08:39:11Z |
| publishDate | 2022-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Implant Dentistry |
| spelling | doaj.art-1339fa4ce6194f49891d89302c53db252022-12-22T03:39:56ZengSpringerOpenInternational Journal of Implant Dentistry2198-40342022-11-01811510.1186/s40729-022-00451-1The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendationsLena Katharina Müller-Heupt0Eik Schiegnitz1Sebahat Kaya2Elisabeth Jacobi-Gresser3Peer Wolfgang Kämmerer4Bilal Al-Nawas5Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University MainzDepartment of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University MainzDepartment of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University MainzOral Surgery, Private PracticeDepartment of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University MainzDepartment of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University MainzAbstract Background There is currently a lack of guidelines for clinicians regarding titanium hypersensitivity in implant dentistry. Diagnostic tests such as the epicutaneous test or the lymphocyte transformation test showed inconsistent results regarding reliability and validity and thus, evidence-based consensus recommendations regarding diagnostic and therapeutic options may be helpful in clinical decision-making. Therefore, the German S3 guideline on titanium hypersensitivity in implant dentistry was developed. Findings In the objectives, procedure, voting method and venue were defined and the consensus participants were invited. A systematic literature research was performed, and the overall quality of the evidence was rated according to the GRADE working group. Eight recommendations were formulated within the framework of a structured consensus conference under independent moderation and could be voted on with strong consensus (> 95% agreement). The formulated statements and recommendations were developed in small groups according to the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) and were discussed and agreed upon in the plenum. Conclusions For reasonable decision-making, a patient’s clinical symptoms should be regarded as leading parameters, which are usually expressed by a local inflammatory reaction with subsequent disturbed osseous integration. Allergy tests, such as the epicutaneous test or the lymphocyte transformation test are not helpful in titanium intolerance assessments, since these tests indicate T cell-mediated allergies, which are not observed in titanium intolerance reactions. Other metals and impurities that might be present in superstructures or alloys also need to be considered as the cause of an intolerance reaction and a trigger for contact sensitization. In the case of a suspected titanium particle-related, local immunologically induced inflammatory reaction with subsequent impaired osseous integration, dental ceramic implants can be considered as a therapeutic option. Graphical Abstracthttps://doi.org/10.1186/s40729-022-00451-1AllergyDental implantCeramic implantEpicutaneous testGerman guidelinesHypersensitivity |
| spellingShingle | Lena Katharina Müller-Heupt Eik Schiegnitz Sebahat Kaya Elisabeth Jacobi-Gresser Peer Wolfgang Kämmerer Bilal Al-Nawas The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations International Journal of Implant Dentistry Allergy Dental implant Ceramic implant Epicutaneous test German guidelines Hypersensitivity |
| title | The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations |
| title_full | The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations |
| title_fullStr | The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations |
| title_full_unstemmed | The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations |
| title_short | The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations |
| title_sort | german s3 guideline on titanium hypersensitivity in implant dentistry consensus statements and recommendations |
| topic | Allergy Dental implant Ceramic implant Epicutaneous test German guidelines Hypersensitivity |
| url | https://doi.org/10.1186/s40729-022-00451-1 |
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