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Metal Allergy: Palladium

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Metal Allergy

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Abstract

Palladium (Pd) has close chemical resemblance with nickel and platinum, and its main applications include use in dentistry for crown and bridgework and sometimes use in jewellery. Especially due to the aggressive oral environment, measurable levels of Pd ions from Pd-based dental alloys are observed in the saliva, oral mucosa, peripheral blood, serum, and urine. Current research shows a strong association between (1) exposure to Pd-based dental alloys and sensitization and (2) sensitization to both Pd and Ni. Although pathological potency of Pd is still poorly understood, it has been shown that Pd can activate both the innate and the adaptive immune systems.

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References

  1. Kielhorn J, Melber C, Keller D, Mangelsdorf I.Palladium--a review of exposure and effects to human health. Int J Hyg Environ Health. 2002;205(6):417–32.

    Article  CAS  PubMed  Google Scholar 

  2. Kapdi AR, Fairlamb IJ. Anti-cancer palladium complexes: a focus on PdX2L2, palladacycles and related complexes. Chem Soc Rev. 2014;43(13):4751–77.

    Article  CAS  PubMed  Google Scholar 

  3. Holbrook DJ Jr, Washington ME, Leake HB, Brubaker PE. Studies on the evaluation of the toxicity of various salts of lead, manganese, platinum, and palladium. Environ Health Perspect. 1975;10:95–101.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Moore W, Hysell D, Hall L, Campbell K, Stara J. Preliminary studies on the toxicity and metabolism of palladium and platinum. Environ Health Perspect. 1975;10:63–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Phielepeit T, Legrum W, Netter KJ, Klotzer WT. Different effects of intraperitoneally and orally administered palladium chloride on the hepatic monooxygenase system of male mice. Arch Toxicol Suppl. 1989;13:357–62.

    Article  CAS  PubMed  Google Scholar 

  6. Cai Z, Vermilyea SG, Brantley WA. In vitro corrosion resistance of high-palladium dental casting alloys. Dent Mater. 1999;15(3):202–10.

    Article  CAS  PubMed  Google Scholar 

  7. Wataha JC, Craig RG, Hanks CT. The release of elements of dental casting alloys into cell-culture medium. J Dent Res. 1991;70(6):1014–8.

    Article  CAS  PubMed  Google Scholar 

  8. Garhammer P, Schmalz G, Hiller KA, Reitinger T. Metal content of biopsies adjacent to dental cast alloys. Clin Oral Investig. 2003;7(2):92–7.

    Article  PubMed  Google Scholar 

  9. Schmalz G, Garhammer P. Biological interactions of dental cast alloys with oral tissues. Dent Mater. 2002;18(5):396–406.

    Article  CAS  PubMed  Google Scholar 

  10. Wataha JC. Biocompatibility of dental casting alloys: a review. J Prosthet Dent. 2000;83(2):223–34.

    Article  CAS  PubMed  Google Scholar 

  11. Milheiro A, Muris J, Kleverlaan CJ, Feilzer AJ. Influence of shape and finishing on the corrosion of palladium-based dental alloys. J Adv Prosthodont. 2015;7(1):56–61.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Manaranche C, Hornberger H. A proposal for the classification of dental alloys according to their resistance to corrosion. Dent Mater. 2007;23(11):1428–37.

    Article  CAS  PubMed  Google Scholar 

  13. Cristaudo A, Bordignon V, Petrucci F, Caimi S, De Rocco M, Picardo M, et al. Release of palladium from biomechanical prostheses in body fluids can induce or support PD-specific IFNgamma T cell responses and the clinical setting of a palladium hypersensitivity. Int J Immunopathol Pharmacol. 2009;22(3):605–14.

    Article  CAS  PubMed  Google Scholar 

  14. Garhammer P, Hiller KA, Reitinger T, Schmalz G. Metal content of saliva of patients with and without metal restorations. Clin Oral Investig. 2004;8(4):238–42.

