Do your patients suffer from?

• Oral diseases: Lichen planus, stomatitis, glossodynia, burning mouth, cheilitis
• Successive implant failure with no infection ie “cluster patients”
• Skin rashes, chronic fatigue, fibromyalgia and worsening autoimmune disease

If so, you may consider MELISA testing as part of your diagnostic protocol.

Metal allergy is an overlooked area in dentistry and may be responsible for diverse symptoms.

MELISA testing is the best method for diagnosing metal-induced delayed hypersensitivity (1) (2) (3).
A blood sample sent to our laboratory can be checked for allergy to all metals used in dentistry, as well as to methacrylates.
Titanium allergy is uncommon, but with implant failure rate estimates varying between 7.6% and 26% (4) (5)
metal allergy may be investigated with MELISA.
MELISA may also be used to pre-test for compatible materials for patients reporting prior dermal reactions to metals.

MELISA studies

• 76% of chronic fatigue patients experienced health improvement after removing dental
  restorations containing allergenic metals, identified by MELISA testing. (6)
• 71% of patients with autoimmune diseases and mercury allergy improved after
  having their amalgam fillings removed. (7)
• 50% of fibromyalgia patients showed that after restricting exposure to metals they were
  allergic to, they no longer fulfilled the criteria for fibromyalgia. 20% had reduced trigger
  points and all reported improvement in symptoms. (8)
• 37% of symptomatic patients (muscle and joint pain, chronic fatigue, dermatitis and
  acne-like inflammation) were found to be allergic to their titanium dental work/implants
  through MELISA testing (all negative in patch testing). Following removal of the implants,
  all 54 patients showed remarkable clinical improvement. (9)

Based on more than 20 years’ research, MELISA has identified symptoms and indicators for
those likely to be metal hypersensitive. Studies show that if metal allergy is found, both
outcome and symptoms will improve if exposure to relevant metals is reduced. Both a
comprehensive questionnaire and a brief online version are available. A complete evaluation
with a list of metal exposure can be provided if the full questionnaire is completed.

Bibliography

1. Hallab N, et al. Metal sensitivity in patients with orthopaedic implants. JBJS. 2001, Vol. 83, 3, pp. 428-436.
2. Evrard L. Titanium: A New Allergen. [book auth.] Prof. Ilser Turkyilmaz. Implant Dentistry – A Rapidly Evolving Practice. s.l. : In-Tech, 2011, p. Chap 23.
3. Campbell S, Crean S, Ahmed W. Titanium allergy: fact or fiction? Royal College of Surgeons, Faculty Dental Journal. 5:1, 2014, pp. 18-25.
4. Derks J, Håkansson J, Wennström JL, Klinge B, Berglundh T. Patient-reported outcomes of dental implant therapy in a large randomly selected sample. Clin Oral Implants Res. May, 2015, Vol. 26 (5), pp. 586-91.
5. Bandeira de Almeida A, et al. Success,survival and failure rates of dental implants a cross sectional study. J Oral Science Rehabilitation. Jun., 2017, Vol. 3 (1), pp. 24-31.
6. Stejskal V, et al. Metal-specific lymphocytes: biomarkers of sensitivity in man. Neuroendocrinology Letters. 1999, pp. 289-298.
7. Prochazkova J, et al. The beneficial effect of amalgam replacement on health in patients with autoimmunity. Neuroendocrinology Letters. 25 (3), 2004, pp. 211-218.
8. Stejskal V, Reynolds T, Bjørklund G. Increased frequency of delayed type hypersensitivity to metals in patients with connective tissue disease. Journal of Trace Elements in Medicine and Biology. 31, 2015, pp. 230-236.
9. Müller K, Valentine-Thon E. Hypersensitivity to titanium: Clinical and laboratory evidence. Neuro Endocrinol Lett. 27(Suppl 1), 2006, pp. 31-35.