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Avatar universal

titanium/vanadium/aluminum dental implant

Eleven months ago I had a titanium alloy dental implant along with a sinus lift and bovine bone graft.  The surgery was successful and the implant has since integrated with the bone.  One to two months after the surgery I started having cramps in the lower extremities that progressed to constant aching in the feet and knees.  Five months after the implant I elected to have the swine flu vaccination which resulted in a numb feeling and tingling in the extremities along with diarrhea and dizziness that subsided after a few days.  Since then the tingling has combined with the aching in the lower extremities and progressed upward to include the thighs.  Exercise makes all of the symptoms worse, as I experience severe aching and muscle twitching after any kind of physical activity.  A MRI of the brain and neck revealed increased areas of signal in the brain not consistent with ms.  Blood tests suggest autoimmune disfunction (positive ana, antithyroid antibodies, high IgG for parvovirus and EBV and CMV without being conclusive of connective tissue or thyroid disease.  A cone beam ct scan revealed an inflammatory process in the sinus above the implant and apical periodontal inflammation on the tooth behind the implant which was also giving me night fevers.  I have since had the root canal retreated on the tooth that was being blamed for my mouth discomfort.  This has resulted in a 100% improvement in the pain and feverish feeling emanating from THAT tooth, but I still have an strange irritating sensation emanating from the implant that extends to the cheek, nostril, and eye above the implant.  I have a feeling the implant is the cause of the mouth trouble and wondering if it is the cause of my neurological symptoms as well.  My physical activity has been reduced to a minimum compared to the level of physical activity previous to the surgery.  I wonder if the implant does not show the typical symptoms of rejection because of nightly bronchial and nasal steroid inhalations.  The implant looks good on scans and xrays.  I am not so good.  I am living a life of an inactive person because I have no tolerance for exercise.  I love to exercise and my dogs need a walk!!!  Today I went for a lower back MRI and had a hard time holding still because of feeling crampy and cold.

All of the docs say it is a coincidence that any of my problems started shortly after receiving the implant.  I have sent blood in for the Melisa test, but wonder if a reaction will show being I was not able to refrain from using inhalers for five days.  The implant has adhered to the bone and looks "perfect".  I am ready to get it out and praying I can return to my normal level of activity.  Is there anyone out there with some information that could help?

Am I the only one????  I don't think the ADA or the implant manufacturers want to investigate the possibility of this lucrative procedure being a problem for anyone, so it is hard to find any data supporting my suspicion.  

Thanks.
1563 Responses
Avatar universal
Wow, I feel like Im looking in a mirror.  I had upper and lower jaw surgery 3 years ago and my health has never been the same.  I was given 4 plates and screws in the mandible and maxilla and got the same story about the bioavailability of titanium, but I question it.  I have done some moderate research over the last few months and I found one excellent study about a very small percentage of patients having significant health systems since receiving Ti implants.  I wish I would have bookmarked that study but even only spending about 20 minutes researching last night after reading your post I came up with the following...  (I'll post excerpts in another response,) but as far as what I experienced, I developed some serious pains in my right foot about 6 or 8 months post op.  I never put the two together, but I also noticed my overall recovery was taking quite awhile.  Fatigue, light-headedness, weakness and confusion, but the pain in the foot started to spread.  It ultimately moved to both feet and now basically my lower limbs are just shot.  Just like you, prior to all this I was quite fit and active.  I actually was up to working out 6 days a week, and doing heavy cardio on top of weight training.  At the moment, I dont think I'll be able to work a year from now, at least a full 50-60 hour work week, if I continue to decline as rapidly as I have been.

I havent moved forward as aggressively as you in my testing because I have to start from square one with another maxilliofacial surgeon and to be honest, I am the type that waits too long to see their doctor and so I keep thinking if I ignore this, it will go away, but I can no longer stand how bad my health has become.

Just out of curiousity, when you did the MELISA, did you have testing for other problematic metals?  I know I read somewhere that Ti implants arent pure Ti like people assume.  Im not a metalurgist, but I believe the article said it was really an alloy that has properties of other metals that are known to not be as "bioavailable" (such as nickel).  

Avatar universal
I found a book online called The Atlas of Craniomaxillofacial Osteosynthesis

Its a medical book for sale and you can only see a couple pages, but from the index there was a whole chapter on plate removal due to immunologic response.

