Toxicological Risks of the Cobalt-Chromium Alloys in Dentistry: A Systematic Review. 2022

Brigitte Grosgogeat, and Alina Vaicelyte, and Rémy Gauthier, and Christine Janssen, and Marc Le Borgne
Laboratoire des Multimatériaux et des Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Univ Lyon, 69008 Lyon, France.

The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the CLP regulation (EC) 1972/2008. : The objective of this review is to conduct a rigorous analysis of the cytocompatibility of cobalt-chromium (Co-Cr) dental alloys. Considering various parameters such as cytotoxicity, type IV hypersensitivity reaction, sensitization, and irritation, we investigated evidence of toxicity of Co-Cr in human dental applications. : Specific search strategies were performed in three electronic databases, namely Medline, Embase, and Web of Science, using a main restriction in the search regarding the publication date (1995-2022). : Out of a total of 836 articles, only 21 studies were selected and analyzed according to PRISMA methodology. : Among them, 10 in vitro studies using human samples and 11 in vivo studies on human patients were distinguished. Most of the in vitro studies confirmed that Co-Cr alloys have a good cytocompatibility compared to Ni alloys. Regarding the in vivo studies, it appeared that Co-Cr could rarely cause sensitization, irritation, and allergic reactions. Reactions were mainly observed for people allergic to Co or Cr. Nevertheless, titanium-based materials showed better results. : This study proposes a new state of the art on Co-Cr dental alloys and will thus be very useful for carrying out additional studies. : This review will help practitioners in their daily clinical choice.

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