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Sayuri Cardoso Ohashi A, Reis de Souza Schacher H, Staub Pizzato C, Ryff Moreira Roca Vianna M, Macedo de Menezes L. Embryotoxicity and teratogenesis of orthodontic acrylic resin in zebrafish. Heliyon 2024; 10:e32067. [PMID: 38952375 PMCID: PMC11215258 DOI: 10.1016/j.heliyon.2024.e32067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 05/09/2024] [Accepted: 05/28/2024] [Indexed: 07/03/2024] Open
Abstract
Objectives This study investigated the in vivo embryotoxicity, teratogenic potential, and additional effects of orthodontic acrylic resin as well as its components, utilizing zebrafish as a model organism. The research focused on morphological, cardiac, behavioral, and cognitive evaluations that were performed on embryos and larval-stage animals subjected to chronic exposure. Materials and methods Embryo and larval-stage zebrafish were categorized into five experimental groups, which were further subdivided into five subgroups. These subgroups included three specific doses for each tested substance, a control with the vehicle (0.1 % dimethyl sulfoxide in water), and an absolute control (water). Assessments were performed on day 5 post-fertilization, which included morphological, cardiac, behavioral, and cognitive evaluations. All experiments had a sample size of ten animals and were performed in triplicate. Survival and hatching rates were analyzed using the Kaplan-Meier test, while other measurements were assessed using one-way analysis of variance (ANOVA), followed by the Tukey post hoc test. Results Statistically significant differences were observed between the control and treatment groups across all the tested substances for heart rate, cognitive responsiveness, and cellular apoptosis. However, survival, hatching rate, and other parameters exhibited no significant variation, except for the highest dose in the dibutyl phthalate group, which demonstrated a notable difference in survival. Conclusions Chronic exposure to acrylic resin and its components may be associated with decreased cognitive ability and cardiac rhythm, as well as an increase in the level of cellular apoptosis in zebrafish.
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Affiliation(s)
- Amanda Sayuri Cardoso Ohashi
- Dental Program, School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Helena Reis de Souza Schacher
- Dental Program, School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christiane Staub Pizzato
- ZebLab & Laboratory of Biology and Development of the Nervous System, School of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Monica Ryff Moreira Roca Vianna
- ZebLab & Laboratory of Biology and Development of the Nervous System, School of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciane Macedo de Menezes
- Dental Program, School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Forkel S, Schubert S, Corvin L, Heine G, Lang CCV, Oppel E, Pföhler C, Treudler R, Bauer A, Sulk M, Kränke B, Schäkel K, Heratizadeh A, Worm M, Witte J, Geier J, Buhl T. Contact allergies to dental materials in patients. Br J Dermatol 2024; 190:895-903. [PMID: 38123140 DOI: 10.1093/bjd/ljad525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/09/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy. OBJECTIVES To analyse current sensitization patterns to dental materials in patients with suspected contact allergy. METHODS This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected participants from 169 834 people tested in 2005-2019 and registered with (i) an affected area of 'mouth' (and 'lips'/'perioral'), (ii) with the dental material in question belonging to one of three groups (dental filling materials, oral implants or dentures or equivalents) and (iii) with patch-testing done in parallel with the German baseline series, (dental) metal series and dental technician series. RESULTS A total of 2730 of 169 834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) aged ≥ 40 years (92.8%). The sensitization rates with confirmed allergic contact stomatitis in women (n = 444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates [2-hydroxyethyl methacrylate (HEMA) 4.8%] and the substances propolis (6.8%) and 'balsam of Peru' (11.4%). The most relevant acrylates were HEMA, 2-hydroxypropyl methacrylate, methyl methacrylate, ethylene glycol dimethacrylate and pentaerythritol triacrylate. Few men were diagnosed with allergic contact stomatitis (n = 68); sensitization rates in men were highest for propolis (14.9%) and amalgam (13.6%). CONCLUSIONS Allergic contact stomatitis to dental materials is rare. Patch testing should not only focus on metals such as nickel, palladium, amalgam and gold, but also (meth)acrylates and the natural substances propolis and 'balsam of Peru'.
