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Slodownik D, Yoshpe M, Mann J, Azulay O, Moshe S, Krakov AO. Prevalence of Occupational Contact Dermatitis Among Dental Personnel Using the Nordic Occupational Skin Questionnaire-2002: A Prospective Cross-Sectional Study. Workplace Health Saf 2024; 72:179-186. [PMID: 38243192 DOI: 10.1177/21650799231221140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Occupational skin disease (OSD), such as contact dermatitis, is widespread among dental professionals; however, reports regarding its prevalence have inconsistent findings and methodology. Therefore, we conducted a cross-sectional survey using a self-reported questionnaire to estimate the prevalence of work-related and occupational exposure-induced skin diseases. METHODOLOGY A self-administered questionnaire, based on the validated Nordic Occupational Skin Questionnaire-2002, was distributed to 15 dental clinics in Israel in the first half of 2022. The questionnaire included questions about the occupation, exposure, and history of atopic disease, dry skin, and hand/arm and wrist eczema, as well as participant demographics. RESULTS Overall, 312 dental professionals completed the questionnaires. Response rate was 80%. The lifetime prevalence of self-reported skin symptoms was 19.23%. Significant risk factors included exposure to metal objects, odds ratio (OR): 2.43, 95% confidence interval (CI): [1.02, 5.78]; p < .05, dry skin (OR: 3.54, 95% CI: [1.93, 6.5]; p < .001), itching when sweating (OR: 2.89, 95% CI: [1.39, 6]; p < .05), contact urticaria (OR: 10.67, 95% CI: [4.46, 25.49]; p < .001), hay fever (OR: 2.25, 95% CI: [1.14, 4.42]; p < .05), allergic symptoms (OR; 2.33, 95% CI: [1.18, 4.58]; p < .05), and asthma (OR: 4.8, 95% CI: [2.17, 10.36]; p < .001). CONCLUSIONS This is the first study to use the NOSQ-2002 among dental professionals. Our study provides a better understanding of the prevalence and consequences of OSDs among dental personnel by utilizing the validated tool NOSQ-2002.
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Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Tel Aviv Sourasky Medical Center
- School of Medicine, Tel Aviv University
| | - Margarita Yoshpe
- Dental Research Unit, Maccabi-Dent, Maccabi Healthcare Fund
- Department of Endodontics, Faculty of Dental Medicine, Hebrew University-Hadassah
| | - Jonathan Mann
- Smile Medical Services, Ltd
- Department of Endodontics, Faculty of Dental Medicine, Hebrew University-Hadassah
- Occupational Medicine Department, Maccabi Healthcare Services
| | - Omer Azulay
- Department of Dermatology, Tel Aviv Sourasky Medical Center
- School of Medicine, Tel Aviv University
| | - Shlomo Moshe
- Occupational Medicine Department, Maccabi Healthcare Services
- The Public Health School, Division of Environmental and Occupational Medicine, Sackler Faculty of Medicine, Tel Aviv University
| | - Ayala Olga Krakov
- Occupational Medicine Department, Maccabi Healthcare Services
- The Public Health School, Division of Environmental and Occupational Medicine, Sackler Faculty of Medicine, Tel Aviv University
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Mulla SA, Kondkari SA, Patil A, Jain A, Mali S, Jaiswal HC, Jakhar A, Ansari ZM, Agarwal S, Yadav P. A Look Into the Cytotoxicity of Composite Fillings: Friend or Foe? Cureus 2023; 15:e46327. [PMID: 37916229 PMCID: PMC10617805 DOI: 10.7759/cureus.46327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/03/2023] Open
Abstract
Dental resin composites are widely used restorative materials in dentistry for the treatment of carious and non-carious lesions as well as pit and fissure sealants, cavity liners, and endodontic sealers. They consist of two parts: an organic resin matrix and an inorganic/organic filler. The organic resin matrix phase is made up of multifunctional monomers and light-sensitive initiators, while the inorganic/organic filler phase is made up of micro/nano-sized fillers that primarily serve as reinforcement. Despite being a very promising dental material, its monomeric component has some drawbacks. It is well known for leaching out during incomplete polymerization, which can result in cytotoxicity. Bis-GMA (bisphenol A-glycidyl methacrylate) is the most cytotoxic of all monomeric components that exhibit synthetic estrogenic effects. The purpose of this article is to assess the cytotoxic effects of dental composite, understand the possible mechanism behind them, and explore ways to screen for and reduce this harmful effect, as well as shed light on its future prospects.
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Affiliation(s)
- Sayem A Mulla
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Saba A Kondkari
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Amit Patil
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ashish Jain
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Sheetal Mali
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Himmat C Jaiswal
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ashima Jakhar
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Zoha M Ansari
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Sumeet Agarwal
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Pooja Yadav
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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Yuan H, Shi R, Chen W, Ma Y, Liu Z, Liu F, Yang J. Evaluating occupational exposures of dental nurses: A retrospective study. Front Public Health 2022; 10:1010531. [PMID: 36466496 PMCID: PMC9708719 DOI: 10.3389/fpubh.2022.1010531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The objective of this study was to investigate occupational blood-borne pathogen exposure among dental nurses and their attitudes toward infected patients, as well as the effectiveness of the training course, to provide a scientific basis for improving the quality of safety management in the dental hospital. Materials and methods The study was conducted using questionnaires administered from November 2019 to December 2019 in three hospitals in Sichuan Province, China. Frequencies for answers were calculated and presented as percentages. Results In total, 257 valid questionnaires were returned. Most (61.9%) nurses stated that they were involved in occupational exposure. Among them, 154 had experienced sharp injuries, and the syringe needle was the most common instrument for injuries (45.8%). Twenty-two individuals had mucosal exposure, and the proportion of eye exposure was the highest (90.9%). Only associations between training and mucosal membrane exposure were found; however, the relevance was weak (r = 0.141). Of the participants, 86.4% felt morally responsible for taking care of patients with infectious diseases, and most (92.6%) said they would continue with this career. Conclusion Occupational exposure, particularly to sharp injuries, was common in medical care among dental nurses; however, vocational training had little effect on their incidence. As dental nurses still have positive attitudes toward patients with infectious diseases, more effective training should be conducted.
