[Allergy diagnostics in suspected metal implant intolerance]

Allergy diagnostics may be requested before implantation or in cases of complications by implants. Preimplant allergy testing by patch test should only be done in patients with a reported history of potential allergies to metal or bone cement components and prophetic prophylactic testing should not be done. For baseline diagnostics of suspected implant allergy a patch test with the standard series (containing Ni, Co and Cr preparations) and with bone cement components and peri-implant histology should be performed after exclusion of frequent complication elicitors (in particular low grade infections). This can show a peri-implant T-lymphocyte dominated inflammation. Additional information on a scientific level is given by the lymphocyte transformation test (LTT) assessing metal sensitivity and by peri-implant molecular cytokine profiling giving the inflammatory pattern.