Metal allergy patient treated by titanium implant denture: a
The present case has been reported in the journal Clinical Case Reports. A female patient had a history of rash in both of her feet when she was 45 years old. Her symptoms aggravated over the period to involve her hands as well until she was 51 years old. The dermatologist prescribed skin ointment, which did not improve her skin condition.

She consulted a metal allergy expert and it was revealed that her dental treatment and skin allergy symptoms coincided. She also gave a history of skin rashes due to cosmetics, earrings and necklace.

A physical examination revealed red rashes on the palmoplantar surfaces of her hands and feet. Intraoral examination findings were hyperemia of the oral mucosa. Amalgam restorations were present on the maxillary left first molar and mandibular right first and second premolars and first molar. Metal 3‐unit fixed dental prostheses were present to replace missing left first premolar using canine and second premolar as abutment.

The results of the skin patch test for dental material showed a high positive reaction to Ni, Pd and molybdenum (Mo). The presence of these materials in the dental restorations was established by applying silica gel point technology to extract metal dust and X‐ray fluorescence (XRF) spectrometer to determine the metal constituent. It was confirmed that the Ni was present in the restorative material and was the cause of her presenting signs and symptoms.

All the metal dental restorations were removed and replaced with composite restorations; temporary bridge fabricated using hybrid composite resin to replace metal fixed dental prostheses. The progress of the case was monitored and allergic symptoms on hands and feet improved gradually.

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