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Affiliation(s)
- Hongmei Yuan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Shi
- Chengdu Workers' Sanatorium of Sichuan Federation of Trade Unions, North Branch of Health Management Center of Sichuan Provincial People's Hospital, Chengdu, China
| | - Wenwen Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ying Ma
- Chengdu Workers' Sanatorium of Sichuan Federation of Trade Unions, North Branch of Health Management Center of Sichuan Provincial People's Hospital, Chengdu, China
| | - Zhiqing Liu
- State Key Laboratory of Oral Diseases, Department of Infectious Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Liu
- State Key Laboratory of Oral Diseases, Department of Nursing, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,*Correspondence: Fan Liu
| | - Jingmei Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Jingmei Yang
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Occupational Contact Dermatitis in Dental Personnel: A Retrospective Analysis of the North American Contact Dermatitis Group Data, 2001 to 2018. Dermatitis 2022; 33:80-90. [PMID: 35029351 DOI: 10.1097/der.0000000000000847] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dental personnel are at risk of developing occupational contact dermatitis. OBJECTIVES The aims of the study were to determine prevalence of occupational contact dermatitis in dental personnel referred for patch testing and to characterize relevant allergens and sources. METHODS The study used a retrospective, cross-sectional analysis of the North American Contact Dermatitis Group (NACDG) data, 2001-2018. RESULTS Of 41,109 patients, 585 (1.4%) were dental personnel. Dental personnel were significantly more likely than nondental personnel to be female (75.7% vs 67.4%, P < 0.0001), have occupationally related dermatitis (35.7% vs 11.5%, P < 0.0001), and/or have primary hand involvement (48.6% vs 22.5%, P < 0.0001). More than one quarter of dental personnel (62/585, 27.7%) had 1 or more occupationally related allergic patch test reaction(s). There were 249 occupationally related reactions to NACDG screening allergens, most commonly glutaraldehyde (18.1%), thiuram mix (16.1%), and carba mix (14.1%). The most common sources of NACDG screening allergens were gloves (30.7%), dental materials (26.6%), and sterilizing solutions (13.1%). Seventy-three dental personnel (12.5%) had 1 or more positive patch test reactions to occupationally related allergen(s)/substances not on the screening series. Occupationally related irritant contact dermatitis was identified in 22.2% (n = 130) of dental personnel, most commonly to nonskin soaps/detergents/disinfectants (32.0%). CONCLUSIONS Occupational contact dermatitis is common in dental personnel referred for patch testing. Comprehensive testing beyond screening series is important in these patients.
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Facial Personal Protective Equipment: Materials, Resterilization Methods, and Management of Occupation-Related Dermatoses. Dermatitis 2021; 32:78-85. [PMID: 33273243 DOI: 10.1097/der.0000000000000699] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The coronavirus infectious disease 2019 pandemic has resulted in health care workers donning personal protective equipment (PPE) for extended periods. OBJECTIVES The aims of the study were to review facial PPE (surgical masks and N95 respirators) ingredients, to identify facial PPE resterilization techniques, and to recommend strategies for prevention and management of facial PPE-related dermatoses. METHODS Twenty-one facial PPE (11 N95 respirators, 10 surgical masks) were reviewed. Resterilization techniques were identified. Personal protective equipment-induced occupational dermatoses and management strategies were explored. RESULTS Polypropylene is the most common chemical identified in facial PPE. Most masks contain aluminum at the nosepiece. Two surgical masks released nickel. Facial PPE dermatoses include irritant contact dermatitis, allergic contact dermatitis, acne, and contact urticaria. Strategies for prevention and management of facial PPE occupational dermatoses are discussed. CONCLUSIONS There are increasing reports of occupational dermatoses associated with facial PPE. This review discusses the components of facial PPE, mask resterilization methods, and strategies for prevention and management of facial PPE dermatoses.
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Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sabantseva EG, Ivanova EV, Rabinovich IM. [Manifestations of allergic reactions occurring at a dental appointment]. STOMATOLOGIIA 2021; 100:29-32. [PMID: 35081697 DOI: 10.17116/stomat202110006229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To analyze the data of modern scientific literature to conduct a study on identifying the true allergic reaction at a dental appointment. MATERIAL AND METHODS The article is based on the study of materials from domestic and foreign research databases eLibrary, PubMed, Cochrane Database Systematic Reviews. The research period is 15 years. RESULTS Among dental materials, the most common allergens are local anesthetics, metal alloys, components of composite materials, latex. CONCLUSION If allergy is suspected, it is necessary to carefully collect an anamnesis and conduct a clinical examination of the patient with the involvement of specialist doctors, with the recommendation of skin tests and test subcutaneous provocation.
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Affiliation(s)
- E G Sabantseva
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - E V Ivanova
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - I M Rabinovich
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Central Research Institute of Dentistry and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
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Occupational dermatitis to facial personal protective equipment in health care workers: A systematic review. J Am Acad Dermatol 2020; 84:486-494. [PMID: 33011325 PMCID: PMC7528888 DOI: 10.1016/j.jaad.2020.09.074] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/01/2020] [Accepted: 09/23/2020] [Indexed: 01/26/2023]
Abstract
Background Prolonged wear of facial protective equipment can lead to occupational dermatoses. Objective To identify important causes of occupational dermatoses from facial protective equipment. Methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using PubMed and Embase databases. Articles were included if they reported occupational dermatoses caused by surgical/procedure masks or N95 respirators, or both. Results We identified 344 articles, and 16 were suitable for inclusion in this review. Selected articles focused on facial occupational dermatoses in health care workers. Allergic contact dermatitis to the elastic straps, glue, and formaldehyde released from the mask fabric was reported. Irritant contact dermatitis was common on the cheeks and nasal bridge due to pressure and friction. Irritant dermatitis was associated with personal history of atopic dermatitis and prolonged mask wear (>6 hours). Acneiform eruption was reported due to prolonged wear and occlusion. Contact urticaria was rare. Limitations Only publications listed in PubMed or Embase were included. Most publications were case reports and retrospective studies. Conclusion This systematic review from members of the American Contact Dermatitis Society highlights cases of occupational dermatitis to facial protective equipment, including potential offending allergens. This work may help in the diagnosis and treatment of health care workers with facial occupational dermatitis.
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9
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Bishop S, Roberts H. Methacrylate perspective in current dental practice. J ESTHET RESTOR DENT 2020; 32:673-680. [PMID: 32744420 DOI: 10.1111/jerd.12633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To provide a current perspective concerning dental personnel sensitivity to methacrylate materials. OVERVIEW Methacrylate related sensitivity and allergies are currently beyond traditional thoughts concerning denture base resins and methyl methacrylate provisional materials. Methacrylates are now ubiquitous in current dental practice and dental personnel should be aware that dental adhesives contain potent sensitizers that may also cross-sensitize individuals to other methacrylates not experienced. The growing sensitivity to 2-hydroxyethyl methacrylate (HEMA) has been described to be epidemic in nature due to the artificial nail industry with dental patients and dental personnel may be more susceptible to dental methacrylate sensitization. While contact dermatitis remains the most prevalent methacrylate-related clinical presentation, respiratory complications and asthma are increasing associated with methacrylate exposure. While additional personal protective equipment (PPE) is thought to be first protective choice, the National Institute for Occupational Safety and Health (NIOSH) considers PPE overall largely ineffective and should be considered only as a last resort. CONCLUSION Dental personnel need to be more aware of methacrylate sources and use workplace control measures to limit methacrylate exposures to both dental personnel and patients. CLINICAL SIGNIFICANCE Sensitivity to methacrylate materials is a growing dental workplace major concern and dental personnel should be aware of both the methacrylate content of current materials and the products that contain ingredients with the most sensitization potential.