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Affiliation(s)
- Susann Forkel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology, Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Lisa Corvin
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Guido Heine
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claudia C V Lang
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Eva Oppel
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical School, Homburg, Germany
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology, University Medical Center, Leipzig, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Mathias Sulk
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Birger Kränke
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Knut Schäkel
- Department of Dermatology, Ruprecht Karls University, Heidelberg, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Witte
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology, Institute at the University Medical Center Göttingen, Göttingen, Germany
- Lower Saxony Institute of Occupational Dermatology, University of Göttingen, Göttingen, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
- Lower Saxony Institute of Occupational Dermatology, University of Göttingen, Göttingen, Germany
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Cieplik F, Hiller KA, Scholz KJ, Schmalz G, Buchalla W, Mittermüller P. General diseases and medications in 687 patients reporting on adverse effects from dental materials. Clin Oral Investig 2023; 27:4447-4457. [PMID: 37212840 PMCID: PMC10415419 DOI: 10.1007/s00784-023-05064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Examination of patients claiming adverse effects from dental materials can be very challenging. Particularly, systemic aspects must be considered besides dental and orofacial diseases and allergies. Therefore, the aim of this study was to investigate a cohort of 687 patients reporting on adverse effects from dental materials focusing on findings related to known general diseases or conditions or medication-related findings with relevance to their subjective complaints. METHODS Six hundred eighty-seven patients visiting a specialized consultation on claimed adverse effects from dental materials were retrospectively investigated for their subjective complaints, findings related to known general diseases or conditions, medication-related findings, dental and orofacial findings, or allergies with relevance to their subjective complaints. RESULTS The most frequent subjective complaints were burning mouth (44.1%), taste disorders (28.5%), and dry mouth (23.7%). In 58.4% of the patients, dental and orofacial findings relevant to their complaints could be found. Findings related to known general diseases or conditions or medication-related findings were found in 28.7% or 21.0% of the patients, respectively. Regarding medications, findings related to antihypertensives (10.0%) and psychotropic drugs (5.7%) were found most frequently. Relevant diagnosed allergies toward dental materials were found in 11.9%, hyposalivation in 9.6% of the patients. In 15.1% of the patients, no objectifiable causes for the expressed complaints could be found. CONCLUSIONS For patients complaining of adverse effects from dental materials, findings related to known general diseases or conditions and medications should be given particular consideration, while still in some patients, no objectifiable causes for their complaints can be found. CLINICAL RELEVANCE For patients complaining about adverse effects from dental materials, specialized consultations and close collaboration with experts from other medical fields are eligible.
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Affiliation(s)
- Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Pauline Mittermüller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Hatton PV, Mulligan S, Martin N. The safety and biocompatibility of direct aesthetic restorative materials. Br Dent J 2022; 232:611-614. [PMID: 35562452 DOI: 10.1038/s41415-022-4198-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022]
Abstract
Restorative dental materials are among the most important medical devices in terms of the numbers of patients who benefit and the technical sophistication of the products. Many though contain toxic or noxious substances, including potentially sensitising resin monomers, photoinitiators, acidic polymers and glass or ceramic filler particles. Despite this, dental materials are among the safest medical devices in use today, with very few reports of adverse reactions or injuries among both patients or the dental team. This paper considers the potential for adverse reactions to dental materials, current evidence for harm and finally examines the reasons why in real-world clinical use the likelihood of an adverse event is extremely low. Medical devices regulations, responsible manufacture and clinical vigilance all appear to play important roles in ensuring that dental materials do not cause or present a risk to patients. While this excellent in-practice safety record is welcome, there is now increasing interest in the 'macro' scale biocompatibility of dental materials and their packaging in the environment, subjects that have been relatively neglected until recently. It was concluded that this should be a priority for future research and development and support is needed from governments alongside the manufacturing industry and the profession.
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Affiliation(s)
- Paul V Hatton
- School of Clinical Dentistry, The University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK.
| | - Steven Mulligan
- School of Clinical Dentistry, The University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK
| | - Nicolas Martin
- School of Clinical Dentistry, The University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK
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Fletcher R, Harrison W, Crighton A. Dental material allergies and oral soft tissue reactions. Br Dent J 2022; 232:620-625. [PMID: 35562454 DOI: 10.1038/s41415-022-4195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022]
Abstract
Dental materials can cause reactions to the oral mucosa and present to the general dental practitioner. These are often referred to as 'allergies' but are frequently lichenoid reactions. Most of these are related to dental amalgam restorations and can be remedied by replacing the restoration with another suitable material. Other metals, including gold, palladium, nickel and chrome, have also been reported to trigger mucosal changes. Less commonly, issues arise from other restorative materials, including denture acrylics, composites and glass polyalkenoates. Reactions are also reported due to endodontic and sealing materials. It is unclear what role skin 'patch' testing has in managing dental material allergies. This article aims to give the practitioner a clearer picture of dental material allergy issues and how they should be approached in primary dental practice.
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Affiliation(s)
- Rosie Fletcher
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK
| | - William Harrison
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK
| | - Alexander Crighton
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK.