    Article  CAS  PubMed  Google Scholar 

  15. Sheard C. Contact dermatitis from platinum and related metals - report of a case. Arch Dermatol. 1955;71(3):357–60.

    Article  Google Scholar 

  16. Munro-Ashman D, Munro DD, Hughes TH. Contact dermatitis from palladium. Trans St. Johns Hosp Dermatol Soc. 1969;55(2):196–7.

    CAS  PubMed  Google Scholar 

  17. Faurschou A, Menne T, Johansen JD, Thyssen JP. Metal allergen of the twenty-first century-a review on exposure, epidemiology and clinical manifestations of palladium allergy. Contact Dermatitis. 2011;64(4):185–95.

    Article  PubMed  Google Scholar 

  18. Wise EM, Eash JT. The role of the platinum metals in dental alloys, III - the influence of platinum and palladium and heat treatment upon the microstructure and constitution of basic alloys. T Am I Min Met Eng. 1933;104:276–303.

    Google Scholar 

  19. Aberer W, Holub H, Strohal R, Slavicek R. Palladium in dental alloys--the dermatologists’ responsibility to warn? Contact Dermatitis. 1993;28(3):163–5.

    Article  CAS  PubMed  Google Scholar 

  20. van Ketel WG, Niebber C. Allergy to palladium in dental alloys. Contact Dermatitis. 1981;7(6):331.

    Article  PubMed  Google Scholar 

  21. Hosoki M, Bando E, Asaoka K, Takeuchi H, Nishigawa K. Assessment of allergic hypersensitivity to dental materials. Biomed Mater Eng. 2009;19(1):53–61.

    PubMed  Google Scholar 

  22. Nonaka H, Nakada T, Iijima M, Maibach HI. Metal patch test results from 1990-2009. J Dermatol. 2011;38(3):267–71.

    Article  PubMed  Google Scholar 

  23. Davis MD, Wang MZ, Yiannias JA, Keeling JH, Connolly SM, Richardson DM, et al. Patch testing with a large series of metal allergens: findings from more than 1000 patients in one decade at Mayo Clinic. Dermatitis. 2011;22(5):256–71.

    CAS  PubMed  Google Scholar 

  24. Fowler JF, Hayden JM. Palladium Patch reactivity. Exog Dermatol. 2003;2:277–8.

    Article  Google Scholar 

  25. Torgerson RR, Davis MD, Bruce AJ, Farmer SA, Rogers RS 3rd. Contact allergy in oral disease. J Am Acad Dermatol. 2007;57(2):315–21.

    Article  PubMed  Google Scholar 

  26. Bordel-Gomez M, Miranda-Romero A, Castrodeza-Sanz J. Isolated and concurrent prevalence of sensitization to transition metals in a Spanish population. J Eur Acad Dermatol Venereol. 2008;22:1452.

    Article  CAS  PubMed  Google Scholar 

  27. Raap U, Stiesch M, Reh H, Kapp A, Werfel T. Investigation of contact allergy to dental metals in 206 patients. Contact Dermatitis. 2009;60(6):339–43.

    Article  PubMed  Google Scholar 

  28. Akasya-Hillenbrand E, Ozkaya-Bayazit E. Patch test results in 542 patients with suspected contact dermatitis in Turkey. Contact Dermatitis. 2002;46(1):17–23.

    Article  PubMed  Google Scholar 

  29. Durosaro O, el- Azhary RA. A 10-year retrospective study on palladium sensitivity. Dermatitis. 2009;20(4):208–13.

    CAS  PubMed  Google Scholar 

  30. Larese Filon F, Uderzo D, Bagnato E. Sensitization to palladium chloride: a 10-year evaluation. Am J Contact Dermat. 2003;14(2):78–81.

    Article  PubMed  Google Scholar 

  31. Downey D. Contact mucositis due to palladium. Contact Dermatitis. 1989;21(1):54.

    Article  CAS  PubMed  Google Scholar 

  32. Downey D. Porphyria induced by palladium-copper dental prostheses: a clinical report. J Prosthet Dent. 1992;67(1):5–6.

