Article by Georges Tawil, DDS, DSc Odont/Peter Tawil, DDS, MSc/Carla Irani, MD, MSCE

This article by Georges Tawil et Coll, published on JOMI in 2020, is a case report of a patient with an autoimmune disease, Hashimoto’s thyroiditis, and metal hypersensitivities. The patient rapidly lost her titanium implant with all the characteristics of a peri-implantitis. The placement of a zirconia implant will allow for a durable replacement of her molar..


Titanium remains the material of choice in the manufacturing of dental implants because of its exceptional biologic and mechanical properties. However, cases of allergy to titanium have been reported in the literature causing skin, mucosal reactions, systemic symptoms, and eventually implant exfoliation. Although the frequency of these cases varied between 0.6% and 5%, undiagnosed or misdiagnosed cases may possibly increase this percentage significantly. Epicutaneous, intradermal inoculation of the allergen or blood tests (LTT, MELISA, IL1β, IL-6, TNF-α, IL-10) have been used with various degrees of sensitivity and specificity to assess Ti allergy. This case report demonstrated that titanium dental implant allergy caused rapid implant loss following an acute inflammatory reaction and its successful replacement by a one-piece zirconium implant. Int J Oral Maxillofac Implants 2020;35:639–644. doi: 10.11607/jomi.7990

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