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Hopkins K, Antelmi A, Dahlin J, Olsson K, Svedman C, Åstrand J, Bruze M. Increased Rates of Gold and Acrylate Allergy in Individuals with Fibromyalgia Tested with an Extended Dental Patch Test Series. Acta Derm Venereol 2023; 103:adv22336. [PMID: 38078690 PMCID: PMC10726376 DOI: 10.2340/actadv.v103.22336] [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] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Fibromyalgia is a common chronic pain condition. Rates of contact allergy in individuals with fibromyalgia have not been widely studied. Systemic contact allergy can present with muscle and joint pain and general malaise. The aim of this study is to investigate contact allergy rates in individuals with fibromyalgia to the sensitizers in an extended dental series and compare with control groups. Contact allergy to gold was significantly more common in the fibromyalgia group than the dermatitis control group. When corrected for patch test system, contact allergy to gold was significantly more common in the fibromyalgia group than the dental control group. Contact allergy to hydroxyethyl methacrylate and grouped acrylates and methacrylates was significantly more common in the fibromyalgia group than the dental control group. In conclusion, individuals with fibromyalgia may have a propensity to sensitization to gold, either via an increased exposure or an alteration in the oral environment. Gold is also implicated in systemic contact dermatitis and may be a factor in elicitation of symptoms in individuals with fibromyalgia. Acrylate allergy is also common in the fibromyalgia population and may be a consequence of occupational exposure or dental treatment.
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Affiliation(s)
- Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Can A, Karabacak DE, Yalcin BK, Demir S, Buyukozturk S, Colakoglu B, Gelincik A. How important is patch testing with dental materials in real-life clinical practice? Allergy Asthma Proc 2023; 44:136-144. [PMID: 36872444 DOI: 10.2500/aap.2023.44.220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Background: Allergy to dental materials in prostheses and implants that leads to dental device dysfunction is a challenging problem. Objective: In this prospective study, we aimed to investigate the diagnostic role and impact of dental patch test (DPT) results on the outcome of proceeding dental procedures with the collaboration of our allergy clinic and dental clinics. Methods: A total of 382 adult patients with oral or systemic signs or symptoms due to the applied dental materials were included. A DPT with 31 items was administered. The clinical findings after dental restoration according to the test results were assessed in the patients. Results: The most common positivity detected in the DPT was due to metals, among which nickel (29.1%) was the leading cause. The frequency of self-reported allergic diseases and metal allergy was significantly higher in patients with at least one positive result in the DPT (p = 0.004 and p < 0.001, respectively). Clinical improvement after the removal of dental restoration was seen in 82% of the patients who had a positive DPT result, whereas this rate was 54% among paatients with negative DPT results (p < 0.001). The only factor that predicted improvement after restoration was the positivity in the DPT result (odds ratio 3.96 [95% confidence interval, 0.21-7.09]; p < 0.001). Conclusion: Our study showed that a self-reported metal allergy was an important finding to predict allergic reactions to dental devices. Therefore, patients should be questioned for the presence of metal allergy-related signs and symptoms before exposure to the dental materials to prevent possible allergic reactions. Furthermore, DPT results are valuable to guide dental procedures in real life.
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Affiliation(s)
- Ali Can
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
| | - Deniz Eyice Karabacak
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
| | - Basak Keskin Yalcin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Semra Demir
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
| | - Suna Buyukozturk
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
| | - Bahauddin Colakoglu
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
| | - Aslı Gelincik
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and
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Bruze M, Hopkins K, Dahlin J, Olsson K, Åstrand J, Svedman C, Ofenloch R, Antelmi A. Increased rates of fragrance allergy in fibromyalgia individuals tested with the Swedish baseline patch test series. J Eur Acad Dermatol Venereol 2023; 37:104-113. [PMID: 36018078 DOI: 10.1111/jdv.18562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Contact allergy can manifest in a variety of ways clinically. Systemic contact allergy may occasionally present with pain in muscles and joints. Fibromyalgia is a chronic rheumatic disease characterized by pain and with virtually unknown aetiology. OBJECTIVES The aim of this study was to investigate the contact allergy rates to the sensitizers in a baseline series and compare with corresponding rates in dermatitis patients and the general population. METHODS Patch testing with the Swedish baseline series was performed in 120 individuals with fibromyalgia. Fisher's exact test was used for pair-wise comparisons of contact allergy rates between the fibromyalgia group and two control groups, dermatitis patients and individuals in the general population. RESULTS Contact allergy was significantly more common in the fibromyalgia group compared to the general population concerning nickel and the fragrance markers Myroxolon pereirae and fragrance mix I. There were fewer allergic reactions to preservatives in the fibromyalgia group compared with the dermatitis group. CONCLUSIONS Myroxolon pereirae and fragrance mix I represent besides fragrance allergy also allergy to flavouring substances which indicate that oral exposure to flavouring substances and hygiene products might be important for sensitization and possibly elicitation of systemic contact allergy symptoms in fibromyalgia individuals.