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Affiliation(s)
- Susan Bishop
- Division of Restorative Dentistry, University of Kentucky College of Dentistry, Lexin1gton, Kentucky, USA
| | - Howard Roberts
- Director of Graduate Studies, University of Kentucky College of Dentistry, Lexington, Kentucky, USA.,USAF Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Carrillo-Cotto R, Etges A, Jardim PS, Torre E, Kaizer MR, Ferrúa CP, Nedel F, Cuevas-Suárez CE, Moraes RR. Cytotoxicity of contemporary resin-based dental materials in contact with dentin. Eur J Oral Sci 2020; 128:436-443. [PMID: 32741041 DOI: 10.1111/eos.12723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 01/09/2023]
Abstract
In this study, the cytotoxicity of different combinations of contemporary resin-based restoratives (adhesives, composites, luting agents) against human keratinocytes (HaCaT) was evaluated under two conditions, whether materials were applied to dentin or not. Adhesives (3-step etch-and-rinse/3ER: OptiBond FL; 2-step self-etch/2SE Clearfil SE Bond; Single Bond Universal/UNI), composites (conventional composite resin/CCR: Filtek Z350XT; flowable/FCR: Filtek Z350XT Flow; self-adhesive composite resin/SACR: Dyad Flow), and luting agents (conventional luting agent/CLA: Variolink-II; self-adhesive luting agent/SLA: RelyXU200) were combined according to their clinical use. Eluates from polymerized specimens applied to dentin were placed in contact with cells grown for 1 and 7 d. The controls were defined by cells without material contact. Cell viability was determined using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)] assay. C=C conversion was investigated using Fourier-transform infrared spectroscopy. After 1 d of incubation, when dentin was not present, 2SE yielded the highest cell viability, whereas 3ER, UNI, and SACR showed higher cell viability in the presence of dentin. After 7 d, when dentin was absent, 2SE and CLA achieved significantly higher cell viability. The presence of dentin resulted in a drastically higher cell viability for all materials, except 2SE and CLA. UNI had the lowest C=C conversion. The presence of dentin was a significant factor, which resulted in higher cell viability than what was seen for the material specimens per se. All materials resulted in a lower viability of HaCaT than what was seen under the no-material control conditions, with effects mainly limited to the first 24 h.
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Affiliation(s)
- Ricardo Carrillo-Cotto
- Department of Restorative Dentistry and Dental Biomaterials, School of Dentistry, University of San Carlos of Guatemala, Guatemala city, Guatemala.,Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Adriana Etges
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Eliana Torre
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marina R Kaizer
- Graduate Program in Dentistry, Positivo University, Curitiba, Brazil
| | - Camila P Ferrúa
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Fernanda Nedel
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Rafael R Moraes
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Stoeva I, Dencheva M, Georgiev N, Chonin A. Skin reactions among Bulgarian dental students: A self-report questionnaire survey. Contact Dermatitis 2019; 81:274-279. [PMID: 31334857 DOI: 10.1111/cod.13362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/13/2019] [Accepted: 07/22/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dental students are at high risk of developing adverse skin reactions following practical work during the dentistry degree program. They encounter multiple irritants and allergens that may cause skin reactions on exposed parts of the body, notably the hands. OBJECTIVES To estimate the prevalence of skin reactions related to the pre-clinical and clinical training courses of the dentistry program and associated risk factors in Bulgarian dental students. METHOD A cross-sectional study was performed using a self-report questionnaire. RESULTS A total of 467 dental students completed the questionnaire (response 51.8%). The prevalence of self-reported skin symptoms was 21.2%. According to logistic regression analysis, the most important risk factors for work-related skin symptoms were a personal history of atopic dermatitis (odds ratio [OR] 3.92, 95% confidence interval [CI]: 1.99-7.72), allergic rhinoconjunctivitis and/or asthma (OR 1.94, 95%CI: 1.03-3.68), personal history of contact allergy (OR 2.19, 95%CI: 1.06-4.55), and hand washing >16 times a day (OR 2.42, 95%CI: 1.06-5.52). CONCLUSIONS The results of this study suggest that work-related skin symptoms are frequent among dental students and indicate the need to establish effective primary preventive programs for occupational skin disorders at a national level.
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Affiliation(s)
- Iliyana Stoeva
- Department of Diagnostic Imaging, Dental Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Maria Dencheva
- Department of Imaging and Oral Diagnostics, Faculty of Dental Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Nikolai Georgiev
- Department of Diagnostic Imaging, Dental Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Atanas Chonin
- Department of Diagnostic Imaging, Dental Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
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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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NASCIMENTO AS, LIMA DB, FOOK MVL, ALBUQUERQUE MSD, LIMA EAD, SABINO MA, BORGES SMP, FILGUEIRA PTD, SOUSA YCD, BRAZ R. Physicomechanical characterization and biological evaluation of bulk-fill composite resin. Braz Oral Res 2018; 32:e107. [DOI: 10.1590/1807-3107bor-2018.vol32.0107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/21/2018] [Indexed: 02/19/2023] Open
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16
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Walters GI, Robertson AS, Moore VC, Burge PS. Occupational asthma caused by acrylic compounds from SHIELD surveillance (1989-2014). Occup Med (Lond) 2017; 67:282-289. [PMID: 28431005 DOI: 10.1093/occmed/kqx036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Acrylic monomers (acrylates), methacrylates and cyanoacrylates all cause asthma by respiratory sensitization. Occupational inhalation exposures occur across a variety of industries including health care and dental work, beauty, laboratory science, assembly and plastic moulding. Aims To examine notifications of occupational asthma caused by acrylic compounds from a UK-based regional surveillance scheme, in order to highlight prevalent exposures and trends in presentation. Methods Retrospective review of all cases reported to the SHIELD surveillance scheme for occupational asthma, West Midlands, UK between 1989 and 2014. Patient data were gathered on demographics, employment, asthma symptoms and diagnostic investigations including serum immunological testing, serial peak flow analysis and specific inhalation challenge tests. Descriptive statistics were used to illustrate worker characteristics and evidence for sensitization to acrylic compounds. Results There were 20 affected patients out of 1790 total cases of occupational asthma (1%); all cases were confirmed by OASYS (Occupational Asthma SYStem) analysis of serial peak flow measurements, with three additional positive specific inhalation challenge tests. Three out of 20 (15%) patients were current smokers and 11/20 (55%) were atopic. A variety of exposures and industries were implicated including: manufacturing, health care, beauty and printing and a novel presentation seen in teachers exposed to floor adhesives. Conclusions This is the largest reported series of occupational asthma caused by acrylic compounds, which remain an important aetiological factor in this disease. Exposure occurs in a variety of industries, particularly in manufacturing and is seen with other, perhaps better recognized sensitizing agents such as isocyanates and epoxy resins.