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Campana F, Lan R, Girard C, Rochefort J, Le Pelletier F, Leroux-Villet C, Mares S, Millot S, Zlowodzki AS, Sibaud V, Tessier MH, Vaillant L, Fricain JC, Samimi M. French guidelines for the management of oral lichen planus (excluding pharmacological therapy). Ann Dermatol Venereol 2022; 149:14-27. [PMID: 34238586 DOI: 10.1016/j.annder.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific guidelines in France. Our objective was to develop French multidisciplinary guidelines for the management of oral lichen. MATERIALS AND METHODS Working groups from the Groupe d'Etude de la Muqueuse Buccale (GEMUB) formulated a list of research questions and the corresponding recommendations according to the "formal consensus" method for developing practice guidelines. These recommendations were submitted to a group of experts and the degree of agreement for each recommendation was assessed by a scoring group. RESULTS Twenty-two research questions, divided into 3 themes (nosological classification and initial assessment, induced oral lichenoid lesions, and follow-up) resulted in 22 recommendations. Initial biopsy for histology is recommended in the absence of reticulated lesions. Biopsy for direct immunofluorescence is recommended for ulcerated, erosive, bullous types and for diffuse erythematous gingivitis. Management should include a periodontal and dental check-up, and investigation for extra-oral lesions. Hepatitis C testing is recommended only if risk factors are present. Definitions, triggering factors and the management of "induced oral lichenoid lesions" were clarified. Oral lichen must be monitored by a practitioner familiar with the disease at least once a year, using objective tools. CONCLUSION This formalised consensus of multidisciplinary experts provides clinical practice guidelines on the management and monitoring of oral lichen.
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Affiliation(s)
- F Campana
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - R Lan
- Aix Marseille Univ, APHM, CNRS, EFS, ADES, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - C Girard
- Dermatologie, CHU de Montpellier, 34295 Montpellier cedex, France
| | - J Rochefort
- Odontologie, Hôpital La Pitié Salpetrière - Université Paris Diderot, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - F Le Pelletier
- Anatomie Pathologique, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - C Leroux-Villet
- Dermatologie, Hôpital Avicenne, 125 Rue de Stalingrad, 93000 Bobigny, France
| | - S Mares
- Chirurgie Maxillo-faciale, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Millot
- Chirurgie Orale, CHU de Montpellier, 34295 Montpellier cedex, France
| | | | - V Sibaud
- Dermatologie, IUCT Oncopôle, 31000 Toulouse, France
| | - M-H Tessier
- Dermatologie, CHU de Nantes, 44000 Nantes, France
| | - L Vaillant
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France
| | - J-C Fricain
- Université de Bordeaux, INSERM U1026, service de chirurgie orale, CHU Bordeaux, 33000 Bordeaux, France
| | - M Samimi
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France.
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Hosseinpour S, Gaudin A, Peters OA. A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials. Int Endod J 2022; 55 Suppl 2:346-369. [PMID: 35124840 PMCID: PMC9315036 DOI: 10.1111/iej.13701] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.
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Affiliation(s)
- S Hosseinpour
- School of Dentistry The University of Queensland Herston QLD Australia
| | - A Gaudin
- Inserm UMR 1229 RMeS, Regenerative Medicine and Skeleton Université de Nantes ONIRIS Nantes France
- Université de Nantes UFR Odontologie Nantes France
| | - O A Peters
- School of Dentistry The University of Queensland Herston QLD Australia
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Non-allergy-related dental and orofacial findings in 625 patients reporting on adverse effects from dental materials. Dent Mater 2021; 37:1402-1415. [PMID: 34218932 DOI: 10.1016/j.dental.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/19/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In a cohort of 500 patients complaining about adverse effects from dental materials, allergies were found to be contributing to the patients' subjective complaints in only about 14% of the cases. Therefore, the aim of this retrospective study was to investigate an enlarged cohort of 625 patients reporting on adverse effects from dental materials on non-allergy-related dental or orofacial findings with relevance for their subjective complaints. METHODS 625 patients visiting a specialized consultation on suspected adverse effects from dental materials were characterized regarding age and sex distribution, subjective complaints, allergies, and dental and orofacial findings with relevance for their subjective complaints. RESULTS This cohort comprised about 81% females and the median age was 58 years. The most often reported subjective complaints were burning mouth (43.8%), taste disorders (28.8%) and dry mouth (22.7%). Allergies toward dental materials were found in 12.3%. In 28.0% of the patients, no dental or orofacial findings with relevance for the subjective complaints expressed by the patients could be found. 19.8% of the patients exhibited relevant functional symptoms, 16.2% relevant orofacial diseases, 15.2% relevant mechanical irritations, 10.1% or 9.4% relevant tooth-related or plaque-related symptoms, respectively, 9.4% hyposalivation, and in 7.2% relevant manufacturing faults were found. SIGNIFICANCE In patients complaining about adverse effects from dental materials, a wide variety of dental or orofacial findings need to be considered despite allergies, although a quarter of the patients did not present any relevant dental or orofacial finding. Therefore, specialized consultations and close collaboration with experts from other fields are eligible.
