In recent years, with the development of oral restoration technology, nickel-chromium alloy, as a common base material for porcelain teeth, has been widely used in clinical practice due to its good mechanical properties and economy. However, some studies and clinical reports suggest that nickel-chromium porcelain teeth may have potential health risks, especially the controversy related to carcinogenic risks has aroused the attention of the academic community. This article aims to review the carcinogenic cases related to nickel-chromium porcelain teeth, explore its potential carcinogenic mechanism and prevention measures, and provide a scientific basis for dentists and patients.
1. Composition and application background of nickel-chromium alloy
Nickel-chromium alloy is mainly composed of nickel (Ni) and chromium (Cr). It has high hardness, corrosion resistance and good biocompatibility. It is suitable for use as the inner crown bracket of porcelain teeth. It is widely used in oral restoration, especially in areas with limited economic conditions. Nickel-chromium alloy has become a common material. However, nickel is a known allergen and potential carcinogen. Its release and accumulation in the body may have adverse effects on tissues.
2. Clinical cases related to carcinogenicity of nickel-chromium porcelain teeth
There have been many case reports showing that some patients wearing nickel-chromium porcelain teeth experienced abnormal hyperplasia of the oral mucosa and even cancer. For example, some patients developed chronic inflammation of the oral mucosa after wearing nickel-chromium porcelain teeth for a long time, which eventually evolved into oral squamous cell carcinoma. Although this transformation process is relatively rare, its existence suggests that the metal ions released by the nickel-chromium alloy material may have a mutagenic effect on cells.
3. Discussion on carcinogenic mechanism
Metal ion release and cytotoxicity
Nickel-chromium alloy is affected by saliva, changes in food pH, etc. in the oral environment, and may release nickel ions and chromium ions. These ions penetrate the oral mucosa and enter the cells, inducing oxidative stress and producing a large amount of reactive oxygen species (ROS), leading to DNA damage and gene mutations.
Chronic inflammatory response
Nickel and chromium ions can activate the immune cells of the oral mucosa and trigger a persistent inflammatory response. Chronic inflammation is an important component of the carcinogenic environment. Inflammatory factors promote cell proliferation, inhibit apoptosis, and accelerate the malignant process.
Immune system dysregulation
The ions released by nickel-chromium alloys may interfere with the local immune microenvironment, inhibit immune surveillance function, reduce the ability to clear abnormal cells, and further promote carcinogenesis.
4. Related epidemiological studies
Some epidemiological surveys have shown that the incidence of oral cancer and precancerous lesions in patients who wear nickel-chromium porcelain teeth for a long time is significantly increased compared with non-wearers. However, due to limited sample size and the influence of multiple factors, there is no clear evidence of causal relationship. There are large differences in the assessment of carcinogenic risks among different studies, and more large-scale and rigorous clinical studies are needed to verify this.
5. Material Safety Assessment and Alternative Solutions
With the increasing concern about metal allergies and carcinogenic risks, the safety of oral materials has become a focus. Some studies suggest avoiding the use of nickel-containing alloys in sensitive populations and using titanium alloys, zirconium ceramics and other materials with better biocompatibility to replace nickel-chromium alloys. At the same time, improvements in manufacturing processes, such as surface passivation treatment and reducing nickel ion release, are also effective ways to reduce risks.
VI. Prevention and Management in Clinical Practice
Preoperative evaluation
Clinicians should inquire about patients' allergy history in detail, conduct necessary metal allergy tests, and avoid the use of nickel-chromium alloys in high-risk patients.
Regular dental check-ups
Patients wearing nickel-chromium porcelain teeth need to undergo regular oral mucosal examinations to promptly detect lesions such as abnormal hyperplasia, leukoplakia or erythema and intervene early.
Improve oral hygiene
Keeping your mouth clean can reduce bacterial infection and inflammation, which can help reduce the risk of cancer.
Material selection
Based on the patient's specific situation, choose materials reasonably and try to avoid long-term contact with alloys that release potentially harmful ions.
Beauty Encyclopedia Tips:
As a traditional oral restoration material, nickel-chromium porcelain teeth have excellent mechanical properties, but the potential release of metal ions may cause local cytotoxicity and chronic inflammation, and there is a significant health risk. In clinical applications, we should pay attention to the safety assessment of materials, rationally select alternative materials, and do a good job of preoperative risk assessment and postoperative follow-up examinations to protect the patient's oral and systemic health. Further clinical and basic research will help clarify the carcinogenic risk of nickel-chromium alloys and guide safer oral restoration practices.