Abstract
Apart from the inflammatory reaction upon surgery itself, the immunological biocompatibility of a given material varies with factors like the site of implantation, the immunogenicity of implant constituents and the individual reactivity of the patient. Most investigations have focused on cytotoxic, osteolytic or proinflammatory effects of wear debris and corrosion products. In some patients specific immune response, e.g. allergic reactions, to the implant components may develop and lead to localized or generalized eczema, local swelling, recurrent urticaria or even implant loosening. However the number of these patients seems to be much lower than the sensitisation rates to cobalt, chromium or nickel ranging between 2–10% in the general population. To identify implant associated allergic reactions the diagnostic approach should encompass both epicutaneous patch testing and in vitro methods, e.g. analysis of T-cell reactivity in peripheral blood and perimplantar tissue. Several patients with allergy-mediated implant intolerance under the picture of eczema, swelling, seroma formation or implant loosening will be presented. Based on these cases, a new panel of patch test substances (developed by the German Contact Dermatitis Group), immunohistology and molecular biology approach to characterize the periimplantar immune response will be exemplified. As the author is actually establishing a nationwide register for implant-associated allergic reactions, more information about incidence and clinical picture of these reactions will be available in the future. Certainly, these patients profit from an interdisciplinary problem solving approach.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