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Bapat RA, Parolia A, Chaubal T, Dharamadhikari S, Abdulla AM, Sakkir N, Arora S, Bapat P, Sindi AM, Kesharwani P. Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry. Biomater Sci 2021; 9:3244-3283. [PMID: 33949464 DOI: 10.1039/d1bm00233c] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Dental treatment is provided for a wide variety of oral health problems like dental caries, periodontal diseases, periapical infections, replacement of missing teeth and orthodontic problems. Various biomaterials, like composite resins, amalgam, glass ionomer cement, acrylic resins, metal alloys, impression materials, bone grafts, membranes, local anaesthetics, etc., are used for dental applications. The physical and chemical characteristics of these materials influence the outcome of dental treatment. It also impacts on the biological, allergic and toxic potential of biomaterials. With innovations in science and their positive results, there is also a need for awareness about the biological risks of these biomaterials. The aim of dental treatment is to have effective, yet safe, and long-lasting results for the benefit of patients. For this, it is important to have a thorough understanding of biomaterials and their effects on local and systemic health. Materials used in dentistry undergo a series of analyses before their oral applications. To the best of our knowledge, this is the first and original review that discusses the reasons for and studies on the toxicity of commonly used biomaterials for applications in dentistry. It will help clinicians to formulate a methodical approach for the selection of dental biomaterials, thus providing an awareness for forecasting their risk of toxic reactions.
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Affiliation(s)
- Ranjeet Ajit Bapat
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Abhishek Parolia
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Tanay Chaubal
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Anshad Mohamed Abdulla
- Faculty, Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nasil Sakkir
- Registrar Endodontist, Central Security Hospital, Abha, Kingdom of Saudi Arabia
| | - Suraj Arora
- Faculty, Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Prachi Bapat
- Dentist, Modern Dental College, Indore 453112, Madhya Pradesh, India
| | - Amal M Sindi
- Faculty, Oral Diagnostic Sciences Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Prashant Kesharwani
- Faculty, Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
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Shahi S, Özcan M, Maleki Dizaj S, Sharifi S, Al-Haj Husain N, Eftekhari A, Ahmadian E. A review on potential toxicity of dental material and screening their biocompatibility. Toxicol Mech Methods 2019; 29:368-377. [PMID: 30642212 DOI: 10.1080/15376516.2019.1566424] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES A wide range of compounds are utilized in dentistry such as dental composites, resins, and implants. The successful clinical use of dental materials relies on theirm physiochemical properties as well as biological and toxicological reliability. Different local and systemic toxicities of dental materials have been reported. Placement of these materials in oral cavity for a long time period might yield unwanted reactions. An extensive variety of materials is used in dentistry including filling materials, restorative materials, intracanal medicines, prosthetic materials, different types of implants, liners, and irrigants. The increasing rate in development of the novel materials with applications in the dental field has led to an increased consciousness of the biological risks and tempting restrictions of these materials. The biocompatibility of a biomaterial used for the replacement or filling of biological tissue such as teeth always had a high concern within the health care disciplines for patients. MATERIALS AND METHODS Any material used in humans should be tested before clinical application. There are many tests evaluating biocompatibility of these materials at the point of in vitro, in vivo, and clinical investigations. RESULTS The current review discusses the potential toxicity of dental material and screening of their biocompatibility. CLINICAL RELEVANCE It is essential to use healthy and safe materials medical approaches. In dentistry, application of different materials in long-term oral usage demands low or nontoxic agents gains importance for both patients and the staff. Furthermore, screening tests should evaluate any potential toxicity before clinical application.
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Affiliation(s)
- Shahriar Shahi
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mutlu Özcan
- b Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science , University of Zürich , Zurich , Switzerland
| | - Solmaz Maleki Dizaj
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Simin Sharifi
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Nadin Al-Haj Husain
- c Specialization Candidate, Department of Reconstructive Dentistry and Gerodontology , School of Dental Medicine, University of Bern , Bern , Switzerland
| | - Aziz Eftekhari
- d Pharmacology and Toxicology Department , Maragheh University of Medical Sciences , Maragheh , Iran
| | - Elham Ahmadian
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,e Students' Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
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Mittermüller P, Hiller KA, Schmalz G, Buchalla W. Five hundred patients reporting on adverse effects from dental materials: Frequencies, complaints, symptoms, allergies. Dent Mater 2018; 34:1756-1768. [PMID: 30360901 DOI: 10.1016/j.dental.2018.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Information on patients with real or claimed adverse reactions towards dental materials in large patient cohorts is rare. Therefore, the aim of the present study was to investigate patients reporting on complaints and symptoms to dental materials over a 16-year period. METHODS Five hundred patients were characterized by one single dental team regarding age and sex distribution, subjective complaints and objective intraoral symptoms, and allergy status relevant to dental materials. RESULTS Elder patients and females predominated. Subjective complaints were reported by 490 patients, ranging from 1 to 12 complaints per patient. Most often, burning mouth (44%), tooth-/jawache (22%) and dry mouth (20%) were reported. In 54% no objective intraoral symptom was diagnosed. The main objective intraoral symptoms were tongue anomalies (lingua plicata or geographica; 14%), gingivitis adjacent to restorations (12%), redness of the palate or the edentulous ridge (7%), oral lichen planus (6%), grayish discolorations, lichenoid contact lesions, and leukoplakia (<5%). Patch testing of 416 (83%) patients revealed that allergy was diagnosed as contributing to the complaints or symptoms in 70 (14%) patients with metals being the most frequent allergens. Gingivitis adjacent to restorations (3.2%), redness of the palate or edentulous ridge (1.4%) and whitish lichen-like lesions (1.8%) were associated to allergy from dental materials. SIGNIFICANCE The high number of subjective complaints per patient and their wide variety suggests that most patients seriously suffered. Furthermore, the fact that only 46% of the patients had objective intraoral symptoms demands for an interdisciplinary collaboration to elucidate other than dental causes.