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Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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4
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Boutefnouchet T, Vallières F, Delisle J, Benderdour M, Fernandes JC. Lymphocyte transformation test reveals low prevalence of true metal hypersensitivity among pre-operative total knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 2022; 30:4123-4133. [PMID: 35380240 DOI: 10.1007/s00167-022-06951-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/15/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to determine the prevalence of metal hypersensitivity, and identify pre-operative factors which could predict susceptibility to hypersensitivity reactions among patients scheduled for primary total knee arthroplasty (TKA). The present study used a testing method consistent with the recognised biological response to metals. METHODS A prospective cross-sectional analysis of 220 patients was conducted. All patients received a testing protocol using lymphocyte transformation test to evaluate reactivity to possible contents of orthopaedic implants. Test response is interpreted as stimulation index (SI) values. A comprehensive questionnaire was used to evaluate prior exposure. Patients were categorised according to SI values and the odds ratios (OR) were calculated as comparative effect measure for each predetermined prior exposure factor. RESULTS The prevalence of metal sensitivity response was 28% (n = 61) among patients with susceptibility to at least one agent (SI = 2 to 4.9), and 3.2% (n = 7) among patients with true hypersensitivity (SI ≥ 5). The population-weighted prevalence, adjusted for sampling weights of symptomatic knee osteoarthritis, was SI ≥ 5 = 4.7% (95% CI 0.4-11.8%) and SI ≥ 2 = 35.2% (95% CI 24.8-48.6%). Stimulation index levels of response to materials were markedly varied with the highest being aluminium. Female sex, smoking history, cutaneous reaction to jewellery, occupational exposure, and dental procedures were among factors shown to increase the odds of having higher reactivity response to tested metals. Nevertheless, patients with well-functioning prior contralateral TKA did not appear at greater risk of having either sensitivity or susceptibility with odds ratio (OR) = 0.2 (95% CI 0.01-3.2), p: NS and OR = 0.6 (95% CI 0.3-1.2), p: NS, respectively. Prior positive patch test was neither predictor of susceptibility to hypersensitivity OR = 1.2 (95% CI 0.6-2.6) p: NS nor predictor of true hypersensitivity OR = 0.7 (95% CI 0.08-6.1), p: NS. CONCLUSION Among patients scheduled for primary TKA with no prior clinical features of metal allergy the prevalence of true hypersensitivity to at least one metal is just over 3%. Patients are likely to encounter a material to which they have pre-existing susceptibility to hypersensitivity. With certain prior exposure factors, there was increased susceptibility to metal hypersensitivity reaction evoking an acquired condition. LEVEL OF EVIDENCE Level II, prospective cross-sectional study.
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Affiliation(s)
- Tarek Boutefnouchet
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada.
- University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
| | - Francis Vallières
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Josee Delisle
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Mohamed Benderdour
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Julio C Fernandes
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
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5
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Zhang Y, de Graaf NPJ, Roffel S, Spiekstra SW, Rustemeyer T, Kleverlaan CJ, Feilzer AJ, Bontkes H, Deng D, Gibbs S. Patch test-relevant concentrations of metal salts cause localized cytotoxicity, including apoptosis, in skin ex vivo. Contact Dermatitis 2021; 85:531-542. [PMID: 34268774 PMCID: PMC9291529 DOI: 10.1111/cod.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Background Metal alloys containing contact sensitizers (nickel, palladium, titanium) are extensively used in medical devices, in particular dentistry and orthopaedic surgery. The skin patch test is used to test for metal allergy. Objective To determine whether metal salts, when applied to freshly excised skin at patch test–relevant concentrations and using a method which mimics skin patch testing, cause in changes in the epidermis and dermis. Methods Tissue histology, apoptosis, metabolic activity, and inflammatory cytokine release were determined for two nickel salts, two palladium salts, and four titanium salts. Results Patch test–relevant concentrations of all metal salts caused localized cytotoxicity. This was observed as epidermis separation at the basement membrane zone, formation of vacuoles, apoptotic nuclei, decreased metabolic activity, and (pro)inflammatory cytokine release. Nickel(II) sulfate hexahydrate, nickel(II) chloride hexahydrate, titanium(IV) bis(ammonium lactato)dihydroxide, and calcium titanate were highly cytotoxic. Palladium(II) chloride, sodium tetrachloropalladate(II), titanium(IV) isopropoxide, and titanium(IV) dioxide showed mild cytotoxicity. Conclusion The patch test in itself may be damaging to the skin of the patient being tested. These results need further verification with biopsies obtained during clinical patch testing. The future challenge is to remain above the elicitation threshold at noncytotoxic metal concentrations.
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Affiliation(s)
- Yan Zhang
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Niels P J de Graaf
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sander W Spiekstra
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centre location AMC, Amsterdam, The Netherlands
| | - Cees J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hetty Bontkes
- Unit Medical Immunology, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Dongmei Deng
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Susan Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
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6
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Zhang XP, Yuan Q, Qi YL, Zheng DJ, Liu QX, Wang BZ, Yang YS, Zhu HL. An umbelliferone-derivated fluorescent sensor for selective detection of palladium(II) from palladium(0) in living cells. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 220:117134. [PMID: 31141780 DOI: 10.1016/j.saa.2019.05.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/05/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Palladium (Pd) has drawn worldwide attentions because its connections to industry, chemistry, biological material and public health. Quantitative and selective detection tools for Pd and its ion forms are in urgent necessity. Here an umbelliferone derivative Umb-Pd2 was provided as a small, steady, safe and selective sensor for detecting Pd(II). It indicated advantages including sensitive (LOD 1.1 nM), wide pH tolerance (5.0-10.0), applicable linear range (0-1.8 equivalent) and low toxicity. The most attractive point was its explicit selectivity towards Pd(II) from Pd(0) in both independent and coexistence systems. This distinguishing ability was further utilized in imaging in living cells, raising this work as a rare and important example among all the published papers on palladium sensing. Thus, Umb-Pd2 supplied a potential approach for further improvement and applications in both daily chemistry and public health.
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Affiliation(s)
- Xu-Ping Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China
| | - Qing Yuan
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China
| | - Ya-Lin Qi
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China
| | - Da-Jun Zheng
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China
| | - Qi-Xing Liu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China
| | - Bao-Zhong Wang
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China.
| | - Yu-Shun Yang
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China.
| | - Hai-Liang Zhu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, China.
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7
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Mondal S, Manna SK, Pathak S, Masum AA, Mukhopadhyay S. A colorimetric and “off–on” fluorescent Pd2+ chemosensor based on a rhodamine-ampyrone conjugate: synthesis, experimental and theoretical studies along with in vitro applications. NEW J CHEM 2019. [DOI: 10.1039/c8nj05194a] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We successfully designed and developed a rhodamine based “turn-on” chemosensor L for the detection of Pd2+ ions down to 1.19 × 10−5 M (11.9 μM).
