Two articles in the British Journal of Oral and Maxillofacial Surgery report: 1) a high number of metal allergies in Temporomandibular Disorders (TMD) patients needing total replacement of their TM joints and 2) one year follow-up data comparing patients with metal allergies treated with all titanium total joint replacements (considered non-allergenic) with non-allergic patients treated with standard cobalt-chromium replacements joints.
Two investigators from Nottingham University Hospitals, A. J. Sidebottom and K. Misty, used patch tests to detect metal allergies in all patients needing a total joint replacement between March 2004 and August 2012. Of these 101 patients, a startling 39 percent tested positive for allergy to one or more metals and were given all titanium prostheses. The investigators report that as of six months follow-up, no patient showed signs of an allergic rejection.
Titanium vs. Cobalt-chromium
Dr. Sidebottom and two other colleagues, S. Sah and O.T Hussain, studied all patients who had joint replacements with one-year follow-up in the period from March 2003 and February 2011. Of these 55 patients, 40 had the standard cobalt-chromium prosthesis, while 15 had all-titanium. The most common disease in both groups was osteoarthritis. Judged on the basis of pain relief, improved mouth opening, and diet scores, both groups of patients benefited with no significant differences between groups. No patient developed a hypersensitivity reaction, and no all-titanium prosthesis failed (at least as of one-year follow-up).