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Downey (1992) reported a case of acute intermittent porphyria after placement of dental prostheses composed of 76% palladium, 2% gold and 10% copper (probably by weight). The symptoms observed in a 45-year-old woman (skin rashes, diarrhoea, metallic taste, short-term memory loss, swelling of feet and arms, signs of chronic fatigue syndrome and others) disappeared following removal of the restorations. Despite the high palladium content, it was concluded that copper was the inducing agent, because copper is known to induce porphyria. The possible role of palladium was not discussed.

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Only on the second day one may conduct morediligent preparation of clasp dental prosthesis.

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No clear clinical effects on oral mucosa were found in 72 patients who wore partial dentures of palladium-copper-indium alloys (Pd73, Cu14, In5) for a period of up to 48 months (Augthun & Spiekermann, 1994), although this alloy showed a relatively low corrosion resistance (see chapter 5). Fourteen patients reported a metallic taste or "battery feeling" in the mouth. Another study noted slight or moderate reactions of the mucosa adjacent to prostheses consisting of palladium-type alloys in less than 20% of the 39 patients examined (Mjör & Christensen, 1993).

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There is a report (Daunderer, 1994) on a dental patient showing a palladium concentration of 1.8 µg/litre in saliva and of 357 µg/kg in a tooth (no further details given). Another patient had palladium concentrations of 0.9 and 1.2 µg/litre in saliva and serum, respectively (Daunderer, 1993). A palladium concentration of 3400 µg/kg has been reported in a bladder papilloma sectioned from a patient with palladium-containing dental prostheses (Daunderer, 1993). No further details were given.

It isobserved on a fixing day of clasp dental prosthesis in the patient mouth.

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Occasional breakage is inevitable due to various mishaps that may befallthe prosthesis, thereby causing loss of retention, instability and discomfortto the patient.

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It is known that clasp dental prostheses, held on teeth, which arenot covered by artificial crowns, require careful hygienic examination toprevent teeth from caries in areas of base attachment from the proximal side ofthe tooth.

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Scrapped automobile catalysts contributed 5.4 tonnes to the world palladium demand of 72 tonnes in the automotive sector in 1998 (Cowley, 1999). According to Cowley (1999), 5.12 tonnes of palladium were recovered from old automobile catalysts in North America and Japan in 1998. The ultimate fate of many automobile catalysts may be disposal in waste dumps. Recycling methods comprise pyrometallurgical refining techniques that are similar to those described previously in section 3.2.1.1 (e.g., Degussa, 1997). The quantities recovered from scrapped electrical components (electrical contacts) are larger, but again no figures exist (Cowley, 1997). It is expected that some of the utilized palladium ends up in wastes or incineration ashes. It can also be expected that dental alloys are completely recycled if dental prostheses have to be replaced.

Only on thesecond day one may conduct more diligent preparation of clasp dentalprosthesis.

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Vitsentzos SJ, Vlahogiannis E, Glaros D, & Vlahomitros J (1988) The effect of fixed partial dentures made of silver-palladium alloy on serum immunoglobulins IgA, IgG and IgM. J Prosthet Dent, 59: 587-589.

It is observed on a fixing day of clasp dental prosthesis in thepatient mouth.

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At the end of the course the student should know the techniques to restore functional morphology of the masticatory system through removable partial dentures and complete dentures. It also needs to know prosthetic techniques applied to the fixed prosthesis.

Downey D (1992) Porphyria induced by palladium-copper dental prostheses: a clinical report. J Prosthet Dent, 67: 5-6.

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The fit, functionand esthetics of the partial denture should be sufficient to warrant arestoration of the clasp assembly rather than fabricating a new prosthesis.1