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Affiliation(s)
- Sanchita Mondal
- Department of Chemistry
- Jadavpur University
- Kolkata 700032
- India
| | | | - Sudipta Pathak
- Department of Chemistry
- Haldia Government College
- Purba Medinipur
- India
| | - Abdulla Al Masum
- Department of Life Science & Bio-technology
- Jadavpur University
- Kolkata 700032
- India
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8
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Balamurugan R, Liu JH, Liu BT. A review of recent developments in fluorescent sensors for the selective detection of palladium ions. Coord Chem Rev 2018. [DOI: 10.1016/j.ccr.2018.07.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Jie X, Liu M, Peng A, Huang J, Zhang Y, Wang X, Tian Z. A new colorimetric, near-infrared fluorescent probe for rapid detection of palladium with high sensitivity and selectivity. Talanta 2018; 183:164-171. [PMID: 29567159 DOI: 10.1016/j.talanta.2018.02.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 01/24/2023]
Abstract
A new type of colorimetric, fluorescent palladium (Pd) probe characterized with beaconing fluorescence signal in the quiet near-infrared (NIR) region (centered ~ 717 nm), recognition response time of approximately 3 min, limit of detection (LOD) down to 5.1 ppb, and excellent recognition specificity over a wide range of interfering metal cations was developed. It is believed that the probe underwent sequential Pd0-mediated oxidative addition and reduction elimination reactions, yielding typical D-π-A molecular skeleton of the final reaction product capable of intramolecular charge transfer (ICT). The benzothiazole moiety of the probe molecular skeleton is believed to play a vital trole in shifting the beaconing fluorescence signal to the quiet NIR region and accelerating the Pd0 recognition process of the probe via the formation of the fluorescent reaction product with largely extended π-delocalization. With unique advantages, the fluorescent probe we developed will find practical applications for detecting residual Pd with concentration below the safety margin in pharmacy and biomedical engineering.
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Affiliation(s)
- Xiaoke Jie
- School of Chemistry and Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Ming Liu
- School of Chemistry and Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Aidong Peng
- College of Materials Science and Opto-electronic Technology, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Jijun Huang
- College of Materials Science and Opto-electronic Technology, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yuanlin Zhang
- School of Chemistry and Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Xuefei Wang
- School of Chemistry and Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Zhiyuan Tian
- School of Chemistry and Chemical Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China.
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10
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Bjørklund G, Dadar M, Aaseth J. Delayed-type hypersensitivity to metals in connective tissue diseases and fibromyalgia. ENVIRONMENTAL RESEARCH 2018; 161:573-579. [PMID: 29245125 DOI: 10.1016/j.envres.2017.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
Rheumatic diseases include a group of autoimmune disorders with environmental and genetic etiology that are characterized as a subgroup of connective tissue diseases (CTD). Rheumatoid arthritis (RA) often involves the small joints of the hands in a symmetrical fashion that can lead to loss of joint function, and RA, as well as Sjögren's syndrome (SS) and other rheumatic diseases, are often accompanied by sensitivity to metals. Numerous investigations on metal sensitivity were evaluated in this review. A detailed metal exposure history was collected by different evaluation of studies. In all subjects, the main source of metal exposure was nickel, mercury, gold, palladium, titanium, and chromium. All of SLE (systemic lupus erythematosus), RA and SS patients appeared to have an increased frequency of metal delayed-type hypersensitivity (DTH) (Type IV allergy). As dental restorative materials release minor amounts of their metals (including mercury, gold, and nickel), many adults are commonly exposed to these metal ions by vapor or corrosion into saliva. Metal-related DTH in these patients will induce an inflammatory response. Such inflammations are important factors in CTD progress. It is hypothesized that metal-specific T cell reactivity can act as an etiological agent in the propagation and chronification of rheumatic inflammation. The key responses of metal delayed-type hypersensitivity in autoimmunity are precipitating as an appealing challenge for further investigations.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Jan Aaseth
- Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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11
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12
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Muris J, Goossens A, Gonçalo M, Bircher AJ, Giménez-Arnau A, Foti C, Rustemeyer T, Feilzer AJ, Kleverlaan CJ. Sensitization to palladium and nickel in Europe and the relationship with oral disease and dental alloys. Contact Dermatitis 2015; 72:286-96. [DOI: 10.1111/cod.12327] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/01/2014] [Accepted: 11/15/2014] [Indexed: 01/09/2023]
Affiliation(s)
- Joris Muris
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam; Gustav Mahlerlaan 3004 1081 LA Amsterdam The Netherlands
| | - An Goossens
- Contact Allergy Unit, Department of Dermatology; K.U. Leuven University Hospital; Kapucijnenvoer 33 3000 Leuven Belgium
| | - Margarida Gonçalo
- Department of Dermatology; Faculty of Medicine, University Hospital, University of Coimbra; Praceta Mota Pinto 3000-075 Coimbra Portugal
| | - Andreas J. Bircher
- Allergy Unit, Department of Dermatology; University Hospital Basel; Spitalstrasse 26 4031 Basel Switzerland
| | - Ana Giménez-Arnau
- Department of Dermatology; Hospital del Mar. Parc de Salut Mar, Universitat Autònoma de Barcelona; Passeig Maritim 25-29 08003 Barcelona Spain
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology; Dermatological Clinic, University of Bari; Policlinico di Bari, Piazza Giulio Cesare 11 70124 Bari Italy
| | - Thomas Rustemeyer
- Department of Dermatology; VU University Medical Centre; De Boelelaan 1117 1081 HV Amsterdam The Netherlands
| | - Albert J. Feilzer
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam; Gustav Mahlerlaan 3004 1081 LA Amsterdam The Netherlands
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam; Gustav Mahlerlaan 3004 1081 LA Amsterdam The Netherlands
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13
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Turan IS, Yilmaz O, Karatas B, Akkaya EU. A sensitive and selective chemiluminogenic probe for palladium. RSC Adv 2015. [DOI: 10.1039/c5ra01551k] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Palladium triggered removal of a propargyl group leads to the cleavage of the 1,2-dioxetane ring, leading to bright chemiluminescence.