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Affiliation(s)
- G I Walters
- Occupational Lung Disease Service, Birmingham Chest Clinic, 151 Great Charles Street, Birmingham B3 3HX, UK
| | - A S Robertson
- Occupational Lung Disease Service, Birmingham Chest Clinic, 151 Great Charles Street, Birmingham B3 3HX, UK
| | - V C Moore
- Occupational Lung Disease Service, Birmingham Chest Clinic, 151 Great Charles Street, Birmingham B3 3HX, UK
| | - P S Burge
- Occupational Lung Disease Service, Birmingham Chest Clinic, 151 Great Charles Street, Birmingham B3 3HX, UK
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Minamoto K, Watanabe T, Diepgen TL. Self-reported hand eczema among dental workers in Japan - a cross-sectional study. Contact Dermatitis 2016; 75:230-9. [PMID: 27523777 DOI: 10.1111/cod.12656] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/10/2016] [Accepted: 06/10/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dental workers are considered to have a high risk of developing occupational hand eczema. OBJECTIVES To estimate the prevalence of work-related hand eczema and associated risk factors in dental workers in Japan. METHODS A self-administered questionnaire was sent by mail to all dental clinics of Kumamoto City, Japan. In addition, patch testing with 24 dentistry-related allergens was offered. RESULTS In total, 46.4% of dental workers (n = 528: response 31.4%, based on 97 clinics) reported a lifetime history of chronic hand eczema. The 1-year prevalence was 36.2%. According to logistic regression analysis, the most important risk factors for the 1-year prevalence were a personal history of atopic dermatitis [odds ratio (OR) 4.7, 95% confidence interval (CI): 2.2-8.8], asthma and/or allergic rhinitis (OR 2.0, 95%CI: 1.3-3.0), dry skin (OR 1.7, 95%CI: 1.1-2.7), shorter duration of work (OR 2.0, 95%CI: 1.2-3.5 for up to 10 years versus >20 years), and washing hands >10 times per day (OR 1.6, 95%CI: 1.0-2.5). Fifty-four workers were patch tested. Rubber chemicals and acrylates were the most frequent occupationally relevant contact allergens. CONCLUSIONS Dental workers in Japan have a high prevalence of hand eczema. Health education to prevent hand eczema and more frequent patch testing are needed.
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Affiliation(s)
- Keiko Minamoto
- Department of Public Health, Faculty of Life Sciences, Graduate School of Kumamoto University, Kumamoto 860-8556, Japan. ,
| | | | - Thomas L Diepgen
- Department of Social Medicine, Occupational & Environmental Dermatology, University of Heidelberg, 69115 Heidelberg, Germany
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Alshali RZ, Salim NA, Sung R, Satterthwaite JD, Silikas N. Analysis of long-term monomer elution from bulk-fill and conventional resin-composites using high performance liquid chromatography. Dent Mater 2015; 31:1587-98. [DOI: 10.1016/j.dental.2015.10.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/02/2015] [Accepted: 10/16/2015] [Indexed: 01/16/2023]
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Syed M, Chopra R, Sachdev V. Allergic Reactions to Dental Materials-A Systematic Review. J Clin Diagn Res 2015; 9:ZE04-9. [PMID: 26557634 PMCID: PMC4625353 DOI: 10.7860/jcdr/2015/15640.6589] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/24/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Utility of various dental materials ranging from diagnosis to rehabilitation for the management of oral diseases are not devoid of posing a potential risk of inducing allergic reactions to the patient, technician and dentist. This review aims to develop a systematic approach for the selection and monitoring of dental materials available in the market thereby giving an insight to predict their risk of inducing allergic reactions. MATERIALS AND METHODS Our data included 71 relevant articles which included 60 case reports, 8 prospective studies and 3 retrospective studies. The source of these articles was Pub Med search done with the following terms: allergies to impression materials, sodium hypochlorite, Ledermix paste, zinc oxide eugenol, formaldehyde, Latex gloves, Methyl methacrylate, fissure sealant, composites, mercury, Nickel-chromium, Titanium, polishing paste and local anaesthesia. All the relevant articles and their references were analysed. The clinical manifestations of allergy to different dental materials based on different case reports were reviewed. RESULTS After reviewing the literature, we found that the dental material reported to cause most adverse reactions in patients is amalgam and the incidence of oral lichenoid reactions adjacent to amalgam restorations occur more often than other dental materials. CONCLUSION The most common allergic reactions in dental staff are allergies to latex, acrylates and formaldehyde. While polymethylmethacrylates and latex trigger delayed hypersensitivity reactions, sodium metabisulphite and nickel cause immediate reactions. Over the last few years, due to the rise in number of patients with allergies from different materials, the practicing dentists should have knowledge about documented allergies to known materials and thus avoid such allergic manifestations in the dental clinic.
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Affiliation(s)
- Meena Syed
- Post Graduate Student, Department of Pedodontics, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Radhika Chopra
- Associate Professor, Department of Pedodontics and Preventive Dentistry, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Vinod Sachdev
- Professor, HOD and Principal, Department of Pedodontics and Preventive Dentistry, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Alshali RZ, Salim NA, Sung R, Satterthwaite JD, Silikas N. Qualitative and quantitative characterization of monomers of uncured bulk-fill and conventional resin-composites using liquid chromatography/mass spectrometry. Dent Mater 2015; 31:711-20. [DOI: 10.1016/j.dental.2015.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/02/2015] [Accepted: 03/24/2015] [Indexed: 11/25/2022]
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Nishimiya H, Yamada M, Ueda T, Sakurai K. N-acetyl cysteine alleviates inflammatory reaction of oral epithelial cells to poly (methyl methacrylate) extract. Acta Odontol Scand 2015; 73:616-25. [PMID: 25915728 DOI: 10.3109/00016357.2015.1021834] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The purpose of this in vitro study was to determine whether the cytotoxicity of self-curing polymethyl methacrylate (PMMA) dental resin to oral epithelial cells was eliminated by mixing the antioxidant amino acid derivative, N-acetyl cysteine (NAC) with the material. MATERIALS AND METHODS Rat and human oral epithelial cells cultured on polystyrene were incubated in culture medium with or without extract from self-curing PMMA dental resin, with or without pre-mixing with NAC. On day 1, the cultures were evaluated for cellular damage, intracellular formaldehyde invasion, cellular redox status and pro-inflammatory cytokine production. Formaldehyde content and the amount of released NAC in the extract were evaluated. RESULTS Rat epithelial cells cultured with PMMA extract showed marked increases in lactate dehydrogenase (LDH) release, intracellular formaldehyde and lysosomal levels and reductions in attached cell number and the amount of E-cadherin compared with those in the culture without the extract; these adverse biological effects were alleviated or prevented by pre-mixing the resin with NAC. In human oral epithelial cells cultured with PMMA extract, the addition of NAC into the resin prevented the intracellular elevation of reactive oxygen species and the reduction in cellular glutathione levels. Human cell cultures with the extract produced higher levels of various pro-inflammatory cytokines than cultures without the extract; this was prevented by mixing the resin with NAC. The extract from PMMA pre-mixed with NAC contained a lower concentration of formaldehyde and a substantial amount of antioxidants. CONCLUSION The cytotoxicity of self-curing PMMA dental resin to oral epithelial cells was eliminated by mixing the resin with NAC.
