**5.4 Removal of metal restorations**

When removing the restorations that contain allergy-positive metal elements, the removal priority should be as follows.


In principle, all restorations with allergy-positive metal elements need to be removed. The build-up material that was used for the inside of the full veneer crown is no exception, as it could be eluted. If the patient does not have an allergy to the acrylic material, composite resin filling and/or a temporary restoration with an acrylic resin can be performed to confirm the effect of removing the metallic materials. For patients with an acrylic allergy, glass ionomer cement can be used as a temporary treatment. After the metal material has been removed, sometimes an almost immediate aggravation of the allergic symptoms is observed. This could potentially be due to the effect of metal dust that was swallowed,

Dental Metal Allergy 101

The combination of a composite resin for rebuilding and glass fiber has been used for an alternative to metal core rebuilding. Both a direct and indirect method can be used to

Type S glass fiber (10 µm in diameter) has a high physical property and is bundled up in matrix resin in order to make up the fibrous post used in the rebuilding. Components of the

Glass fibers that have a diameter of 14 µm are bundled lengthwise to create high density within the resin matrix. This material contains 58 vol% (77 wt%) of uniformed glass fiber.

This product contains 68% pre-silanated Zirconia-rich glass fibers within a composite

The progress in the field of ceramic materials has been quite remarkable as of late. Some of the all-ceramic restoration systems now on the market have a fine biostability and aesthetics that are suitable for use in treating metal allergy patients. With the development of computer-aided design and computer-aided manufacturing (CAD/CAM), all ceramics restorations with aluminous and zirconium coping have become the practical choice for esthetic prostheses (Fig. 12, 13). The zirconium ceramic systems in particular possess fine

Artglass (Heraeus Kulzer) 70 CERAMAGE (SHOFU) 73 GRADIA (GC) 75 ESTENIA C&B (Kuraray) 92 BelleGlass NG (Sybron Dental) 75 Targis (Ivoclar Vivadent) 77 Sculpture (Pentron) 78

Table 4. The official property of hybrid ceramics

fabricate the fibrous post using these materials.

5.5.2.2.2 FIBER POST (GC Corp.)

matrix.

5.5.2.2.3 CLEARFIL® FIBER POST (Kuraray)

5.5.2.2.4 FRC Postec (Ivoclar Vivadent)

**5.5.3 Ceramic materials** 

Premier® Integra Fiber Post (Premier Products Co.)

**5.5.2.2 Rebuilding materials for an abutment tooth** 

The following are materials that can be used for fibrous posts. 5.5.2.2.1 FiberKor Post system (Pentron Clinical Technologies)

fibrous post are glass fiber (42%), filler (29%) and matrix resin (29%).

**Name (Product) Filler content (wt%)** 

breathed in, or taken up by the oral mucosa during the removal procedure. In most cases, these symptoms are transient and the patient will recover within a couple of weeks. To avoid the possibility that a patient will develop such symptoms, all metal dust needs to be carefully excluded with oral evacuation equipment along with the adoption of the rubber dam dry field technique, whenever possible. In cases where allergy free metal materials are available, the final prosthesis using such metal material should be avoided until all allergy-positive metal materials have been removed. Additional metal restoration can increase the number of different metal elements in the oral cavity under certain circumstances, which may accelerate the elution of metallic ions from an allergy-positive metal element.