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Affiliation(s)
- Pauline Mittermüller
- University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany
| | - Karl-Anton Hiller
- University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany.
| | - Gottfried Schmalz
- University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany; University of Bern, Department of Preventive, Restorative and Pediatric Dentistry, Bern, Switzerland
| | - Wolfgang Buchalla
- University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany
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Heratizadeh A, Werfel T, Schubert S, Geier J. Contact sensitization in dental technicians with occupational contact dermatitis. Data of the Information Network of Departments of Dermatology (IVDK) 2001-2015. Contact Dermatitis 2018; 78:266-273. [DOI: 10.1111/cod.12943] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy; Hannover Medical School; 30625 Hannover Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy; Hannover Medical School; 30625 Hannover Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology; University Medical Centre Göttingen; 37075 Göttingen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology; University Medical Centre Göttingen; 37075 Göttingen Germany
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Bailey E, Tickle M, Campbell S, O'Malley L. Systematic review of patient safety interventions in dentistry. BMC Oral Health 2015; 15:152. [PMID: 26613736 PMCID: PMC4662809 DOI: 10.1186/s12903-015-0136-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 11/11/2015] [Indexed: 11/11/2022] Open
Abstract
Background The concept of patient safety in dentistry is in its infancy, with little knowledge about the effectiveness of tools or interventions developed to improve patient safety or to minimise the occurrence of adverse events. Methods The aim of this qualitative systematic review was to search the academic and grey literature to identify and assess tools or interventions used in dental care settings to maintain or improve patient safety. All study designs were included from all dental care settings. Outcome measures were: patient safety, harm prevention, risk minimization, patient satisfaction and patient acceptability, professional acceptability, efficacy, cost-effectiveness and efficiency. Quality assessments were performed on the included studies based on CASP tools. Further analysis was undertaken to discover whether any of the tools had been trialled or verified by the authors, or by subsequent authors. Results Following abstract screening, and initial qualitative synthesis, nine studies were found to meet the inclusion criteria with 31 being excluded following initial analysis. Tools identified included: checklists (4 studies), reporting systems (3), the use of electronic notes (1) and trigger tools (1). Grey literature searching did not identify any further appropriate studies. In terms of study design, there were observational studies including audit cycles (5 studies), epidemiological studies (3) and prospective cluster randomised clinical trials (1). The quality of the studies varied and none of their outcomes were verified by other researchers. The tools identified have the potential to be used for measuring and improving patient safety in dentistry, with two surgical safety checklists demonstrating a reduction in erroneous dental extractions to nil following their introduction. Reporting systems provide epidemiological data, however, it is not known whether they lead to any improvement in patient safety. The one study on trigger tools demonstrates a 50 % positive predictive value for safety incidents. It is not clear as to what impact the introduction of electronic guidelines has on patient safety outcomes. Conclusions This systematic review finds that the only interventions in dentistry that reduce or minimise adverse events are surgical safety checklists. We believe this to be the first systematic review in this field; it demonstrates the need for further research into patient safety in dentistry across several domains: epidemiological, conceptual understanding and patient and practitioner involvement. Electronic supplementary material The online version of this article (doi:10.1186/s12903-015-0136-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Edmund Bailey
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health - Centre for Primary Care, University of Manchester, 7th Floor: Williamson Building, Manchester, M13 9PL, UK.
| | - Martin Tickle
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health - Centre for Primary Care, University of Manchester, 7th Floor: Williamson Building, Manchester, M13 9PL, UK.
| | - Stephen Campbell
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health - Centre for Primary Care, University of Manchester, 7th Floor: Williamson Building, Manchester, M13 9PL, UK.
| | - Lucy O'Malley
- School of Dentistry, University of Manchester, J R Moore Building, Oxford Road, Manchester, M13 9PL, UK.