    Article  CAS  PubMed  Google Scholar 

  33. Fernandez-Acenero MJ, Fernandez-Lopez P. Granulomatous contact dermatitis to palladium following ear piercing. Indian J Dermatol Venereol Leprol. 2008;74(6):651–2.

    Article  CAS  PubMed  Google Scholar 

  34. Hanafusa T, Yoshioka E, Azukizawa H, Itoi S, Tani M, Kira M, et al. Systemic allergic contact dermatitis to palladium inlay manifesting as annular erythema. Eur J Dermatol. 2012;22(5):697–8.

    PubMed  Google Scholar 

  35. Koch P, Baum HP. Contact stomatitis due to palladium and platinum in dental alloys. Contact Dermatitis. 1996;34(4):253–7.

    Article  CAS  PubMed  Google Scholar 

  36. Mizoguchi S, Setoyama M, Kanzaki T. Linear lichen planus in the region of the mandibular nerve caused by an allergy to palladium in dental metals. Dermatology. 1998;196(2):268–70.

    Article  CAS  PubMed  Google Scholar 

  37. Namikoshi T. Case of oral lichen planus due to dental metal allergy. Nihon Hotetsu Shika Gakkai Zasshi. 2006;50(3):461–3.

    Article  PubMed  Google Scholar 

  38. Pfohler C, Korner R, Vogt T, Muller CS. Contact allergic gastritis: an underdiagnosed entity? BMJ Case Rep. 2012;2012:bcr2012006916.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Pigatto PD, Feilzer AJ, Valentine-Thon E, Zerboni R, Guzzi G. Burning mouth syndrome associated with palladium allergy? Eur J Dermatol. 2008;18(3):356–7.

    PubMed  Google Scholar 

  40. Van Loon LA, Nieboer C, Van Ketel WG. A case of local and systemic disorders caused by palladium hypersensitivity. Ned Tijdschr Tandheelkd. 1982;89(2):50–1.

    PubMed  Google Scholar 

  41. Hansen PA, West LA. Allergic reaction following insertion of a Pd-Cu-Au fixed partial denture: a clinical report. J Prosthodont. 1997;6(2):144–8.

    Article  CAS  PubMed  Google Scholar 

  42. Kutting B, Brehler R. Clinically relevant solitary palladium allergy. Hautarzt. 1994;45(3):176–8.

    Article  CAS  PubMed  Google Scholar 

  43. Garau V, Masala MG, Cortis MC, Pittau R. Contact stomatitis due to palladium in dental alloys: a clinical report. J Prosthet Dent. 2005;93(4):318–20.

    Article  CAS  PubMed  Google Scholar 

  44. Feilzer AJ. Complaints caused by palladium-containing alloys. Ned Tijdschr Tandheelkd. 1997;104(12):475–6.

    CAS  PubMed  Google Scholar 

  45. Feilzer AJ, Laeijendecker R, Kleverlaan CJ, van Schendel P, Muris J. Facial eczema because of orthodontic fixed retainer wires. Contact Dermatitis. 2008;59(2):118–20.

    Article  CAS  PubMed  Google Scholar 

  46. Muris J, Feilzer AJ, Rustemeyer T, Kleverlaan CJ. Palladium allergy prevalence is underestimated because of an inadequate test allergen. Contact Dermatitis. 2011;65(1):62.

    Article  PubMed  Google Scholar 

  47. Muris J, Kleverlaan CJ, Rustemeyer T, von Blomberg ME, van Hoogstraten IMW, Feilzer AJ, et al. Sodium tetrachloropalladate for diagnosing palladium sensitization. Contact Dermatitis. 2012;67(2):94–100.

    Article  CAS  PubMed  Google Scholar 

  48. Muris J, Goossens A, Goncalo M, Bircher AJ, Gimenez-Arnau A, Foti C, et al. Sensitization to palladium in Europe. Contact Dermatitis. 2015;72(1):11–9.