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Affiliation(s)
- Ilke Simsek Turan
- UNAM-National Nanotechnology Research Center
- Bilkent University
- Ankara 06800
- Turkey
| | - Ozge Yilmaz
- Department of Chemistry
- Ahi Evran University
- Kirsehir
- Turkey
| | - Betul Karatas
- Department of Chemistry
- Ahi Evran University
- Kirsehir
- Turkey
| | - Engin U. Akkaya
- UNAM-National Nanotechnology Research Center
- Bilkent University
- Ankara 06800
- Turkey
- Department of Chemistry
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14
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Fage SW, Faurschou A, Thyssen JP. Copper hypersensitivity. Contact Dermatitis 2014; 71:191-201. [DOI: 10.1111/cod.12273] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Simon W. Fage
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
| | - Annesofie Faurschou
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
| | - Jacob P. Thyssen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; 2900 Hellerup Denmark
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Mawardi H. Oral Contact Allergy to Suture Material Resulting in Connective Tissue Graft Failure: A Case Report. Clin Adv Periodontics 2014. [DOI: 10.1902/cap.2013.120108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Tillman C, Engfeldt M, Hindsén M, Bruze M. Usage test with palladium-coated earrings in patients with contact allergy to palladium and nickel. Contact Dermatitis 2013; 69:288-95. [PMID: 23909829 DOI: 10.1111/cod.12118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/07/2013] [Accepted: 05/21/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Since the EU Nickel Directive came into force, concern has been raised that palladium may increasingly replace nickel in alloys used in jewellery and dentistry, and that it may cause as many allergy problems as nickel. OBJECTIVES (i) To investigate the clinical relevance of contact allergy to palladium resulting from the wearing of palladium-coated earrings, and (ii) to evaluate the concordance in test results between palladium chloride (PdCl2 ), sodium tetrachloropalladate (Na2 PdCl4 ), and nickel(II) sulfate hexahydrate (NiSO4 .6H2 O), as well as variability in patch test reactivity. MATERIALS/METHODS Forty female patients with pierced earlobes and previously known contact allergy to palladium and nickel were patch tested with dilution series of nickel and palladium salts. They wore earrings covered with palladium and titanium for 9 weeks to monitor the appearance of any clinical manifestations. RESULT/CONCLUSION There is a low risk of eczema in palladium-allergic and nickel-allergic individuals when they wear jewellery coated with pure palladium, but further studies are needed to determine whether palladium, when present in alloys, could cause allergic reactions. PdCl2 , like NiSO4 .6H2 O, shows variability in patch test reactivity over time. Furthermore, Na2 PdCl4 seems to be a more sensitive test substance than PdCl2 for the detection of palladium allergy.
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Affiliation(s)
- Cecilia Tillman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, S-205 02, Sweden,; Department of Dermatology, Skåne University Hospital, Lund University, Malmö, S-205 02, Sweden
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Frankenberger R, Garcia-Godoy F, Murray PE, Feilzer AJ, Krämer N. Risk aspects of dental restoratives: From amalgam to tooth-colored materials. World J Stomatol 2013; 2:1-11. [DOI: 10.5321/wjs.v2.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 02/06/2013] [Indexed: 02/06/2023] Open
Abstract
Dental materials’ choice of patients has considerably changed. Whereas cast gold and amalgam have been the predominant biomaterials for decades, today tooth-colored materials like resin-based composites and ceramics are more and more successful. However, are we going to replace a good but biologically questionable material (amalgam) with an equal material (resin composite) being more esthetic but also biologically questionable For amalgam, long-term clinical studies reported some significant hints that in single cases amalgam may be a health hazard for patients, finally Norway banned amalgam completely. The main advantage of a resin-based composite over amalgam is its tooth-like appearance and more or less absence of extensive preparation rules. For many years it was believed that resin-based composites may cause pulpal injury. However, pulpal injury associated with the use of resin-based composites is not correlated with their cytotoxic properties. Nevertheless, resin-based composites and other dental materials require rigorous safety evaluation and continuous monitoring to prevent adverse events similar like with amalgam. Because of non-biocompatible pulp responses to resin-based composites and amalgam, they should not be placed in direct contact with the dental pulp. The less dentin remaining in the floor of preparations between resin-based composites or other dental materials is more likely to cause pulpitis. Percentage of patients and dental practitioners who display allergic reactions is between 0.7% and 2%. The release of cytotoxic monomers from resin-based materials is highest after polymerization and much lower after 1 wk. Substances released from resin-based composites have been shown to be toxic in cytotoxicity tests. Nevertheless, in vitro cytotoxicity assays have shown that amalgam has greater toxic effects than resin-based composites, sometime 100-700-fold higher. Altogether, the risk of side-effects is low, but not zero, especially for dental personnel.
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Balamurugan R, Chien CC, Wu KM, Chiu YH, Liu JH. A depropargylation-triggered fluorescence “turn-on” probe for the detection of Pd2+ based on a bispropargylamine–rhodamine conjugate. Analyst 2013; 138:1564-9. [DOI: 10.1039/c3an36758d] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Beck KA, Sarantopoulos DM, Kawashima I, Berzins DW. Elemental Release from CoCr and NiCr Alloys Containing Palladium. J Prosthodont 2012; 21:88-93. [DOI: 10.1111/j.1532-849x.2011.00800.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Faurschou A, Menné T, Johansen JD, Thyssen JP. Metal allergen of the 21st century-a review on exposure, epidemiology and clinical manifestations of palladium allergy. Contact Dermatitis 2011; 64:185-95. [DOI: 10.1111/j.1600-0536.2011.01878.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Basko-Plluska JL, Thyssen JP, Schalock PC. Cutaneous and systemic hypersensitivity reactions to metallic implants. Dermatitis 2011. [PMID: 21504692 DOI: 10.2310/6620.2011.10055] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cutaneous reactions to metal implants, orthopedic or otherwise, are well documented in the literature. The first case of a dermatitis reaction over a stainless steel fracture plate was described in 1966. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous, and vasculitic eruptions may occur. Also, more complex immune reactions may develop around the implants, resulting in pain, inflammation, and loosening. Nickel, cobalt, and chromium are the three most common metals that elicit both cutaneous and extracutaneous allergic reactions from chronic internal exposure. However, other metal ions as well as bone cement components can cause such hypersensitivity reactions. To complicate things, patients may also develop delayed-type hypersensitivity reactions to metals (ie, in-stent restenosis, prosthesis loosening, inflammation, pain, or allergic contact dermatitis) following the insertion of intravascular stents, dental implants, cardiac pacemakers, or implanted gynecologic devices. Despite repeated attempts by researchers and clinicians to further understand this difficult area of medicine, the association between metal sensitivity and cutaneous allergic reactions remains to be fully understood. This review provides an update of the current knowledge in this field and should be valuable to health care providers who manage patients with conditions related to this field.