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Abstract
This study evaluated the biocompatibility of contemporary bulk-fill resin-based composites (RBCs) including PRG (pre-reacted glass ionomer) materials based on the International Organization for Standardization 10993. In addition, the effect of composite thickness on cytotoxicity was also assessed. Two standard composites, two bulk-fill PRG RBCs, and three bulk-fill non-PRG RBCs were investigated. Block-shaped specimens of 2-mm and 4-mm thickness were cured with an irradiance of 700 mW/cm(2) for 20 seconds with a light-emitting diode curing light and eluted with culture medium at 37°C for 24 hours. L929 mouse fibroblasts were exposed to extracts at varying dilutions (1:1, 1:2, and 1:10) for 24 hours. Analyses were performed to assess cytotoxicity, phase contrast microscopy, and quantitative cell viability. Among the bulk-fill RBCs, extracts of PRG materials resulted in the lowest cell viability. At 4-mm thickness, undiluted extracts of bulk-fill non-PRG RBCs had significantly higher cell viability than the standard composites. Chemical composition, specimen thickness, and testing concentrations of extracts had significant effects on cell viability and morphology. Cytotoxic effects of composites on cell viability were parallel with cell morphologic changes. Not all bulk-fill RBCs demonstrated high cell viability (>70%) at 4-mm thickness despite manufacturers' recommendations of bulk placement and curing.
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Mallineni SK, Nuvvula S, Matinlinna JP, Yiu CK, King NM. Biocompatibility of various dental materials in contemporary dentistry: a narrative insight. ACTA ACUST UNITED AC 2012; 4:9-19. [PMID: 23255468 DOI: 10.1111/j.2041-1626.2012.00140.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 03/08/2012] [Indexed: 11/27/2022]
Abstract
In the past few decades, there has been an increase in demand for safety evaluation and control of dental materials used daily in dentistry; however, this task is difficult and cumbersome. Dental materials that are passive and do not react with the oral environment will be more stable and have superior durability. It is expected that dental materials will be universally accepted and will not cause harm or injury to the surrounding structures in the oral cavity. This is an entirely negative approach to the material tolerance and biocompatibility, and hides the possibility that some positive gains can be achieved. Side-effects of dental materials are believed to be rare, and generally, those that have been reported are mild. There are wide varieties of materials used in dentistry, which include liners, irrigants, intracanal filling materials, intracanal medicaments, prosthetic materials, restorative materials, subgingival implants, and mouth rinses. Therefore, in this study, the biocompatibility of various commonly-used clinical materials used in contemporary dentistry was discussed.
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Affiliation(s)
- Sreekanth K Mallineni
- Department of Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong.
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16
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Lim HP, Lee KM, Koh YI, Park SW. Allergic contact stomatitis caused by a titanium nitride-coated implant abutment: A clinical report. J Prosthet Dent 2012; 108:209-13. [DOI: 10.1016/s0022-3913(12)60163-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Oral Diseases (2012) Lichen planus (LP) is a common disorder affecting the oral cavity (OLP) and skin. Despite intensive research, LP/OLP etiology and treatment remain controversial. We investigated four controversial topics: (i) Is hepatitis C virus (HCV) infection associated with LP and involved in its pathogenesis? (ii) Should all patients with LP be screened for HCV? (iii) Should patients with OLP have all their amalgam restorations removed? (iv) Are there any new treatments for OLP? Results from extensive literature searches suggested that: (i) Robust evidence from three meta-analyses indicate that HCV is associated with LP and might be involved in OLP pathogenesis (ii) It would be prudent to screen patients with LP/OLP at significant risk with an ELISA for HCV antibodies using country-specific screening strategies (iii) There is no evidence that either OLP or oral lichenoid lesions patients would routinely benefit from having all their amalgam restorations replaced. Weak evidence from potentially very biased, small, non-randomized, unblinded studies suggests that a small fraction of patients may benefit from targeted amalgam replacement. (iv) There is weak evidence that, among new OLP treatments, topical pimecrolimus, aloe vera, and oral curcuminoids may be useful. The development of specific formulations for oral delivery of topical medications is a promising field.
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Affiliation(s)
- L Baccaglini
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE, USA Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand Department of Oral Medicine, Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
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Johnson A, Shiraishi T, Hurrell-Gillingham K. In vitro biocompatibility of novel Au-Pt-based metal-ceramic alloys. J Oral Sci 2011; 53:387-91. [PMID: 21959668 DOI: 10.2334/josnusd.53.387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this research was to evaluate the effect of individual metallic elements within experimental Au-Pt-based metal-ceramic alloys on in vitro biocompatibility. A binary Au-10 at.% Pt alloy (AP10) was designed as a parent alloy. Six ternary AP10-X (X = In/Fe/Sn/Zn) alloys and four quaternary (AP10-In2)-Y (Y = Fe/Sn/Zn) with different compositions were cast into square plates with size 10X10X0.5 mm(3) and subjected to porcelain-firing thermal cycling. A commercial alloy was used as a control. In vitro biocompatibility was investigated using L929 murine aneuploid fibrosarcoma cell line. The test samples and cells were incubated at 37°C in a 5% CO(2) atmosphere for 72 h. Alamar™ Blue Assay was carried out to determine the respiratory viability of cultures maintained in the presence of the different materials. The cell only control showed significantly higher levels of cell viability than all six of the ternary alloys and two of the four quaternary alloys, (AP10-In2)-Zn2.1 and (AP10-In2)-Sn1.0 (P < 0.05). The quaternary alloys showed slightly higher levels of cell viability than the ternary alloys, with the exception of AP10-Sn0.9. No statistical differences were seen between the ternary and quaternary alloy groups. Acceptable cell viability was observed on the surfaces of all the alloys.
