Eurasian Health Journal
ISSN 1694-8882 / e-ISSN 1694-8890
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Vol. 18, No. 1, 2026 / Pages 145-156

Delayed-type hypersensitivity to metals in dentistry: Modern approaches to diagnostics (literature review)

Sofya Khostelidi*Marina ElichevaEkaterina BuryginaArailym AbilbayevaAlexey Silin

sofianic@mail.ru

Received 11.09.2025
Revised 24.12.2025
Accepted 25.12.2025

Abstract

Delayed-type metal hypersensitivity, according to the current classification, is classified as subtype IVa. With the introduction of new dental devices, the number of patients with intolerance to metal alloys has increased. The aim of this study was to identify the pathogenesis and clinical manifestations, the main risk factors for the development of delayed-type hypersensitivity to metal structural components, and optimal diagnostic methods in patients in dental practice. A search was conducted on PubMed and e-library (as of February 2026) using the following keywords: adverse effects of dental alloys, skin patch testing, contact allergy to metals, dental materials, allergic reactions, lichenoid reaction. Forty-seven scholarly sources were analysed using bibliographic search, source selection and screening, comparative analysis, and data synthesis. Various diagnostic methods are used to identify these hypersensitivity reactions. A literature review showed that patch testing is the most informative diagnostic method for detecting hypersensitivity reactions to metals used in the fabrication of dental restorations and denture components. They allow for the identification and confirmation of the involvement of a specific causative factor in the development of clinical symptoms in a patient. Delayed-type hypersensitivity is most common to metals such as nickel, cobalt, and chromium. A similar mechanism of hypersensitivity to nickel is recorded in 17% of women and 3% of men, while hypersensitivity to cobalt and chromium is reported in 1-3% of both sexes. An increase in delayed-type hypersensitivity to other metals, such as aluminum, beryllium, copper, gold, iridium, mercury, palladium, platinum, rhodium, and titanium, has also been observed. Patients with immune-mediated pathologies are at high risk for developing delayed-type metal hypersensitivity

Keywords

side effects of dental alloys; skin patch tests; contact allergy to metals; dental materials; allergic reactions; lichenoid reaction

Suggested citation

APA Style
Khostelidi, S., Elicheva, M., Burygina, E., Abilbayeva, A. & Silin, A. (2026). Delayed-type hypersensitivity to metals in dentistry: Modern approaches to diagnostics (literature review). Eurasian Health Journal, 18(1), 145-156. https://doi.org/10.54890/1694-8882-2026-1-145
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Vancouver Style
Khostelidi, S., Elicheva, M., Burygina, E., Abilbayeva, A., Silin, A.. Delayed-type hypersensitivity to metals in dentistry: Modern approaches to diagnostics (literature review). Eurasian Health J. 2026;18(1):145-56. https://doi.org/10.54890/1694-8882-2026-1-145
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