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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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Khamaysi Z, Bergman R, Weltfriend S. Positive patch test reactions to allergens of the dental series and the relation to the clinical presentations. Contact Dermatitis 2006; 55:216-8. [PMID: 16958919 DOI: 10.1111/j.1600-0536.2006.00905.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The clinical manifestations of contact allergic dermatitis to dental materials are not uniform. This study was performed to detect the frequent allergens in the dental series associated with contact dermatitis and to define the causal relationship between the different allergens and the relevant clinical presentations. Between the years 2000 and 2004, 134 patients, aged 20-80 years, were patch tested. 121 patients were included in the study. The most frequent oral manifestations were cheilitis and perioral dermatitis (25.6%), burning mouth (15.7%), lichenoid reaction (14.0%), and orofacial granulomatosis (10.7%). 18 (14.9%) patients were dental personnel, all of whom suffered from hand dermatitis. The common allergens detected included goldsodiumthiosulphate (14.0%), nickel sulfate (13.2%), mercury (9.9%), palladium chloride (7.4%), cobalt chloride (5.0%), and 2-hydroxyethyl methacrylate (5.8%). Positive reactions to metals were frequent in all the different clinical variants, and no specific association between a specific clinical presentation and a particular allergen was found. Allergy to mercury was not a significant factor contributing to the pathogenesis of oral lichenoid reactions. However, a strong association with contact allergy to mercury in dental fillings was found in 2 patients with orofacial granulomatosis.
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Affiliation(s)
- Ziad Khamaysi
- Department of Dermatology, Rambam Medical Center, Haifa 31096, Israel
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Garau V, Masala MG, Cortis MC, Pittau R. Contact stomatitis due to palladium in dental alloys: A clinical report. J Prosthet Dent 2005; 93:318-20. [PMID: 15798680 DOI: 10.1016/j.prosdent.2005.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A patient was treated with a maxillary gold-palladium alloy fixed partial denture (FPD). Shortly after placement, the patient contracted severe contact mucositis. Patch-testing revealed a positive reaction to palladium chloride (PdCl 2 , 1% petrolatum) but not to any other component of the prosthesis. After removal of the FPD and placement of a provisional acrylic resin restoration, all signs and symptoms disappeared. A definitive metal-ceramic (titanium-porcelain) prosthesis was placed, and no signs of lesions appeared. This clinical report demonstrates that titanium may be a satisfactory alternative for patients who require prostheses and are sensitive to other metals.
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Affiliation(s)
- Valentino Garau
- School of Dentistry, University of Cagliari, Cagliari, Italy.
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van Noort R, Gjerdet NR, Schedle A, Björkman L, Berglund A. An overview of the current status of national reporting systems for adverse reactions to dental materials. J Dent 2004; 32:351-8. [PMID: 15193782 DOI: 10.1016/j.jdent.2004.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2003] [Accepted: 02/03/2004] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Since all dental materials pose a potential risk to patients and members of the dental team, the post-market monitoring of adverse reactions caused by dental materials should be considered essential. This article reviews the current status of post-market monitoring of adverse reactions to dental materials and highlights some of the issues that arise in trying to establish an evidence base on the characteristics of adverse reactions to dental materials. METHODS Norway, Sweden and more recently the UK have sought to monitor adverse reactions to dental materials systematically and proactively in an effort to add to the evidence base on the safety of dental materials. Their experiences in undertaking post-market surveillance have been combined in preparing this article. RESULTS To date the Norwegian, Swedish and the UK projects has received 1268 reports over 11 years, 848 reports over 5.5 years and 1117 reports over 3 years, respectively, relating to adverse reactions seen or experienced by dental personnel and patients. Presently, there are no harmonized criteria for what can be classified as an adverse reaction related to dental materials. Under reporting is a recognised problem and lack of awareness and lack of clarity as to what constitutes an adverse reaction may be contributory factors. A pro-active reporting system takes a considerable time to become established, but can generate a lot of potentially useful information. CONCLUSIONS There is a need to raise the awareness among dental professionals of the potential for adverse reactions due to dental materials and to develop an internationally accepted system of data gathering that can produce the evidence that reflect the extent, severity and incidence of adverse reactions to dental materials.
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Affiliation(s)
- Richard van Noort
- Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK.
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Dundar M, Gungor MA, Cal E. Multidisciplinary approach to restoring anterior maxillary partial edentulous area using an IPS Empress 2 fixed partial denture: a clinical report. J Prosthet Dent 2003; 89:327-30. [PMID: 12690341 DOI: 10.1067/mpr.2003.80] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Esthetics is a major concern during restoration of anterior partial edentulous areas. All-ceramic fixed partial dentures may provide better esthetics and biocompatibility in the restoration of anterior teeth. This clinic report describes a multidisciplinary approach and treatment procedures with an IPS Empress 2 fixed partial denture to restore missing anterior teeth.
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Affiliation(s)
- Mine Dundar
- Department of Prosthodontics, Ege University, School of Dentistry, Izmir, Turkey.
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Jin GB, Nakayama H, Shmyhlo M, Inoue S, Kondo M, Ikezawa Z, Ouchi Y, Cyong JC. High positive frequency of antibodies to metallothionein and heat shock protein 70 in sera of patients with metal allergy. Clin Exp Immunol 2003; 131:275-9. [PMID: 12562388 PMCID: PMC1808639 DOI: 10.1046/j.1365-2249.2003.02074.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two principal types of stress protein, heat shock proteins (hsps) and metallothionein (MT), are induced in cells responding to a variety of stresses. They play an important role in protecting cells from these stresses. However, many reports indicate that antibodies to hsps are present in human serum and are associated with several autoimmunity diseases. Metals, which are commonly allergenic to humans, induce both MT and hsp70 (one of the hsps family). Until now, there has been no report of any antibody to MT in human serum. In the present study, serum samples from healthy controls (Group I), and patients suffering from atopic dermatitis without (Group II) or with (Group III) metal allergy, were measured for antibodies to MT and hsp70, using an enzyme-linked immunosorbent assay (ELISA). Metal allergy was confirmed by patch testing. We first found that antibody to MT exists in human serum. We also found a high positive frequency of antibody to MT (51.3%) and to hsp70 (43.6%) in the sera of Group III, compared to those of Group I (3.8% and 5.1%) or Group II (6.4% and 5.1%). Furthermore, there was a strong positive correlation between antibody to MT and antibody to hsp70 in Group III (P = 0.0013), but not in Group I and Group II. Our results indicate that antibody to MT exists in human serum, as do antibodies to hsps, and suggest that elevated levels of MT and hsp70 antibodies are associated with metal allergy in atopic patients.