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Affiliation(s)
- Anthony Johnson
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK.
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Johnson A, Shiraishi T, Al-Salehi SK. Ion release from experimental Au–Pt-based metal–ceramic alloys. Dent Mater 2010; 26:682-7. [DOI: 10.1016/j.dental.2010.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 11/06/2009] [Accepted: 03/08/2010] [Indexed: 12/01/2022]
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Jones SB, Taylor RL, Colligon JS, Johnson D. Effect of element concentration on nickel release from dental alloys using a novel ion beam method. Dent Mater 2010; 26:249-56. [DOI: 10.1016/j.dental.2009.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 10/20/2009] [Accepted: 11/05/2009] [Indexed: 10/20/2022]
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Abstract
Oral and mucosal adverse reactions to resin-based dental materials have been reported. Numerous studies have examined the biocompatibility of restorative dental materials and their components, and a wide range of test systems for the evaluation of the biological effects of these materials have been developed. This article reviews the biological aspects of resin-based dental materials and discusses the conventional as well as the new techniques used for biocompatibility assessment of dental materials.
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Moharamzadeh K, Brook IM, Scutt AM, Thornhill MH, Van Noort R. Mucotoxicity of dental composite resins on a tissue-engineered human oral mucosal model. J Dent 2008; 36:331-6. [DOI: 10.1016/j.jdent.2008.01.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 01/26/2008] [Accepted: 01/28/2008] [Indexed: 01/09/2023] Open
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23
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Al-Salehi SK, Hatton PV, Johnson A, Cox AG, McLeod C. The effect of hydrogen peroxide concentration on metal ion release from dental casting alloys. J Oral Rehabil 2008; 35:276-82. [PMID: 18321263 DOI: 10.1111/j.1365-2842.2007.01793.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There are concerns that tooth bleaching agents may adversely affect dental materials. The aim of this study was to test the hypothesis that increasing concentrations of hydrogen peroxide (HP) are more effective than water at increasing metal ion release from two typical dental casting alloys during bleaching. Discs (n = 28 for each alloy) were prepared by casting and heat treated to simulate a typical porcelain-firing cycle. Discs (n = 7) of each alloy were immersed in either 0%, 3%, 10% or 30% (w/v) HP solutions for 24 h at 37 degrees C. Samples were taken for metal ion release determination using inductively coupled plasma-mass spectrometry and the data analysed using a two-way anova followed by a one-way anova. The surface roughness of each disc was measured using a Talysurf contact profilometer before and after bleaching and the data analysed using a paired t-test. With the exception of gold, the differences in metal ion concentration after treatment with 0% (control) and each of 3%, 10% and 30% HP (w/v) were statistically significant (P < 0.05). Metal ion release from the two alloys increased with increasing HP concentrations (over 3000% increase in Ni and 1400% increase in Pd ions were recorded when HP concentration increased from 0% to 30%). Surface roughness values of the samples before and after bleaching were not significantly different (P > 0.05) Exposure of the two dental casting alloys to HP solutions increased metal ion release of all the elements except gold.
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Affiliation(s)
- S K Al-Salehi
- Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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Schedle A, Ortengren U, Eidler N, Gabauer M, Hensten A. Do adverse effects of dental materials exist? What are the consequences, and how can they be diagnosed and treated? Clin Oral Implants Res 2007; 18 Suppl 3:232-56. [PMID: 17594385 DOI: 10.1111/j.1600-0501.2007.01481.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES All dental biomaterials release substances into the oral environment to a varying degree. Various preclinical biocompatibility test systems have been introduced, aiming at an evaluation of the potential risks of dental materials. Potential pathogenic effects of released substances from dental materials have been demonstrated. For the biocompatibility of a biomaterial, it is not only important that minimal diffusable substances are released when it is in body contact--the material must also fulfill the function for which it has been designed. This is also very much dependent on the material properties and its handling properties. The aim of this review was to generate an overview of the present status concerning adverse reactions among patients and personnel. MATERIALS AND METHODS A systematic review was performed using a defined search strategy in order to evaluate all MEDLINE-literature published between 1996 and 2006. RESULTS The compilation of the literature available has revealed that the majority of studies have been carried out on patients compared with personnel. Adverse reactions towards dental materials do occur, but the prevalence and incidence are difficult to obtain. The results were essentially based on cohort studies. Clinical trials, especially randomized-controlled trials, are in the minority of all studies investigated, with the exception of composite and bonding studies, where clinical trials, but not randomized-controlled trials, represent the majority of studies. Patients and personnel were treated separately in the manuscript. Amalgam studies show the lowest degree of verified material-related diagnosis. Even if objective symptoms related to adverse reactions with polymer resin-based materials have been reported, postoperative sensitivity dominates reports concerning composites/bondings. Verified occupational effects among dental personnel show a low frequency of allergy/toxic reactions. Irritative hand eczema seemed to be more common than in the general population. CONCLUSIONS Patient- and personnel-related studies are of variable quality and can be improved. There is a need for a better description of the content of materials. A registry for adverse effects of dental materials would be useful to detect the occurrence of low-incidence events.