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Affiliation(s)
- Hiroko Nishimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College , Tokyo , Japan
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22
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Concomitant contact allergy to formaldehyde and methacrylic monomers in students of dental medicine and dental patients. Int J Occup Med Environ Health 2014; 27:797-807. [DOI: 10.2478/s13382-014-0314-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 07/18/2014] [Indexed: 11/20/2022] Open
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Yalcin M, Ahmetoglu F, Sisman R, Bozkurt BS, Hakki SS. Cytotoxicity of low-shrink composites with new monomer technology on bovine dental pulp-derived cells. Hum Exp Toxicol 2014; 34:93-9. [DOI: 10.1177/0960327113497773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objectives: The aim of this study was to evaluate the cytotoxicity of four low-shrink composites with new monomer technology on the bovine dental pulp-derived cells (bDPCs). Materials and methods: Ten samples were prepared for each group composites, and the samples were immersed in 7 mL of culture medium for 72 h at 37°C to extract residual monomer or cytotoxic substances. The culture medium containing the material extracts was sterile filtered for use on the cell cultures. Materials were incubated in medium with serum for 72 h. bDPCs were maintained in a medium with serum. A real-time cell analyzer was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, bDPCs were treated with bioactive components released by the composite materials (1:1 and 1:2 dilutions) and monitored every 15 min for 50 h. Results: According to analysis of variance, there were significant differences between the cell indexes of the control and GC kalore ( p < 0.05) and Bisco Reflexions ( p < 0.001) groups for the 1:1 dilutions at 25 h. When evaluated at 50 h, 1:1 dilutions of GC Kalore ( p < 0.01) and Bisco Reflexions ( p < 0.001) reduced cell survival significantly. Conclusions: Although composites resins are being advanced, their cytotoxic effects have been proceeding till this time. However, two of the four materials tested significantly reduced cell viability when compared with control. Clinical relevance: Research should focus on the cytotoxicity of composites in addition to their mechanical properties.
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Affiliation(s)
- M Yalcin
- Department of Restorative Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - F Ahmetoglu
- Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - R Sisman
- Department of Restorative Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - BS Bozkurt
- Research Center, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - SS Hakki
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
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24
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Kocak O, Gul U. Patch test results of the dental personnel with contact dermatitis. Cutan Ocul Toxicol 2014; 33:299-302. [DOI: 10.3109/15569527.2013.866132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Manojlovic D, Radisic M, Lausevic M, Zivkovic S, Miletic V. Mathematical modeling of cross-linking monomer elution from resin-based dental composites. J Biomed Mater Res B Appl Biomater 2012; 101:61-7. [DOI: 10.1002/jbm.b.32815] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 07/06/2012] [Accepted: 08/10/2012] [Indexed: 11/08/2022]
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Cataldi A, Zara S, Rapino M, Patruno A, di Giacomo V. Human gingival fibroblasts stress response to HEMA: A role for protein kinase C α. J Biomed Mater Res A 2012; 101:378-84. [DOI: 10.1002/jbm.a.34337] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 05/18/2012] [Accepted: 06/26/2012] [Indexed: 11/10/2022]
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Visscher MO, Randall Wickett R. Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues. Int J Cosmet Sci 2012; 34:402-15. [DOI: 10.1111/j.1468-2494.2012.00733.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/05/2012] [Indexed: 12/14/2022]
Affiliation(s)
| | - R. Randall Wickett
- The James L. Winkle College of Pharmacy; University of Cincinnati; Cincinnati; OH; 45267; U.S.A
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Huang YQ, Wong CKC, Zheng JS, Bouwman H, Barra R, Wahlström B, Neretin L, Wong MH. Bisphenol A (BPA) in China: a review of sources, environmental levels, and potential human health impacts. ENVIRONMENT INTERNATIONAL 2012; 42:91-9. [PMID: 21596439 DOI: 10.1016/j.envint.2011.04.010] [Citation(s) in RCA: 655] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 04/08/2011] [Accepted: 04/12/2011] [Indexed: 05/17/2023]
Abstract
Bisphenol A (BPA), identified as an endocrine disruptor, is an industrially important chemical that is used as a raw material in the manufacture of many products such as engineering plastics (e.g., epoxy resins/polycarbonate plastics), food cans (i.e., lacquer coatings), and dental composites/sealants. The demand and production capacity of BPA in China have grown rapidly. This trend will lead to much more BPA contamination in the environmental media and in the general population in China. This paper reviews the current literature concerning the pollution status of BPA in China (the mainland, Hong Kong, and Taiwan) and its potential impact on human health. Due to potential human health risks from long-term exposure to BPA, body burden of the contaminant should be monitored.
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Affiliation(s)
- Y Q Huang
- Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Hong Kong, PR China
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29
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Machovcová A, Fenclová Z, Pelclová D. Occupational skin diseases in Czech healthcare workers from 1997 to 2009. Int Arch Occup Environ Health 2012; 86:289-94. [DOI: 10.1007/s00420-012-0764-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
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Abstract
Due to the complexity of the nail salon work environment, traditional approaches to exposure assessment in this context tend to mischaracterize potential hazards as nuisances. For this investigation, a workable “indoor air” approach was devised to characterize potential hazards and ventilation in Boston, Massachusetts area nail salons which are primarily owned and staffed by Vietnamese immigrants. A community-university partnership project recruited salons to participate in a short audit which included carbon dioxide measurements and evaluation of other air quality metrics. Twenty-two salons participated. Seventy-three percent of the salons had spot carbon dioxide measurements in excess of 700 ppm, the level corresponding to a ventilation rate recommended for beauty salons. Fourteen salons (64%) did not have a mechanical ventilation system to provide fresh air and/or exhaust contaminated air. The lack of adequate ventilation is of significant concern because of the presence of potentially hazardous chemicals in salon products and the common self-report of symptoms among nail technicians. Community and worker health may be improved through adoption of recommended ventilation guidelines and reduction in the hazard potential of nail products.
