Titanium Ions Released from Oral Casting Alloys May Contribute to the Symptom of Burning Mouth Syndrome

Purpose: Many metal ions released from dental casting alloys have been reported to influence the intraoral symptoms of oral lichen planus (OLP) and burning mouth syndrome (BMS). The aim of this study was to investigate the relationship between salivary metal ion levels and the prosthetic duration as well as to evaluate the time-dependent morbid effects of metal ions in OLP and BMS patients. Methods: Three study groups consist of the following subjects respectively: 17 OLP patients, 12 BMS patients, and 12 patients without oral symptoms. The salivary concentrations of 13 metal ions (copper, cobalt, zinc, chromium, nickel, aluminum, silver, iron, titanium [Ti], platinum, tin, palladium, and gold) were measured by Laser Ablation Microprobe Inductively coupled Plasma Mass Spectrometry. Results: The Ti ions had statistically significant differences among the groups with a prosthetic duration of less than 5 years. There were no significant differences between all ion levels among the groups wearing dental cast alloys for over 5 years. In the BMS group, the level of Ti ions in patients with prosthetic restorations less than 5 years old were significantly high (p<0.05). Conclusions: In the BMS group, 3-60 months during which salivary Ti levels were higher were matched with the duration of burning symptoms ($15.6{\pm}17.1months$). Furthermore, Ti ions were statistically high in the oral cavity of BMS patients fitted with dental casting alloys for 5 years. These results suggest that Ti ions released from dental implants and oral prostheses could attribute to burning sensation of BMS.