金属アレルギーの現状と歯科領域における対応

抄録

Sensitization and allergic lesions resulting from metals in our living environment have often been reported. However, dentists have paid little attention so far on sensitization or dermal or mucosal lesions caused by metal restorations. We have established a team of 14 research institutions to perform patch tests with 18 kinds of dental metals and to conduct and epidemiological survey on the patch test positive subjects.
Prior to the study, application of the testing solutions and reading of the skin reactions were standardized. Patch tests were done on volunteers and patients with the total of 1, 728 subjects. On those patients who showed positive reactions to the patch tests, metal analysis for the intraoral restorations was done by the method developed by Inoue et al. The analysis results were then compared to the patch test results to investigate the relation between the two.
The following data was collected and discussions were made:(1) patch test posit ive/negative rates for the total subjects, (2) their differences regarding sex, age, or a kind of metal, (3) regional dfference, (4) relation between an individual with patch test positive result and his/her intraoral metal restoration (s), (5) types and locations of the lesions, (6) patch test positive rate (overall and of the each metal) for the patient group, (7) difference in the patch test positive rate between the volunteer group and the patient group, (8) comparison between the patch test positive rates among the M-9, M-11 or M-13 series, and among the different concentrations of the testing solutions, (9) comparison of the results between patch tests and their confirmation tests, (10) changes in the patch test reaction during the testing period.
From these results, it is considered that careful and adequate measures against the metal allergy should be taken, when the dentist starts the prosthodontic treatment.