Increase in the Incidence of Allergy to Prosthetic Materials and Local Anesthetics: Immunophysiology and Laboratory Diagnostics of Intolerance

Combined analysis of drug sensitivity in vitro and in vivo is necessary for reliable diagnosis of the intolerance to prosthetic materials and local anesthetics as an intrinsic allergic reaction, especially in the cases of generally weak allergic reactions. Changes in peroxidase release from granulocytes in response to a corresponding substance is an effective in vitro test, and the provocative mucosal-gingival test (MGT) is used in vivo. During the past decade, a growth was observed in the population developing allergies to prosthetic materials and local anesthetics, which is expressed in an increased number of patients with intolerance to these materials against the background of increasing hyperresponsiveness to the drugs which have usually been tolerated well, as well as an increased proportion of patients with a polyvalent allergy to many prosthetic materials and anesthetics. At the same time, the amount of weak responses to drugs in the in vitro test has increased. Some of these patients exhibit a pathologic response to the given drug, which can be detected using the MGT. In most cases, polyvalent allergies to prosthetic materials or anesthetics and a pathological response accompanied by a weak in vitro reaction are found in patients with bronchial asthma and other chronic allergies, chronic candidosis of the oral cavity, and chronic Helicobacter and Giardia lamblia infections.