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  • Title: Get tested
  • Content text:

    MELISA testing is currently available only through two laboratories in Europe and a laboratory in Israel. Availability of MELISA testing is currently limited at some locations.

    Testing for most EU-based clients can be provided without limitations. Order MELISA test kits for your patients based in the European Union HERE.

    If you require more information about the availability of MELISA for your patients based in the UK, US or Canadaplease contact us using THIS FORM.

    If you are interested in testing from another location please contact us HERE.

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  • Title: Nickel in titanium
  • Subtitle: Metal exposure
  • List item:
    • List title: Nickel can be found in titanium implants, List text:

      These articles demonstrate that various “commercially pure” and alloyed titanium samples contain a low but consistent percentage of contaminants that are associated with allergies. Traces of nickel, related to the manufacturing process were found in titanium materials used for surgical implants. Nickel allergic patients may develop hypersensitivity reactions due to this low nickel content.

      "Under certain circumstances, these small amounts may be enough to trigger allergic reactions in patients suffering from corresponding allergies, such as a nickel, palladium or chromium allergy.”

      Titanium allergy or not? “Impurity” of titanium implant materials, 2010
      Article here

      "The low nickel content in the implant material results from the production process. The nickel atoms are in solid solution in the titanium lattice. Nickel allergic patients may develop hypersensitivity reactions even due to this low nickel content. Hence, this reaction may be falsely attributed to the titanium material itself. "

      Allergic potential of titanium implants, 2005
      Abstract here

      "Fifteen commercial titanium dental implant systems were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS) and optical emission spectrometry (ICP-OES). All investigated implant samples contained fractions of nickel, chromium, antimony and niobium."

      Impurities in commercial titanium dental implants – A mass and optical emission spectrometry elemental analysis, 2022
      Article here

    • List title: Nickel is released from titanium dental implants, List text:

      “According to our results, all implants immersed in human saliva already released metallic particles of titanium, nickel and vanadium after 7 days.”

      Corrosion behavior of dental implants immersed into human saliva: preliminary results of an in vitro study, 2017
      Article here

    • List title: Nickel is the first metal released from orthopaedic implants, List text:

      Nickel is released preferentially from orthopaedic devices, so even though there is only a trace it may be released first. More research in the area is needed but an interesting study looks at cobalt chromium hips which were removed and studied. Nickel makes up around 13% of this alloy but was not found in the corroded hips as it was the first metal to have corroded and moved into the body.

      In vivo corrosion of 316L stainless-steel hip implants: morphology and elemental compositions of corrosion products, 1998
      Abstract here

    • List title: Removal of titanium implants containing small amounts of nickel lead to resolution of symptoms in a nickel-allergic patient, List text:

      In another recently published case report, a patient reported severe pain after titanium plate placement, containing only 0.1% nickel. There was no rash, no infection and no loosening but an MRI revealed swelling, patch testing identified a nickel allergy.

      The hardware was removed, and the patient’s pain resolved completely.

      Could a Titanium Ulnar Shortening Plate Trigger a Metal Allergy? A Case Report, 2019
      Abstract here

    • List title: Patch testing is unsuitable for diagnosing titanium allergy, List text:

      Titanium does not penetrate unbroken skin either as an alloy or as a nano-particle. The first article concludes “patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate”. The second article looks at a symptomatic patient with no patch test reactions to metals. The patient subsequently tested positive in a lymphocyte transformation test (like MELISA), the metals were removed and the symptoms resolved

      Titanium: a review on exposure, release, penetration, allergy, epidemiology, and clinical reactivity, 2016
      Abstract here

      Hypersensitivity to titanium osteosynthesis with impaired fracture healing, eczema, and T-cell hyperresponsiveness in vitro: case report and review of the literature, 2006
      Abstract here

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