Also....
Allergic reactions to metal implants:
Influence of wear debris
Properties of implant materials and particles. The release of potential allergens
like nickel, chromium or cobalt depends on composition, surface modification
and chemical or physical corrosion factors. Low pH and low oxygenation of
adjacent tissue may influence metallic surface – even leading to titanium release
in surrounding tissue [24]. ”Hidden” nickel contamination of titanium materials may
result from manufacturing processes

FROM THE TRAUMA ORTHOPEDIC JOURNAL
Another example is 6 titanium implants introduced into the jaws of a 49 year woman.
All the implants were of IV degree titanium: LIBB implant, cylinder implant and the
Brånemark type. It was a part of research project supervised by Ethical Commission. A
serious clinical and radiological reaction followed around all the implants, which made
the removal of the implant necessary. After which the allergic ailment was healed.
Histological: irritation reaction and setting of the cells of intrusive object and the
process of fibration

FROM A SPANISH STUDY
Background: In dentistry, allergic reactions to Ti implants have not been studied, nor considered by professionals. Placing permanent metal dental implants in allergic patients can provoke type IV or I reactions. Several symptoms have been described, from skin rashes and implant failure, to non-specific immune suppression.

Objective: Our objective was to evaluate the presence of titanium allergy by the anamnesis and examination of patients, together with the selective use of cutaneous and epicutaneous testing, in patients treated with or intending to receive dental implants of such material.

Material and methods: Thirty-five subjects out of 1500 implant patients treated and/or examined (2002–2004) were selected for Ti allergy analysis. Sixteen presented allergic symptoms after implant placement or unexplained implant failures [allergy compatible response group (ACRG)], while 19 had a history of other allergies, or were heavily Ti exposed during implant surgeries or had explained implant failures [predisposing factors group (PFG)]. Thirty-five controls were randomly selected (CG) in the Allergy Centre. Cutaneous and epicutaneous tests were carried out.

Results: Nine out of the 1500 patients displayed positive (+) reactions to Ti allergy tests (0.6%): eight in the ACRG (50%), one in the PFG (5.3%)(P=0.009) and zero in the control group. Five positives were unexplained implant failures (five out of eight).

Conclusions: Ti allergy can be detected in dental implant patients, even though its estimated prevalence is low (0.6%). A significantly higher risk of positive allergic reaction was found in patients showing post-op allergy compatible response (ACRG), in which cases allergy tests could be recommended.
Avatar universal
YOU CAN FIND THE FOLLOWING ON A FEW DIFFERENT SITES. ITS NOT VERY PROFESSIONALLY WRITTEN AND I DONT KNOW WHO THE AUTHOR IS, NOR DO THEY REFERENCE STUDIES, BUT I THINK A LOT OF IT RINGS TRUE.

Titanium is NOT Biologically Inert

Titanium implants release metal ions into your mouth 24 hours a day, and this chronic exposure may trigger inflammation, allergies, and autoimmune disease in susceptible individuals. They are a precursor to disease.

Cases of intolerance to metal implants have been reported over the years, and the removal of this incompatible dental material has resulted in reduced metal sensitivity and long-term health improvement in the majority of patients.

Titanium has the potential to induce hypersensitivity as well as other immunological dysfunctions.

One study investigated 56 patients who developed severe health problems after receiving titanium-based dental implants. These medical problems included muscle, joint, and nerve pain; chronic fatigue syndrome; neurological problems; depression; and skin inflammation.

Removal of the implants resulted in a dramatic improvement in the patients’ symptoms, as well as a decrease in many patients’ sensitivity to titanium.


FROM A GREAT GERMAN STUDY ABOUT A WOMAN WHO CAME DOWN "with myalgia and arthralgia predominantly in the knees and small joints of the hands and feet, with morning stiffness lasting at least 2 h. AFTER RECEIVING Ti IMPLANT.  
CONCLUSION:Clinicians should be aware of the possibility of implant-related immune activation when patients develop symptoms of arthritis after receiving implants. Diagnostic testing by TNF-release assay could be a diagnostic tool in these patients, although comprehensive studies are needed to test the validity of this method of diagnosis in broader populations. The arthritic complaints were alleviated in the case patient following removal of the implant.


SITED PAPER COMMENTS IN A PhD STUDY
The extensive use of metal implants in orthopedic surgery as well as in dentistry calls for a general attention to their biological safety. Titanium (Ti) is used for many types of implants and is generally considered a safe metal to use in implantation. However, it has been shown that particulate debris, also in the nanoscale range, are released from implants. These particulate debris may cause health problems either at the implant site or in distant organs (Frisken et al. 2002).
Avatar universal
Thanks. I have read some of the info. you refer to.  A 2002 study published by the "Journal of Materials Science: Materials in Medicine" reveals that aluminum leaks diffusely into the surrounding bone of dental implants.  Apparently none of what we are reading is of any consequence to the conclusions of the safety of dental implants for the American Dental Association.  Alot of the research reveals what can support the multi-million/billion?? dollar medical and pharmaceutical industry, I think.