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Affiliation(s)
- G-B Jin
- Department of Geriatric Medicine and Department of Bioregulatory Function, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Abstract
Contact stomatitis is inflammation or pain of the oral mucosa due to both irritant and allergic substances. Irritants include heat, frictional trauma, and chemicals. Oral flavorings, preservatives, and dental materials are common allergens. Simplification of oral care and avoidance of contactants is the primary mode of therapy. Patch testing to a broad series of antigens may be required to identify specific causes of allergic contact stomatitis.
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Affiliation(s)
- Benjamin W LeSueur
- Department of Dermatology, Mayo Clinic Scottsdale, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA
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Kielhorn J, Melber C, Keller D, Mangelsdorf I. Palladium--a review of exposure and effects to human health. Int J Hyg Environ Health 2002; 205:417-32. [PMID: 12455264 DOI: 10.1078/1438-4639-00180] [Citation(s) in RCA: 278] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Palladium is a metal the output and use of which has more than doubled in the past ten years. It is used in dental appliances, chemical catalysts, electrical appliances and jewelry, but the greatest increase in Pd demand has been in automotive emission control catalysts. Studies on Pd concentrations in ancient ice and recent snow samples reflect the increase in mining, smelting and use of palladium in the last decades. Increases of palladium in the environment have been shown in air and dust samples. There is no data as yet available to assess the effect of this exposure. A major source of health concern is the sensitization risk of Pd as very low doses are sufficient to cause allergic reactions in susceptible individuals. Persons with known nickel allergy may be especially susceptible. Workers occupationally exposed to Pd include miners, dental technicians and chemical workers. The latter are exposed mainly to Pd salts several of which may cause primary skin and eye irritations. It is advised that persons with known Pd allergy should not work with Pd compounds. The general population may come into contact with palladium mainly through mucosal contact with dental restorations and jewelry containing palladium and possibly via emissions from Pd catalysts. Protection of the public from related adverse effects may be achieved by the use of alloys with high corrosion stability and thus minimal release of palladium. In general, in dental patients who are sensitive to Pd, restorations using Pd-containing materials should not be used although Pd has been used without allergic effects in some of these individuals. Further, those patients who have an allergy to nickel should be informed that use of Pd-containing dental materials may cause Pd allergy, though this risk appears to be low.
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Affiliation(s)
- Janet Kielhorn
- Fraunhofer Institute for Toxicology and Aerosol Research, Drug Research and Clinical Inhalation, Nikolai-Fuchs-Strasse 1, D-30625 Hannover, Germany.
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Abstract
Contact allergy to gold as demonstrated by patch testing is very common among patients with eczematous disease and seems to be even more frequent among patients with complaints from the oral cavity. There is a positive correlation between gold allergy and the presence of dental gold. Gold allergy is often found in patients with non-specific stomatitides as well as in those with lichenoid reactions or with only subjective symptoms from the oral cavity. The therapeutic effect of substituting other dental materials for gold alloys is conspicuous in casuistic reports but less impressive in larger patient materials. The amount of dental gold is correlated qualitatively and quantitatively to the blood level of gold and the effects if any of circulating blood gold are unknown. There is clearly a need for prospective studies in the field and gold sodium thiosulfate is considered an important item in the dental series for patch testing.
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Affiliation(s)
- Halvor Möller
- Department of Dermatology, Malmö University Hospital, Lund University, Sweden.
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Lygre H. Prosthodontic biomaterials and adverse reactions: a critical review of the clinical and research literature. Acta Odontol Scand 2002; 60:1-9. [PMID: 11902606 DOI: 10.1080/000163502753471925] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Prosthodontic biomaterials include impression materials, luting cements, and restorative materials. They consist of metals and alloys ceramics, and polymer materials and are retained in patients for <60 min or for decades. Oral release of compounds from biomaterials occurs, and adverse reactions may follow dental treatment. Especially in allergically vulnerable patients contact allergy may occur. There are reports from many different countries on contact allergy from gold/palladium alloys, components from polymer-based materials, chromium/cobalt alloys, and nickel. Notifications on adverse reactions in Norway, Sweden, and England are handled by a registry in which patient reactions and occupational exposure are recorded. Data from The Adverse Reaction Unit in Bergen and Umeå have been a most valuable basis in extending knowledge in a field of current interest in dentistry. A review of the clinical and research literature relating to prosthodontic biomaterials and adverse reactions shows that reliable methods seem necessary to expose the frequency of adverse reactions in general dentistry, including prosthodontic treatment.
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Affiliation(s)
- Henning Lygre
- Department of Odontology-Oral Pharmacology, University of Bergen, Norway.
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Tsuruta K, Matsunaga K, Suzuki K, Suzuki R, Akita H, Washimi Y, Tomitaka A, Ueda H. Female predominance of gold allergy. Contact Dermatitis 2001; 44:55-6. [PMID: 11156030 DOI: 10.1034/j.1600-0536.2001.440107-22.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- K Tsuruta
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
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Cederbrant K, Gunnarsson LG, Marcusson JA. Mercury intolerance and lymphocyte transformation test with nickel sulfate, palladium chloride, mercuric chloride, and gold sodium thiosulfate. ENVIRONMENTAL RESEARCH 2000; 84:140-144. [PMID: 11068927 DOI: 10.1006/enrs.2000.4079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The peripheral lymphocytes of 10 patients referred to as mercury intolerant and 9 patients referred to as tolerant with regard to presence or absence of psychosomatic symptoms when percutaneously exposed to low patch test doses of mercury were stimulated in vitro with four metal salts. In addition, cells from 7 subjects with no anamnestic mercury intolerance or allergy to metals as well as free from dental alloys were included as controls. Lymphocyte transformation test was done by in vitro challenge with five concentrations of gold sodium thiosulfate, nickel chloride, palladium chloride, and seven concentrations of mercuric chloride. Stimulation with palladium chloride and mercuric chloride showed a difference between the mercury-intolerant and -tolerant patients on one hand and the controls on the other, but there was no difference between the two patient groups. With regard to nickel sulfate, there was a significant dose-dependent stimulation in all the three groups but no difference between the groups could be seen. Gold sodium thiosulfate did not stimulate the lymphocytes at all. Based on these results, we therefore conclude that lymphocyte transformation test performed with the four metal salts cannot be used to further differentiate between mercury-intolerant and -tolerant patients.