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Affiliation(s)
- Cora Roelofs
- Department of Work Environment, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Tuan Do
- Department of Work Environment, University of Massachusetts Lowell, Lowell, MA 01854, USA
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Szczepanska J, Pawlowska E, Synowiec E, Czarny P, Rekas M, Blasiak J, Szaflik JP. Protective effect of chitosan oligosaccharide lactate against DNA double-strand breaks induced by a model methacrylate dental adhesive. Med Sci Monit 2011; 17:BR201-208. [PMID: 21804456 PMCID: PMC3539618 DOI: 10.12659/msm.881898] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Monomers of methacrylates used in restorative dentistry have been recently reported to induce DNA double-strand breaks (DSBs) in human gingival fibroblasts (HGFs) in vitro. Because such monomers may penetrate the pulp and oral cavity due to the incompleteness of polymerization and polymer degradation, they may induce a similar effect in vivo. DSBs are the most serious type of DNA damage and if misrepaired or not repaired may lead to mutation, cancer transformation and cell death. Therefore, the protection against DSBs induced by methacrylate monomers released from dental restorations is imperative. Material/Methods We examined the protective action of chitosan oligosaccharide lactate (ChOL) against cytotoxic and genotoxic effects induced by monomers of the model adhesive consisting of 55% bisphenol A-diglycidyl dimethacrylate (Bis-GMA) and 45% 2-hydroxyethyl methacrylate (HEMA). We evaluated the extent of DSBs by the neutral comet assay and the phosphorylation of the H2AX histone test. Results ChOL increased the viability of HGFs exposed to Bis-GMA/HEMA as assessed by flow cytometry. ChOL decreased the extent of DSBs induced by Bis-GMA/HEMA as evaluated by neutral comet assay and phosphorylation of the H2AX histone. ChOL did not change mechanical properties of the model adhesive, as checked by the shear bond test. Scanning electron microscopy revealed a better sealing of the dentinal microtubules in the presence of ChOL, which may protect pulp cells against the harmful action of the monomers. Conclusions ChOL can be considered as an additive to methacrylate-based dental materials to prevent DSBs induction, but further studies are needed on its formulation with the methacrylates.
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Affiliation(s)
- Joanna Szczepanska
- Department of Developmental Dentistry, Medical University of Lodz, Lodz, Poland
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Van Landuyt K, Nawrot T, Geebelen B, De Munck J, Snauwaert J, Yoshihara K, Scheers H, Godderis L, Hoet P, Van Meerbeek B. How much do resin-based dental materials release? A meta-analytical approach. Dent Mater 2011; 27:723-47. [DOI: 10.1016/j.dental.2011.05.001] [Citation(s) in RCA: 234] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/24/2011] [Accepted: 05/09/2011] [Indexed: 01/10/2023]
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Andersson J, Dahlgren U. 2-Hydroxyethyl methacrylate (HEMA) promotes IgG but not IgM antibody production in vivo in mice. Eur J Oral Sci 2011; 119:305-9. [DOI: 10.1111/j.1600-0722.2011.00836.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis 2011; 63:177-86. [PMID: 20831687 DOI: 10.1111/j.1600-0536.2010.01763.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Occupational contact dermatitis is the most frequently reported work-related skin disease in many countries. A systematic review was commissioned by the British Occupational Health Research Foundation in response to a House of Lords Science and Technology Committee recommendation. OBJECTIVES The systematic review aims to improve the prevention, identification and management of occupational contact dermatitis and urticaria by providing evidence-based recommendations. METHODS The literature was searched systematically using Medline and Embase for English-language articles published up to the end of September 2009. Evidence-based statements and recommendations were graded using the Royal College of General Practitioner's three-star system and the revised Scottish Intercollegiate Guidelines Network grading system. RESULTS Three thousand one hundred and fifty-five abstracts were identified and screened. From these, 786 full papers were obtained and appraised. One hundred and nineteen of these studies were used to produce 36 graded evidence statements and 10 key recommendations. CONCLUSIONS This evidence review and its recommendations focus on interventions and outcomes to provide a robust approach to the prevention, identification and occupational management of occupational contact dermatitis and urticaria, based on and using the best available medical evidence.
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Wisniewska-Jarosinska M, Poplawski T, Chojnacki CJ, Pawlowska E, Krupa R, Szczepanska J, Blasiak J. Independent and combined cytotoxicity and genotoxicity of triethylene glycol dimethacrylate and urethane dimethacrylate. Mol Biol Rep 2010; 38:4603-11. [PMID: 21127987 PMCID: PMC3162630 DOI: 10.1007/s11033-010-0593-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 11/20/2010] [Indexed: 01/06/2023]
Abstract
Dental composite materials contain polymers of methacrylates, which, due to mechanical abrasion and enzymatic action of saliva, may release their monomers into oral cavity and the pulp. Moreover, polymerization is always incomplete and leaves usually considerable fraction of free monomers. Mechanisms of the genotoxicity of methacrylate monomers have been rarely explored. As the polymerization of a monomer is catalyzed by a co-monomer, their combined action should be considered. In the present work, we investigated cytotoxic and genotoxic effects of urethane dimethacrylate (UDMA), often used as a monomer, at 1 mM, and triethylene glycol dimethacrylate (TEGDMA), a typical co-monomer, at 5 mM singly and in combination. Experiments were conducted on Chinese hamster ovary cells. Cell viability, apoptosis and cell cycle were assessed by flow cytometry, whereas DNA damage was evaluated by plasmid conformation test and comet assay. Both compounds decreased the viability of the cells, but did not induce strand breaks in an isolated plasmid DNA. However, both substances, either singly or in combination, damaged DNA in CHO cells as evaluated by comet assay. Both compounds induced apoptosis, but a combined action of them led to a decrease in the number of apoptotic cells. The combined action of UDMA and TEGDMA in the disturbance of cell cycle was lesser compared to the action of each compound individually. Individually, though UDMA and TEGDMA may induce cytotoxic and genotoxic, however, a combination of both does not produce a significant increase in these effects.
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Affiliation(s)
- Maria Wisniewska-Jarosinska
- Department of Gastroenterology and Internal Medicine, Medical University of Lodz, 1 Haller's Square, 90-647 Lodz, Poland
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Abstract
The successful treatment of hand dermatitis (HD) depends less on the selection of the proper topical steroid or a particular systemic agent than on addressing any underlying cause or perpetuating factor. Thus, innovative treatment is based on comprehensively addressing the patient's problem. Aggressive approaches may be required for the most severe forms of HD.
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Affiliation(s)
- William Abramovits
- Department of Medicine, Baylor University Medical Center, Dallas, TX, USA.
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Abstract
Plastic resin systems have an increasingly diverse array of applications but also induce health hazards, the most common of which are allergic and irritant contact dermatitis. Contact urticaria, pigmentary changes, and photoallergic contact dermatitis may occasionally occur. Other health effects, especially respiratory and neurologic signs and symptoms, have also been reported. These resin systems include epoxies, the most frequent synthetic resin systems to cause contact dermatitis, (meth)acrylics, polyurethanes, phenol-formaldehydes, polyesters, amino resins (melamine-formaldehydes, urea-formaldehydes), polyvinyls, polystyrenes, polyolefins, polyamides and polycarbonates. Contact dermatitis usually occurs as a result of exposure to the monomers and additives in the occupational setting, although reports from consumers, using the raw materials or end products periodically surface. Resin- and additive-induced direct contact dermatitis usually presents on the hands, fingers, and forearms, while facial, eyelid, and neck involvement may occur through indirect contact, eg, via the hands, or from airborne exposure. Patch testing with commercially available materials, and in some cases the patient's own resins, is important for diagnosis. Industrial hygiene prevention techniques are essential to reduce contact dermatitis when handling these resin systems.