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Affiliation(s)
- Andreas Schedle
- Bernhard Gottlieb University Clinic of Dentistry, Central Research Unit, Medical University of Vienna, Vienna, Austria.
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Abstract
Resin-based restorative materials are considered safe for the vast majority of dental patients. Although constituent chemicals such as monomers, accelerators and initiators can potentially leach out of cured resin-based materials after placement, adverse reactions to these chemicals are rare and reaction symptoms commonly subside after removal of the materials. Dentists should be aware of the rare possibility that patients could have adverse reactions to constituents of resin-based materials and be vigilant in observing any adverse reactions after restoration placement. Dentists should also be cognisant of patient complaints about adverse reactions that may result from components of resin-based materials. To minimise monomer leaching and any potential risk of dermatological reactions, resin-based materials should be adequately cured. Dental health care workers should avoid direct skin contact with uncured resin-based materials. Latex and vinyl gloves do not provide adequate barrier protection to the monomers in resin-based materials.
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Affiliation(s)
- P L Fan
- International Science and Standards Division of Science, American Dental Association, Chicago, IL 60611, USA.
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Moharamzadeh K, Van Noort R, Brook IM, Scutt AM. HPLC analysis of components released from dental composites with different resin compositions using different extraction media. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2007; 18:133-7. [PMID: 17200823 DOI: 10.1007/s10856-006-0671-z] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Accepted: 11/04/2005] [Indexed: 05/13/2023]
Abstract
Components released from dental composite resins are essential factors in the assessment of biocompatibility of these materials. The effect of different extraction media on monomer release from composite resins based on different monomer types was evaluated. Three types of visible light cured composite resins were formulated based on the following monomers: triethylene glycol dimethacrylate (TEGDMA), bisphenol A glycerolate dimethacrylate (BisGMA), and urethane dimethacrylate (UDMA). Seventy-five composite resin discs were fabricated and light cured for 1 min in the absence of oxygen. Extraction media used were: distilled water, saline solution, artificial saliva, serum-free culture medium, and culture medium with 10% fetal calf serum. The analysis of extracts from the composite resins was carried out by High Performance Liquid Chromatography (HPLC). Quantifiable amounts of TEGDMA were released into the aqueous media. However, BisGMA and UDMA were not detectable in any of the extracts from the composite resins. Statistical analysis by one-way ANOVA followed by Tukey's test showed that there was a significant difference in TEGDMA release between culture media and other media (p < 0.05). From the results of this experiment it can be concluded that TEGDMA-based composite resins can release a high quantity of monomer into aqueous environments. The type of extraction medium may have a significant effect on monomer release from composite resins.
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Affiliation(s)
- K Moharamzadeh
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK.
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Abstract
Patients undergoing dental treatment can be exposed to a wide range of potential allergens, but adverse events seem infrequent. Patients with symptoms or signs of stomatitis, burning, tingling, cheilitis, oral lichenoid lesions, lip and facial swelling may relate their problems to dental treatment or to the use of dental products. Investigation for immediate type or delayed type hypersensitivity is indicated using patch testing, prick testing and blood tests for allergen-specific IgE. The main allergic reactions found in patients include contact allergy to metals, cosmetics, food additives, flavours and acrylates, and immediate type allergy to latex. Adverse reactions following the administration of local anaesthetics are seen in about 0.5% of cases, but immediate type allergy to these agents is rare. In dental staff, occupationally related problems are common and usually take the form of hand or facial dermatitis or respiratory disease. The most common allergic reactions in dental staff are immediate type allergy to latex, and contact allergy to rubber additives, fragrances, acrylates and formaldehyde. Occupational irritant problems causing hand dermatitis are probably more common in dental personnel than is dermatitis caused by contact allergy. Patch testing and tests for immediate type allergy are useful investigative methods in the investigation of patients who present with oral or facial symptoms possibly related to dental treatments and are also beneficial in dental personnel who present with hand or facial dermatitis or respiratory symptoms.
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Affiliation(s)
- D J Gawkrodger
- Department of Dermatology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
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Who is responsible for reporting adverse reactions? Br Dent J 2004. [DOI: 10.1038/sj.bdj.4811185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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