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OHE K, KUSU F. Metal Ion Elution from Dental Alloys Due to <i>Compound Iodine Glycerin </i>in Artificial Saliva. ELECTROCHEMISTRY 2000. [DOI: 10.5796/electrochemistry.68.582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Keiji OHE
- School of Pharmacy, Tokyo University of Pharmacy and Life Science
| | - Fumiyo KUSU
- School of Pharmacy, Tokyo University of Pharmacy and Life Science
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Marcusson JA, Carlmark B, Jarstrand C. Mercury intolerance in relation to superoxide dismutase, glutathione peroxidase, catalase, and the nitroblue tetrazolium responses. ENVIRONMENTAL RESEARCH 2000; 83:123-128. [PMID: 10856185 DOI: 10.1006/enrs.1999.4030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Through percutaneous provocation with metallic mercury and phenyl mercuric acetate in patients stating the presence of subjective psychosomatic symptoms following dental amalgam treatment, it has been possible to categorize and score two extreme groups of patients, mercury-intolerant and mercury-tolerant patients reacting and not reacting, respectively, to low doses of mercury. The intolerant patients had a high psychosomatic score and the tolerant patients had a low or null score when exposed to low doses of the two mercury compounds. Determination of the scavenger enzymes superoxide dismutase, glutathione peroxidase, and catalase showed no significant differences between the mercury-intolerant and the mercury-tolerant patients and the controls. The activity of superoxide dismutase and the quantitative psychosomatic score elicited by either metallic mercury or phenyl mercuric acetate showed a positive correlation. On the other hand, analyses of the psychosomatic score and the areas under the curves of the nitroblue tetrazolium test response showed negative correlations. The results indicate that the oxidative metabolism and, in particular, superoxide dismutase may be perturbed in mercury-intolerant patients.
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Affiliation(s)
- J A Marcusson
- Department of Dermatology, Huddinge University Hospital, Huddinge, S-141 86, Sweden
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38
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Koch P, Bahmer FA. Oral lesions and symptoms related to metals used in dental restorations: a clinical, allergological, and histologic study. J Am Acad Dermatol 1999; 41:422-30. [PMID: 10459117 DOI: 10.1016/s0190-9622(99)70116-7] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergy to mercury as a cause of oral lichenoid lesions (OLL) remains controversial. Some authors reported high frequency of sensitization to mercury and beneficial effect from removal of amalgam fillings in such patients, whereas others state that this procedure affects favorably all OLL, whether patients are sensitized to inorganic mercury or not. OBJECTIVE Our purpose was to determine the frequency of sensitization to metal salts in 194 patients (patients with OLL partly adjacent to amalgam fillings: 19, oral lichen planus (OLP) without close contact to amalgam: 42, other oral diseases: 28, oral complaints: 46, control group: 59). We further studied the histologic changes of biopsy specimens from positive patch tests to metal salts, and investigated the effect of removal of amalgam in OLL, to clarify whether it is possible to identify patients who will benefit from this procedure. METHODS Patch testing was performed with the German standard series, a dental prosthesis series, and a metal salt series including gold, mercury, and palladium salts as well as other salts of metals used in dental restorations. Late readings (10 and 17 days after application of the patch tests) were performed in all patients. RESULTS Of 19 patients with OLL adjacent to amalgam fillings, 15 (78.9%) were sensitized to inorganic mercury (INM), significantly more than those with OLL not adjacent to amalgam, other oral diseases or complaints, and the control group. In 5 of 15 (33.3%) of the patients with OLL, a positive patch test to INM was observed only at D10 or D17. Amalgam was removed in 18 patients with OLL (sensitization to INM: 15), and in 11 patients with OLP (sensitization to INM: 2). After removal, the lesions of 13 of 15 of the INM-sensitized patients with OLL (86. 7%) and 2 with OLP healed or improved significantly, but this was not observed with the INM negative patients. Frequency of sensitization to gold sodium thiosulfate (GST) and palladium chloride 1% pet (PDC) was high in all groups. This was partly because readings were performed late. Lesions of 2 patients with allergic contact stomatitis caused by gold and 1 caused by palladium healed completely after removal of these restorations. Histologically, lichenoid changes were observed in 14 of 36 biopsy specimens of positive patch tests from INM (9/21), GST (2/10), and PDC (3/5) in all patient groups, mainly in persistent patch tests at D10 or D17. This was not observed in 12 biopsy specimens taken from persistent patch tests from other substances, including nickel sulfate. CONCLUSION Our results suggest that sensitization to mercury is an important cause of OLL, whether all lesions or only a part of them are adjacent to amalgam fillings. Sensitization to GST may reflect true gold allergy and should be considered as a cause of oral diseases in some patients. Sensitization to PDC is frequent but has yet only little clinical relevance. Patch tests may be positive only at D10 or D17. This suggests the importance of additional readings of GST, PDC, and mercury salts at this time.