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Affiliation(s)
- Lauren Y Cao
- MD/MS Clinical Research Scholars Program, Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106, USA
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Teti G, Mazzotti G, Zago M, Ortolani M, Breschi L, Pelotti S, Ruggeri A, Falconi M. HEMA down-regulates procollagen alpha1 type I in human gingival fibroblasts. J Biomed Mater Res A 2009; 90:256-62. [PMID: 18496863 DOI: 10.1002/jbm.a.32082] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
2-Hydroxyethyl methacrylate (HEMA) can be released from restorative materials and diffused into the tooth pulp over long periods of time. Although cytotoxicity due to high concentrations of monomers has been well studied, little is known about the risk of chronic toxicity resulting from low concentrations. The purpose of the study was to evaluate the effects of a minor toxic concentration of HEMA in the synthesis and expression of procollagen alpha1 type I produced by human gingival fibroblasts (HGF). HGF were exposed to 3 mM HEMA from 24 to 96 h. An MTT assay was performed to evaluate cell viability while reverse-transcriptase polymerase chain reaction (RT-PCR), real-time polymerase chain reaction (real-time PCR), and Western-blot analysis were carried out to evaluate the variability in the expression and synthesis of procollagen alpha1. Immunofluorescence was performed to detect the protein inside the cells. The results showed that there was a strong reduction of procollagen alpha 1 type I expression at 72 and 96 h. These findings demonstrate that, even if it does not reduce cell viability, 3 mM HEMA interferes both with the synthesis of the procollagen alpha 1 type I protein and its mRNA expression, suggesting that normal cell production and activity are modified by HEMA at concentrations below those which cause acute cytotoxicity.
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Affiliation(s)
- Gabriella Teti
- Department of SAU and FAL, University of Bologna, Bologna 40126, Italy
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Poplawski T, Pawlowska E, Wisniewska-Jarosinska M, Ksiazek D, Wozniak K, Szczepanska J, Blasiak J. Cytotoxicity and genotoxicity of glycidyl methacrylate. Chem Biol Interact 2009; 180:69-78. [PMID: 19428346 DOI: 10.1016/j.cbi.2009.02.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Revised: 02/02/2009] [Accepted: 02/04/2009] [Indexed: 12/11/2022]
Abstract
Methacrylates are used in the polymer form as composite restorative materials in dentistry. However, the polymers can release monomers and co-monomers into the oral cavity and pulp, from where they can migrate into the bloodstream reaching virtually all organs. The local concentration of the released monomers can be in the millimolar range, high enough to induce adverse biological effects. Genotoxicity of methacrylate monomers is of a special significance due to potential serious phenotypic consequences, including cancer, and long latency period. In the present work, we investigated cytotoxicity and genotoxicity of glycidyl methacrylate (GMA) in the human peripheral blood lymphocytes and the CCR-CM human cancer cells. GMA at concentrations up to 5mM evoked a concentration-dependent decrease in the viability of the lymphocytes up to about 80%, as assessed by flow cytometry. This agent did not induce strand breaks in the isolated plasmid DNA, but evoked concentration-dependent DNA damage in the human lymphocytes evaluated by the alkaline and neutral comet assay. This damage included oxidative modifications to the DNA bases, as checked by DNA repair enzymes Endo III and Fpg as well as single and double DNA strand breaks. The lymphocytes exposed to GMA at 2.5 microM were able to remove about 90% of damage to their DNA in 120 min. The ability of GMA to induce DNA double-strand breaks was confirmed by pulsed field gel electrophoresis. The drug evoked apoptosis and induced an increase in the G2/M cell population, accompanied by a decrease in the S cell population and an increase in G0/G1 cell population. Due to broad spectrum of GMA genotoxicity, including DNA double-strand breaks, and a potential long-lasting exposure to this compound, its use should be accompanied by precautions, reducing the chance of its release into blood stream and the possibility to induce adverse biological effects.
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Affiliation(s)
- Tomasz Poplawski
- Department of Molecular Genetics, University of Lodz, Lodz, Poland
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Sauni R, Kauppi P, Alanko K, Henriks-Eckerman ML, Tuppurainen M, Hannu T. Occupational asthma caused by sculptured nails containing methacrylates. Am J Ind Med 2008; 51:968-74. [PMID: 18702110 DOI: 10.1002/ajim.20633] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In recent decades, the use of artificial nails including methacrylates (MAs) has increased. This study presents the first two clinical cases of occupational asthma (OA) caused by sculptured nails containing MAs. METHODS In both cases, OA was diagnosed on the basis of a work simulation test combined with the patient's history of occupational exposure and respiratory symptoms. RESULTS Both patients developed work-related respiratory symptoms 4-5 years before the current examinations. Previously, the first patient (a 30-year-old female) was diagnosed as having allergic contact dermatitis (ACD) to MAs; the second patient (a 27-year-old female) had no skin symptoms. In both cases, a dual asthmatic reaction was observed in the bronchial provocation test, in which the patients simulated their work using their own products including MAs. CONCLUSIONS Sculptured nails containing MAs can induce OA in nail technicians. Products not containing MAs should be used to prevent OA and ACD. If MAs are used, they should be handled with appropriate safety measures.
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Affiliation(s)
- Riitta Sauni
- Team of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
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42
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Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, Sicherer S, Golden DBK, Khan DA, Nicklas RA, Portnoy JM, Blessing-Moore J, Cox L, Lang DM, Oppenheimer J, Randolph CC, Schuller DE, Tilles SA, Wallace DV, Levetin E, Weber R. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol 2008; 100:S1-148. [PMID: 18431959 DOI: 10.1016/s1081-1206(10)60305-5] [Citation(s) in RCA: 291] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Aalto-Korte K, Alanko K, Kuuliala O, Jolanki R. Methacrylate and acrylate allergy in dental personnel. Contact Dermatitis 2008; 57:324-30. [PMID: 17937748 DOI: 10.1111/j.1600-0536.2007.01237.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Methacrylates are important allergens in dentistry. OBJECTIVE The study aimed to analyse patch test reactivity to 36 acrylic monomers in dental personnel in relation to exposure. METHODS We reviewed the test files at the Finnish Institute of Occupational Health from 1994 to 2006 for allergic reactions to acrylic monomers in dental personnel and analysed the clinical records of the sensitized patients. RESULTS 32 patients had allergic reactions to acrylic monomers: 15 dental nurses, 9 dentists, and 8 dental technicians. The dentists and dental nurses were most commonly exposed to 2-hydroxyethyl methacrylate (2-HEMA), triethyleneglycol dimethacrylate (TREGDMA), and 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (bis-GMA). 8 dentists and 12 dental nurses were allergic to 2-HEMA. The remaining dentist was positive to bis-GMA and other epoxy acrylates. The remaining 3 dental nurses reacted to diethyleneglycol diacrylate (DEGDA) or triethyleneglycol diacrylate (TREGDA), but not to monofunctional and multifunctional methacrylates. Our dental technicians were mainly exposed and sensitized to methyl methacrylate (MMA) and ethyleneglycol dimethacrylate (EGDMA). 1 technician reacted only to 2-HEMA, and another to ethyl methacrylate (EMA) and ethyl acrylate (EA). CONCLUSIONS 2-HEMA was the most important allergen in dentists and dental nurses, and MMA and EGDMA in dental technicians. Reactions to bis-GMA, DEGDA, TREGDA, EMA and EA were relevant in some patients.