    Article  CAS  PubMed  Google Scholar 

  49. Muris J, Goossens A, Goncalo M, Bircher AJ, Gimenez-Arnau A, Foti C, et al. Sensitization to palladium and nickel in Europe and the relationship with oral disease and dental alloys. Contact Dermatitis. 2015;72(5):286–96.

    Article  CAS  PubMed  Google Scholar 

  50. Wahlberg JE, Boman AS. Cross-reactivity to palladium and nickel studied in the guinea pig. Acta Derm Venereol. 1992;72(2):95–7.

    CAS  PubMed  Google Scholar 

  51. Muris J. Palladium allergy in relation to dentistry. University of Amsterdam. 2015.

    Google Scholar 

  52. Bircher AJ, Stern WB. Allergic contact dermatitis from “titanium” spectacle frames. Contact Dermatitis. 2001;45(4):244–5.

    Article  CAS  PubMed  Google Scholar 

  53. Suhonen R, Kanerva L. Allergic contact dermatitis caused by palladium on titanium spectacle frames. Contact Dermatitis. 2001;44(4):257–8.

    Article  CAS  PubMed  Google Scholar 

  54. Gonzalez-Perez R, Ruiz-Carrillo G, Soloeta R. Sarcoid-type allergic contact granuloma caused by earrings in a boy. Actas Dermosifiliogr. 2012;103(1):73–4.

    Article  PubMed  Google Scholar 

  55. Thijs L, Deraedt K, Goossens A. Granuloma possibly induced by palladium after ear piercing. Dermatitis. 2008;19(5):E26–9.

    PubMed  Google Scholar 

  56. Goossens A, De Swerdt A, De Coninck K, Snauwaert JE, Dedeurwaerder M, De Bonte M. Allergic contact granuloma due to palladium following ear piercing. Contact Dermatitis. 2006;55(6):338–41.

    Article  CAS  PubMed  Google Scholar 

  57. Casper C, Groth W, Hunzelmann N. Sarcoidal-type allergic contact granuloma: a rare complication of ear piercing. Am J Dermatopathol. 2004;26(1):59–62.

    Article  CAS  PubMed  Google Scholar 

  58. Jappe U, Bonnekoh B, Gollnick H. Persistent granulomatous contact dermatitis due to palladium body-piercing ornaments. Contact Dermatitis. 1999;40(2):111–2.

    Article  CAS  PubMed  Google Scholar 

  59. Blum R, Baum HP, Ponnighaus JM, Kowalzick L.Sarcoidal allergic contact dermatitis due to palladium following ear piercing. Hautarzt. 2003;54(2):160–2.

    CAS  PubMed  Google Scholar 

  60. Fernandez-Redondo V, Gomez-Centeno P, Toribio J. Chronic urticaria from a dental bridge. Contact Dermatitis. 1998;38(3):178–9.

    Article  CAS  PubMed  Google Scholar 

  61. Katoh N, Hirano S, Kishimoto S, Yasuno H. Dermal contact dermatitis caused by allergy to palladium. Contact Dermatitis. 1999;40(4):226–7.

    Article  CAS  PubMed  Google Scholar 

  62. Thyssen JP, Johansen JD, Jellesen MS, Menne T. Provocation test with metallic palladium in a palladium-allergic patient. Contact Dermatitis. 2011;65(5):304–6.

    Article  CAS  PubMed  Google Scholar 

  63. Tillman C, Engfeldt M, Hindsen M, Bruze M. Usage test with palladium-coated earrings in patients with contact allergy to palladium and nickel. Contact Dermatitis. 2013;69(5):288–95.

    CAS  PubMed  Google Scholar 

  64. Marcusson JA. Contact allergies to nickel sulfate, gold sodium thiosulfate and palladium chloride in patients claiming side-effects from dental alloy components. Contact Dermatitis. 1996;34(5):320–3.