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Affiliation(s)
- P Koch
- Department of Dermatology, University of the Saarland, Homburg/Saar, Germany
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39
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Marcusson JA. The frequency of mercury intolerance in patients with chronic fatigue syndrome and healthy controls. Contact Dermatitis 1999; 41:60-1. [PMID: 10416724 DOI: 10.1111/j.1600-0536.1999.tb06225.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Bruze M, Andersen KE. Gold--a controversial sensitizer. European Environmental and Contact Dermatitis Research Group. Contact Dermatitis 1999; 40:295-9. [PMID: 10385331 DOI: 10.1111/j.1600-0536.1999.tb06079.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Until recently, gold allergy was considered to be extremely rare. Gold has been used and worshipped for thousands of years without any obvious complaints of skin problems, either in those participating in mining and other ways of prospecting, or in those wearing jewellery. When studies on contact allergy to gold sodium thiosulfate were published at the beginning of the 1990s, the allergic nature of the reported positive patch test reactions to gold was questioned. The major argument for such questioning was the lack of demonstrable clinical relevance in most positive reactors. A major reason for the questioning may have been confusion in differentiating between contact allergy and allergic contact dermatitis. To arrive at a diagnosis of allergic contact dermatitis, 3 steps have, in principle, to be fulfilled: (i) establishment of contact allergy; (ii) demonstration of present exposure; (iii) assessment of clinical relevance, i.e., causing or aggravating a contact dermatitis. In this paper, these steps are discussed with regard to gold. With our present knowledge of contact allergy-allergic contact dermatitis, we do not recommend including gold sodium thiosulfate in the standard series. It should be applied for scientific purposes and when allergic contact dermatitis from gold is suspected.
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Affiliation(s)
- M Bruze
- Department of Occupational and Environmental Dermatology, University Hospital Malmö, Sweden
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41
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Abstract
50 patients with chronic fatigue syndrome (CFS) and 73 controls were patch tested with 8 metal allergens. We found an overrepresentation of allergies among the CFS patients, which was not significant. However, allergy to nickel occurred in 36% of patients in the CFS group and in 19% of subjects in the control group (p<0.05). The high frequency of nickel allergy was more noteworthy in females in the CFS group than among female controls (52% and 24%, respectively, p<0.05). Similarly, in the males the figures were 14% and 9%. We suggest that in vivo immunoactivation by ions of nickel, or metal cross-reacting with nickel, could be an etiological factor in CFS.
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Affiliation(s)
- J A Marcusson
- Department of Dermatology, Huddinge University Hospital, Sweden
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42
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Katoh N, Hirano S, Kishimoto S, Yasuno H. Dermal contact dermatitis caused by allergy to palladium. Contact Dermatitis 1999; 40:226-7. [PMID: 10208524 DOI: 10.1111/j.1600-0536.1999.tb06051.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine, Japan
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43
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Abstract
It is well-known that some metals/alloys are sensitizing on skin contact, but it is not so well appreciated that sensitization is dependent on the reaction of the metal/alloy with sweat. The first step in skin sensitization by metals/alloys is a corrosion process and the formation of soluble metal ions. The nature of this process has implications with respect to occurrence of metal contact dermatitis, to testing techniques and to classification of metals/alloys as skin sensitizers.
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Affiliation(s)
- G N Flint
- Nickel Development Institute, Technical Centre, Alvechurch, Birmingham, UK
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44
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Abstract
Signs and symptoms of contact allergic reactions affecting the oral mucosa may mimic other common oral disorders, making diagnosis difficult. Patients frequently seek multiple consultations and do not receive the correct diagnosis or effective management. As intraoral contact allergy may be more prevalent than previously believed, a review of this topic is warranted. This article emphasizes signs and symptoms that suggest intraoral contact allergy, and the authors discuss the allergens that most frequently affect the oral mucosa.
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Affiliation(s)
- S S De Rossi
- Department of Oral Medicine, University of Pennsylvania, School of Dental Medicine, Philadelphia 19104, USA
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45
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Marcusson JA, Cederbrant K, Heilborn J. Indium and iridium allergy in patients exposed to dental alloys. Contact Dermatitis 1998; 38:297-8. [PMID: 9667461 DOI: 10.1111/j.1600-0536.1998.tb05758.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- J A Marcusson
- Department of Dermatology, Huddinge University Hospital, Sweden
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46
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Fleming C, Lucke T, Forsyth A, Rees S, Lever R, Wray D, Aldridge R, MacKie R. A controlled study of gold contact hypersensitivity. Contact Dermatitis 1998; 38:137-9. [PMID: 9536404 DOI: 10.1111/j.1600-0536.1998.tb05679.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
1203 patients attending for routine patch testing at 3 hospitals and 105 volunteers were tested with 0.5% and 0.05% gold sodium thiosulfate (GST). 38 patients (3.2%) and 5 volunteers (4.8%) had positive patch tests to GST. There were no significant differences between volunteers and patients with respect to age, sex, atopy or exposure to gold in dental restorations, jewellery or through occupation. There were no significant differences in prevalence of GST hypersensitivity in the 3 hospitals, or between patients and controls. This is the 1st controlled study of hypersensitivity to GST, and suggests that routine patch testing to gold is of limited clinical benefit.
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Affiliation(s)
- C Fleming
- University Department of Dermatology Western Infirmary, Glasgow, Scotland, UK
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47
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Strang R, Whitters CJ, Brown D, Clarke RL, Curtis RV, Hatton PV, Ireland AJ, Lloyd CH, McCabe JF, Nicholson JW, Scrimgeour SN, Setcos JC, Sherriff M, van Noort R, Watts DC, Woods D. Dental materials: 1996 literature review. J Dent 1998; 26:191-207. [PMID: 9594471 DOI: 10.1016/s0300-5712(97)00063-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This critical review of the published literature on dental materials for the year 1996 has been compiled by the Dental Materials Panel of the UK. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, resin-bonded bridges and ceramo-metallic restorations, ceramics, denture base resins and soft lining materials, impression materials, implants materials, orthodontic materials, biomechanics and image processing, resin composites and casting investment materials and waxes). Three hundred and thirteen articles have been reviewed.
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Affiliation(s)
- R Strang
- Glasgow Dental Hospital and School NHS Trust, UK
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Affiliation(s)
- V Fernández-Redondo
- Servicio Dermatología, Hospital Gral. Galicia- Gil Casares, Complejo Hospitalario Universitario, Santiago de Compostela, La Coruña, Spain
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49
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Schuppe HC, Rönnau AC, von Schmiedeberg S, Ruzicka T, Gleichmann E, Griem P. Immunomodulation by heavy metal compounds. Clin Dermatol 1998; 16:149-57. [PMID: 9472445 DOI: 10.1016/s0738-081x(97)00194-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- H C Schuppe
- Department of Dermatology, Heinrich Heine University, Duesseldorf, Germany
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50
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Affiliation(s)
- M Wiesner
- Department of Dermatology, Ernst Moritz Arndt University, Greifswald, Germany
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