Palladium allergy prevalence is underestimated because of an inadequate test allergen

Additive Manufacturing of Customized Metallic Orthopedic Implants: Materials, Structures, and Surface Modifications

Metals have been used for orthopedic implants for a long time due to their excellent mechanical properties. With the rapid development of additive manufacturing (AM) technology, studying customized implants with complex microstructures for patients has become a trend of various bone defect repair. A superior customized implant should have good biocompatibility and mechanical properties matching the defect bone. To meet the performance requirements of implants, this paper introduces the biomedical metallic materials currently applied to orthopedic implants from the design to manufacture, elaborates the structure design and surface modification of the orthopedic implant. By selecting the appropriate implant material and processing method, optimizing the implant structure and modifying the surface can ensure the performance requirements of the implant. Finally, this paper discusses the future development trend of the orthopedic implant.

Immunology of metal allergies

Allergic contact hypersensitivity to metal allergens is a common health concern worldwide, greatly impacting affected individuals with regard to both quality of life and their ability to work. With an estimated 15-20 % of the Western population hypersensitive to at least one metal allergen, sensitization rates for metallic haptens by far outnumber those reported for other common triggers of allergic contact dermatitis such as fragrances and rubber. Unfortunately, the prevalence of metal-induced hypersensitivity remains high despite extensive legislative efforts to ban/reduce the content of allergy-causing metals in recreational and occupational products. Recently, much progress has been made regarding the perception mechanisms underlying the inflammatory responses to this unique group of contact allergens. This review summarizes recent advances in our understanding of this enigmatic disease. Particular emphasis is put on the mechanisms of innate immune activation and T cell activation by common metal allergens such as nickel, cobalt, palladium, and chromate.

In vitro cytotoxicity of metallic ions released from dental alloys

The cytotoxicity of a dental alloy depends on, but is not limited to, the extent of its corrosion behavior. Individual ions may have effects on cell viability that are different from metals interacting within the alloy structure. We aimed to investigate the cytotoxicity of individual metal ions in concentrations similar to those reported to be released from Pd-based dental alloys on mouse fibroblast cells. Metal salts were used to prepare seven solutions (concentration range 100 ppm-1 ppb) of the transition metals, such as Ni(II), Pd(II), Cu(II), and Ag(I), and the metals, such as Ga(III), In(III), and Sn(II). Cytotoxicity on mouse fibroblasts L929 was evaluated using the MTT assay. Ni, Cu, and Ag are cytotoxic at 10 ppm, Pd and Ga at 100 ppm. Sn and In were not able to induce cytotoxicity at the tested concentrations. Transition metals were able to induce cytotoxic effects in concentrations similar to those reported to be released from Pd-based dental alloys. Ni, Cu, and Ag were the most cytotoxic followed by Pd and Ga; Sn and In were not cytotoxic. Cytotoxic reactions might be considered in the etiopathogenesis of clinically observed local adverse reactions.

Palladium-induced Th2 cytokine responses reflect skin test reactivity

Recently, a crucial role of Th2 responses in nickel allergic contact dermatitis (ACD) was demonstrated. As palladium allergy is an issue of growing interest, the diagnostic potential of Th2 parameters for palladium sensitization was investigated. Palladium (Na(2) [PdCl(4)])-induced lymphocyte proliferation (LPT), Th1 and Th2 cytokine production were correlated with skin test (ST) reactivity in 16 positive and 21 negative controls. Furthermore, the diagnostic potential of these assays was evaluated using receiver operating characteristics (ROC) analysis. For comparison, same experiments were carried out for nickel (NiSO(4)). Correlation coefficients between palladium ST reactivity and IFN-γ, LPT, IL-5, and IL-13 were 0.34, 0.51, 0.69, and 0.78, and overall test accuracies were 68%, 81%, 89%, and 95%, respectively. Both palladium- and nickel-mediated Th2 responses tightly correlate with ST reactivity, supporting recent findings on the crucial role of Th2 involvement in ACD. Therefore, these assays may have great potential as diagnostic tools for future in vitro sensitization testing.