    Article  CAS  PubMed  Google Scholar 

  65. Moulon C, Vollmer J, Weltzien HU. Characterization of processing requirements and metal cross-reactivities in T cell clones from patients with allergic contact dermatitis to nickel. Eur J Immunol. 1995;25(12):3308–15.

    Article  CAS  PubMed  Google Scholar 

  66. Pistoor FH, Kapsenberg ML, Bos JD, Meinardi MM, von Blomberg ME, Scheper RJ. Cross-reactivity of human nickel-reactive T-lymphocyte clones with copper and palladium. J Invest Dermatol. 1995;105(1):92–5.

    Article  CAS  PubMed  Google Scholar 

  67. Sellmann D, Prechtel W, Knoch F, Moll M. Transition-metal complexes with sulfur ligands 0.94. Synthesis and reactivity of nickel, palladium, and platinum complexes with the thiolate carbene ligand S2c2--x-ray structure determinations of [Ni(Pme3)(S2c)], [Ni(Pph3)(S2c)], [Ni(Sc)2], [Pt(Pme3)(S2c)], and (S2co)2. Inorg Chem. 1993;32(5):538–46.

    Article  CAS  Google Scholar 

  68. Santucci B, Cristaudo A, Cannistraci C, Picardo M. Interaction of palladium ions with the skin. Exp Dermatol. 1995;4(4 Pt 1):207–10.

    Article  CAS  PubMed  Google Scholar 

  69. Hindsen M, Spiren A, Bruze M. Cross-reactivity between nickel and palladium demonstrated by systemic administration of nickel. Contact Dermatitis. 2005;53(1):2–8.

    Article  CAS  PubMed  Google Scholar 

  70. Kranke B, Aberer W. Multiple sensitivities to metals. Contact Dermatitis. 1996;34(3):225.

    Article  CAS  PubMed  Google Scholar 

  71. Rachmawati D, Bontkes HJ, Verstege MI, Muris J, von Blomberg BM, Scheper RJ, et al. Transition metal sensing by Toll-like receptor-4: next to nickel, cobalt and palladium are potent human dendritic cell stimulators. Contact Dermatitis. 2013;68(6):331–8.

    Article  CAS  PubMed  Google Scholar 

  72. Rachmawati D, von Blomberg BM, Kleverlaan CJ, Scheper RJ, van Hoogstraten IM. Immunostimulatory capacity of dental casting alloys on endotoxin responsiveness. J Prosthet Dent. 2016;117:677.

    Article  PubMed  Google Scholar 

  73. Muris J, Feilzer AJ, Kleverlaan CJ, Rustemeyer T, van Hoogstraten IM, Scheper RJ, et al. Palladium-induced Th2 cytokine responses reflect skin test reactivity. Allergy. 2012;67(12):1605–8.

    CAS  PubMed  Google Scholar 

  74. Minang JT, Arestrom I, Troye-Blomberg M, Lundeberg L, Ahlborg N. Nickel, cobalt, chromium, palladium and gold induce a mixed Th1- and Th2-type cytokine response in vitro in subjects with contact allergy to the respective metals. Clin Exp Immunol. 2006;146(3):417–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Muris J, Scheper RJ, Kleverlaan CJ, Rustemeyer T, van Hoogstraten IM, von Blomberg ME, et al. Palladium-based dental alloys are associated with oral disease and palladium-induced immune responses. Contact Dermatitis. 2014;71(2):82–91.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

    Joris Muris & Cees J. Kleverlaan

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  1. Joris Muris
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  2. Cees J. Kleverlaan
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Correspondence to Cees J. Kleverlaan .

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Editors and Affiliations

  1. Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA

    Jennifer K Chen

  2. Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen, Hellerup, Denmark

    Jacob P. Thyssen

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Muris, J., Kleverlaan, C.J. (2018). Metal Allergy: Palladium. In: Chen, J., Thyssen, J. (eds) Metal Allergy. Springer, Cham. https://doi.org/10.1007/978-3-319-58503-1_33

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  • DOI: https://doi.org/10.1007/978-3-319-58503-1_33

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