{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:33:59Z","timestamp":1784306039396,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003958","name":"Stichting voor de Technische Wetenschappen","doi-asserted-by":"publisher","award":["13382"],"award-info":[{"award-number":["13382"]}],"id":[{"id":"10.13039\/501100003958","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Titanium is being increasingly used. Although it is considered to be a non\u2010allergenic material, allergic reactions to it have been reported. Titanium dioxide has been found to be an unreliable patch test material. Few studies to date have profiled titanium allergy, and it therefore remains difficult to distinguish its manifestations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate alternatives for titanium dioxide as a patch test preparation, and to profile titanium reactions and manifestations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted with 458 patients who underwent patch testing with at least 1 of 5 different titanium salts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At least 1 positive result was noted in 5.7% of the patients. The frequency of positive results for the tested salts ranged from 0.9% to 7.9%. Titanium(IV) oxalate hydrate had the highest yield and titanium dioxide the lowest. Erythema, dermatitis and local swelling were the most common objective complaints. In 16 (61.5%) patients, the test result had partial or full clinical relevance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No titanium\u2010specific risk factors and clinical picture could be identified. Titanium dioxide is not adequately sensitive for identifying titanium allergy. The titanium salts seem to be possible superior patch test preparations, but appear to be unsuitable if used singly. The patient's medical history and clinical picture remain crucial in the diagnostic work\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.13010","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T02:50:11Z","timestamp":1527216611000},"page":"85-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["A retrospective study on titanium sensitivity: Patch test materials and manifestations"],"prefix":"10.1111","volume":"79","author":[{"given":"Niels P. J.","family":"de Graaf","sequence":"first","affiliation":[{"name":"Department of Dermatology VU University Medical Centre  Amsterdam The Netherlands"},{"name":"Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Feilzer","sequence":"additional","affiliation":[{"name":"Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees J.","family":"Kleverlaan","sequence":"additional","affiliation":[{"name":"Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty","family":"Bontkes","sequence":"additional","affiliation":[{"name":"Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Unit Medical Immunology, Department of Clinical Chemistry VU University Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3446-6138","authenticated-orcid":false,"given":"Sue","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Department of Dermatology VU University Medical Centre  Amsterdam The Netherlands"},{"name":"Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rustemeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology VU University Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v3.i1.52"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B0-08-043152-6\/01843-X"},{"key":"e_1_2_5_4_1","first-page":"28","article-title":"Titanium: the ultimate solution or an evolutionary step?","volume":"16","author":"Akagawa Y","year":"2003","journal-title":"Int J Prosthodont."},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11837-008-0031-1"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(98)90439-6"},{"issue":"1","key":"e_1_2_5_7_1","first-page":"31","article-title":"Hypersensitivity to titanium: clinical and laboratory evidence","volume":"27","author":"Muller K","year":"2006","journal-title":"Neuroendocrinol Lett."},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0501.2008.01544.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12565"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0000000000000091"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B1.1991768"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2006.00931.x"},{"key":"e_1_2_5_13_1","first-page":"691","article-title":"Revision of a tibial baseplate using a customized oxinium component in a case of suspected metal allergy. A case report","volume":"77","author":"Opstal N","year":"2011","journal-title":"Acta Orthop Belg."},{"key":"e_1_2_5_14_1","unstructured":"Chemotechnique Diagnostics. Titanium Patch Test Haptens [Internet].2017.https:\/\/www.chemotechnique.se\/products\/products\/"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12432"},{"key":"e_1_2_5_16_1","first-page":"113","volume-title":"Clinical Relevance of Patch Test Reactions. 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