I was able to get the materials specification from the manufacturer of my dental implant in order to be tested for a reaction to these materials via the Melisa test.  I read somewhere in an orthopedic journal that there is a lymphokine test that is related to the lymphocyte transformation test Melisa offers.  None of the various healthcare providers have offered this to me.  You should talk to your surgeon about getting the materials specification of what is in your body so you can be tested for it.  I expect the results of the Melisa test later this week, so I will let you know.

Meanwhile I am going to an oral surgeon this afternoon for a consultation on the removal of this implant.  I may be doing this regardless of the Melisa test, as I don't know what else to do.  I would like to get back my life!!  I feel sorry for you, as the materials in your jaw are much more extensive and a single dental implant.

Oh--I asked a dental hygenist who has practiced for 30 years if she had ever heard of something similar to my situation.  A friend of hers also had an implant which had adhered to the bone.  This person also started having a myriad of health issues, and so  had the implant removed and did start feeling better.  This would contradict my periodontists' assertion that osseointigration of implant material is evidence of no problem for your body.  I gave her my number and asked for her friend to call me.  I am waiting to talk to her.

Talk to you later.
Avatar universal
I am just curious--have you suffered neurological symptoms, or is it just an aching in your muscles and/or joints?  Do you have any symptoms in the area of the implants?  Do you notice your symptoms are worse after any kind of activity?
Avatar universal
Thanks for responding.  I am so grateful I found your posting because I guess I feel validated by whats going on with me as I read more about what is going on with you.  Plus, what I'm researching and also the story of the friend of your hygienist who had similar issues seems to confirm quite a lot.

For one, you are far more advanced and knowledgeable than where I am at with this.  It didnt even occur to me to research the plates and screws used on me.  The very unfortunate problem behind all this is that my surgeon is really incompetent. He completely oversold his skills and led me to believe he could fix all my problems. He did a horrible job and put the jaws back off center, cantilevered and rotated. Yes, all three axis of the 3D plane are wrong. On top of that, he collapsed the middle vault of my nose, so the right side caved in.  I already had that fixed by an amazing surgeon but I know I have to get more follow up work on top of all the damage.  After three requests he still wont release my file and many of the important pages from the hospital records out of his file have been copied so lightly, they are unreadable.  I dont know if I'll ever get proper information from him.

As far the lymphokine test, is it possible for you to point me in a direction regarding that study?  I have a wonderful internist at a major university and she is quite open to information I bring to her, so she may be willing to help me move forward in regard to all this.  She is definitely aware of my health changes and she has mulled over the concept that I have a fibromylagia, but my instinct leads me back to this all being started within months of post op.  I remember in my earlier research the study that mentions it takes a few months post op for symptoms to manifest, and that is in line with how mine progressed.

As far as neurological, yes.  Outside of poor mental focus and a bit of memory loss, the one thing that bothers me a lot is a pulsing that occurs in the eyes.  I know that sounds weird, but it wasn't a typical twitch, but a pulse that occurred intermittently for awhile and moved back and forth between one eye and the other. The first time it happened I became totally alarmed and ultimately went to my ophthalmologist who could find nothing wrong.  It happens every once in awhile without warning and I have sort of become used to it, but I have no other explanation.  

And yes, my mental focus has dwindled significantly.  Anything that takes exerted effort just leaves me scatter brained.  

I also want these plates out.  I have pain around them still, but I was chalking that up to how off my bite is because of his poor surgery, but now Im more concerned that its direct inflammation and bone damage that is continuing.  

I am anxious to know how your visit with the oral surgeon goes.  I tend to agree with you, if I am understanding your point on that many people who work in the field are either not aware of, or wont admit to the problems with Ti.  I think the bandwagon has been well established that its an inert, bioavailable material, and most dont want to hear any different.  

After communicating with you, I know Im going to have start moving forward with tests and looking at options.  I think my internist will help me as much as she can, but I have lost faith in the oral surgeon community.  Plus, my removal will be major surgery, but I know I have to do something to get my normal life back.  

Please keep writing!
Avatar universal
So, from the math in the Spanish study, about 1 out 150 or 180 (depending on how you read the numbers) have an immunologic reaction to Ti.  And then take into account how many people dont relate their ailment to the implants and get a misdiagnosis from another physician so they dont figure into the real numbers.  I could see in real life how that number of occurrences may be actually higher, but the number correctly diagnosed may be lower.

I really like my doctor but she seems to be going in a wrong direction with this and wants to categorize me with fibromyalgia. Thats why Id like to bring her some information and see if she'd help with the lymphokine and MELISA tests.

I think those odds are just high enough so that the oral surgeon community isn't/or doesnt want to be aware of them so that it is an issue.

How did the appointment with the oral surgeon go?
Avatar universal
You can go to www.melisa.org and find out about ordering the test yourself.  They will tell you to get a materials specification list of the implants you have.  I think I read somewhere that the lymphokine test is a more updated term for lymphocyte--maybe an orthopedic surgeon could help you.  I didn't want to spend more time and money going to another surgeon to find this out, but maybe one who does joint replacement on a regular basis would be someone familiar with this kind of testing.  