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Affiliation(s)
- Kristiina Aalto-Korte
- Finnish Institute of Occupational Health, Control of Hypersensitivity Diseases, Helsinki, Finland.
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44
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Aalto-Korte K, Ackermann L, Henriks-Eckerman ML, Välimaa J, Reinikka-Railo H, Leppänen E, Jolanki R. 1,2-Benzisothiazolin-3-one in disposable polyvinyl chloride gloves for medical use. Contact Dermatitis 2007; 57:365-70. [DOI: 10.1111/j.1600-0536.2007.01278.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Results from a Community-based Occupational Health Survey of Vietnamese-American Nail Salon Workers. J Immigr Minor Health 2007; 10:353-61. [DOI: 10.1007/s10903-007-9084-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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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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47
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Abstract
The method used by the working group was an iterative process based upon a structured review of the relevant literature by a group of rapporteurs. The literature was searched using common databanks (e.g., Medline, Pubmed, Cochrane Library etc.), and also by performing manual searches in the non-indexed literature. The review papers were circulated to the members of the group before and during a conference that served as the basis for subsequent discussions. Each paper was subject to detailed collective analysis and subsequently modified on the basis of panel's discussion and referred to additional relevant literature where appropriate. The consensus statements were prepared after a detailed consideration of the papers submitted to the workshop by the working group. The papers were scrutinized, amended and approved by the group.
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Jaakkola MS, Leino T, Tammilehto L, Ylöstalo P, Kuosma E, Alanko K. Respiratory effects of exposure to methacrylates among dental assistants. Allergy 2007; 62:648-54. [PMID: 17508969 DOI: 10.1111/j.1398-9995.2007.01379.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Case reports of occupational asthma in dental personnel have been published, but there is little data on the risk of respiratory disorders related to occupational exposure to methacrylates in dental assistants. The objective of this study was to investigate the relation of exposure to methacrylates to occurrence of respiratory symptoms and diseases among dental assistants. METHODS A cross-sectional study of female dental assistants from the membership register of the Finnish Association of Dental Hygienists and Assistants was conducted in the Helsinki metropolitan area. A CATI was carried out to collect information on health and exposures. A total of 799 dental assistants participated (response rate 87%). RESULTS Daily use of methacrylates was related to a significantly increased risk of adult-onset asthma (adjusted OR 2.65, 95% CI 1.14-7.24), nasal symptoms (1.37, 1.02-1.84), and work-related cough or phlegm (1.69, 1.08-2.71). Nasal symptoms showed a dose-response relation with increasing years of exposure to methacrylates, and those with >10 years of exposure had also increased risk of hoarseness, dyspnoea, and wheezing with dyspnoea. Dental assistants with a history of atopic diseases were particularly susceptible to exposure to methacrylates, the adjusted OR for adult asthma being in this group 4.18 (95% CI 1.02-28.55) and for nasal symptoms 2.11 (1.08-4.19). CONCLUSIONS This study provides new evidence that the risk of adult-onset asthma, nasal symptoms and other respiratory symptoms increase significantly with daily use of methacrylates in dental assistants' work. The results suggest that exposure to methacrylates poses an important occupational hazard for dental assistants.
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Affiliation(s)
- M S Jaakkola
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
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Ulrich S, Skudlik C, John SM. Occupational allergic contact dermatitis from monoethanolamine in a dental nurse. Contact Dermatitis 2007; 56:292-3. [PMID: 17441861 DOI: 10.1111/j.1600-0536.2006.01012.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Stefan Ulrich
- Department of Dermatology, Environmental medicine and Health Theory, University of Osnabrueck, Sedanstr. 115, 49090 Osnabrueck, Germany.
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50
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Abstract
Monomers are released from dental resin materials, and thus cause adverse biological effects in mammalian cells. Cytotoxicity and genotoxicity of some of these methacrylates have been identified in a vast number of investigations during the last decade. It has been well-established that the co-monomer triethylene glycol dimethacrylate (TEGDMA) causes gene mutations in vitro. The formation of micronuclei is indicative of chromosomal damage and the induction of DNA strand breaks detected with monomers like TEGDMA and 2-hydroxyethyl methacrylate (HEMA). As a consequence of DNA damage, the mammalian cell cycle was delayed in both G1 and G2/M phases, depending on the concentrations of the monomers. Yet, the mechanisms underlying the genetic and cellular toxicology of resin monomers have remained obscure until recently. New findings indicate that increased oxidative stress results in an impairment of the cellular pro- and anti-oxidant redox balance caused by monomers. It has been demonstrated that monomers reduced the levels of the natural radical scavenger glutathione (GSH), which protects cell structures from damage caused by reactive oxygen species (ROS). Depletion of the intracellular GSH pool may then significantly contribute to cytotoxicity, because a related increase in ROS levels can activate pathways leading to apoptosis. Complementary, cytotoxic, and genotoxic effects of TEGDMA and HEMA are inhibited in the presence of ROS scavengers like N-acetylcysteine (NAC), ascorbate, and Trolox (vitamin E). Elevated intracellular levels of ROS can also activate a complex network of redox-responsive macromolecules, including redox-sensitive transcription factors like nuclear factor kappaB (NF-kappaB). It has been shown that NF-kappaB is activated probably to counteract HEMA-induced apoptosis. The induction of apoptosis by TEGDMA in human pulp cells has been associated with an inhibition of the phosphatidylinositol 3-kinase (PI3-K) cell-survival signaling pathway. Although the details of the mechanisms leading to cell death, genotoxicity, and cell-cycle delay are not completely understood, resin monomers may be able to alter the functions of the cells of the oral cavity. Pathways regulating cellular homeostasis, dentinogenesis, or tissue repair may be modified by monomers at concentrations well below those which cause acute cytotoxicity.
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Affiliation(s)
- H Schweikl
- Department of Operative Dentistry and Periodontology, University of Regensburg, D-93042 Regensburg, Germany.
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