Rehabilitation of a patient with manifestations of intolerance to dental materials in the oral cavity (clinical case)

Signi­ficant achievements in modern dental materials science, improvements in all-ceramic technologies, microprosthetics, and inert removable prosthetics have not eliminated the relevance of assessing the biocompatibility of dental construction materials with the tissues of the prosthetic bed. Currently, almost 47% of the global population suffers from food, drugs, various materials, and chemical compounds intolerances. Aim of the study – to present a clinical case of intolerance to structural materials, and to demonstrate the prediction and prevention of their adverse effects on the whole organism through biocompatibility testing with the tissues of the prosthetic bed. A 62-years-old male patient sought prosthodontic care with complaints of pain, bleeding, redness, and swelling at the sites where metal-ceramic crowns contacted the oral mucosa, along with itching, burning sensations, and halitosis. Approximately two weeks after fixing the bridge prostheses, skin rashes appeared on the neck, accompanied by itching and tingling sensations. Given that the patient associated symptom onset with the fixation of full-cast metal-ceramic bridges, and based on the clinical picture in the oral cavity and results of epicutaneous patch testing, a diagnosis was established: “Intolerance to dental materials. Localized periodontitis complicated by Kennedy Class II, Subclass 2 maxillary and Class I, Subclass 1 mandibular edentulous areas. Masticatory efficiency loss according to Agapov – 84%.” Due to positive patch test results and clinical findings, removal of the metal-ceramic constructions from the oral cavity was deemed necessary. After extraction of all mobile teeth and their destroyed roots, it was planned to restore the edentulous spaces with zirconia bridge prostheses and fabricate clasp dentures based on polyamide for both jaws.