I scheduled an appt. with the oral surgeon to have the implant removed.  I am also going to consult with the periodontist who installed the implant about having it removed.  I will go with whoever I think can do a better job.  My husband went with me to the oral surgeon & made the comment "Oh, I think they think you are a little crazy".  At least I have a spouse who knows the effect these symptoms are having on our lives!!

Avatar universal
So can I ask what sort of neurological issues were you having, if any?

Congrats on having it removed!
Avatar universal
A few months after the implant I started having cramping in the lower extremities that evolved into a constant ache in the feet and knees.  I thought perhaps I was developing arthritis and at the time did not make a connection to the implant.  A few months later I was silly enough to get the swine flu shot at the local health dept. and had a bad reaction to that.  Neurological symptoms include burning pain in the knees as well as aching in the forearms and a numb feeling in the left hand.  My right leg is also quite painful and I have no tolerance for exercise.  Never in my life have I ever been so inactive for such an extended period of time.  I am worried that these symptoms could be transverse myelitis as a symptom of ms, but I also have an itchy annoying feeling in the area of the implant and always feel like I have a low grade infection in the area.  Sensitivity to metal can cause neurological symptoms, so this is why I think my symptoms may be related to the implant.  

Today I saw my allergist (all I do is go to dr. appts!) and she said that if my body had a problem with the implant that it would be loosening at the site.  I wish this would happen!!!  She also said there is no evidence that having an implant of any kind will produce problems with autoimmunity or the symptoms I am having in other parts of the body.  ---I guess all those women with health issues due to the breast implants are delusional!!  So apparently none of what I am saying or feeling has any basis in reality or science.  This is pretty much what most health care practitioners say.

Meanwhile, my health and energy levels continue to decline.  I was not able to get a removal date until the 24th.  The periodontist wants me to wait until the permanent filling is in the tooth they did a retreat on the root canal on, and for a month after that to see if the feeling in my mouth will go away.  He also says that he is 100% sure that none of my symptoms are related to the implant.  He just does not get it.  

Next week I am going to an ENT to talk about the inflammation of the sinus above the implant and to ask his opinion, so I will let you know how that goes.

--I am supposed to have the results of the melisa test at the end of this week, and tomorrow is Friday.  I will let you know about that.

Later.....
Avatar universal
The surgeon who won't release your files??  It is the law that you are entitled to your health records, and you should be able to read what you get.  It is also illegal to alter the information on your records.

I did encounter some resistance or maybe it was nervousness when I inquired about the materials used in my implant.  I told them that either they could get me the information, or that I would get someone to get it for me.  It is material in my body that I have paid for--give me a break!  

Sorry if sound wound up--all of this has been trying on my patience!
Avatar universal
Please feel free to be wound up... Ive been wound up over this for a few years.  Yes, this doctor turned out to be about the slimiest person I have ever dealt with. (You know the old saying, someone had to graduate at the bottom of their medical school) I fell for his sales pitch in him telling me everything I wanted to hear.  I had the procedure to help my sleep apnea, and now I'm in more pain, I breathe worse because of his sloppy work and collapsing my middle vault, and both upper and lower jaws are crooked. Also, as my dentist verifies, this doctor "made the deepest incisions I've ever seen" for a surgery like mine, and he wont release my full file (I've seen it on the desk, its probably 50-75 pages long.  They will only release 9 pages.)

So, I can totally relate to whats going on with your legs and feet.  As I said, mine started in one foot, but over time spread to both feet and legs.  What I find fascinating was the first paper I ever read claimed the number one complaint of symptoms regarding allergic reaction to dental Ti implants was chronic sinus inflammation.  I had to get my nose basically gutted and rebuilt with rib cartilage because the jaw surgeon was so sloppy and invasive.  But even before the rebuild, I developed chronic sinus inflammation.  My nose/sinuses felt "swollen" inside and it was hard to breathe, but I wasnt typically congested.  It is like this to this day.

Isnt it tremendously aggravating when physicians just flat out say "this definitely isnt related to the implant?"  Dont you just want to say, "Hey Doc, let me stick a hunk of metal in your body, and you know, if it bothers you, I'll tell you that you are crazy?"  Physicians are so dogmatic to trust a study (you know, the one done by the manufacturer which is being pitched by the good looking medical sales rep with the glossy brochure) over their own patients real life symptoms, that they are really jeopardizing the patients well being.  

Well, Im sorry you are going through this because I certainly know what you are up against.  I'll keep checking back here if you dont mind keeping me up to date.  You are giving me inspiration to want to move forward with my own issues.

Thanks!


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