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Case Reports
. 2025 May 6;17(5):e83598.
doi: 10.7759/cureus.83598. eCollection 2025 May.

Metal-Free Prosthodontic Treatment of Periungual Allergic Contact Dermatitis: A Case Report

Yasuda Hiroyasu  1 , Ito Kenji  1 , Matsuda Yuko  2 , Fukushima Ryo  1 , Akita Daisuke  1
Affiliations
Case Reports

Metal-Free Prosthodontic Treatment of Periungual Allergic Contact Dermatitis: A Case Report

Yasuda Hiroyasu et al. Cureus. .

Abstract

Prosthodontic treatments utilize various procedures and materials such as gold, silver, copper, palladium, cobalt, chromium, and titanium to restore oral function; however, these materials are known to induce allergic contact dermatitis (ACD). We present herein a case in which a patient showed improvement in ACD after undergoing prosthetic treatment using metal-free dental materials. A 53-year-old female patient with periungual inflammation was referred to our department due to instability with her maxillary prosthesis, which was attributed to severe peri-implantitis. Skin tests were conducted due to the suspicions of a metal allergy, and patch testing revealed positive reactions to dental metals, specifically cobalt and palladium. As a result of this finding, all of the patient's metal-based prostheses were systematically replaced with provisional crowns. During this period, any teeth and dental implants affected by severe periodontitis were extracted, after which the patient was fitted with zirconia-based prostheses, resulting in a significant reduction in periungual inflammation. In this case, therefore, the utilization of metal-free prostheses facilitated improvement of the patient's ACD, providing valuable insights for dental practitioners managing patients with ACD.

Keywords: allergic contact dermatitis; case report; metal allergy; patch testing; prosthodontics.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethics Committee of the Nihon University School of Dentistry issued approval EP22D003. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preoperative radiographs obtained at the patient’s initial visit
(A)  Panoramic radiograph (B)  Radiograph of the right anterior maxilla
Figure 2
Figure 2. Intraoral photographs obtained early in the treatment course
(A) Maxillary occlusal view (B) Right lateral view (C) Frontal view (D) Left lateral view (E)  Mandibular occlusal view
Figure 3
Figure 3. Intraoral photographs obtained during maxillary treatment
(A) Implant extraction on the right side (B) Post-right maxillary implant extraction intraoral photograph (C) Implant extraction on the left side (D) Post-left maxillary implant extraction intraoral photograph (E) Frontal view of provisional crown after extracting the implants (F) Maxillary occlusal view of eth provisional crown after post-implant extraction
Figure 4
Figure 4. Images obtained prior to manufacturing the maxillary definitive prosthesis
(A) Front view of the maxillary abutment teeth (B) Maxillary occlusal view of the abutment teeth (C) Maxillary occlusal view using individual trays for abutment impressions (D) Impression using individual trays for abutment impressions, an individual tray, and three kinds of silicone impression materials
Figure 5
Figure 5. Postoperative intraoral photographs
(A) Maxillary occlusal view (B) Right lateral view (C) Frontal view (D) Left lateral view (E) Mandibular occlusal view
Figure 6
Figure 6. Postoperative radiographs
(A) Radiographic image of temporomandibular joint (B) Panoramic radiograph
Figure 7
Figure 7. Pre- and postoperative photographs of the fingers
(A–D) Left hand (E–H) Right hand
See this image and copyright information in PMC

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