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Clinical Effects of Mercury in Conservative Dentistry: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials. Int J Dent 2020; 2020:8857238. [PMID: 32849873 PMCID: PMC7441433 DOI: 10.1155/2020/8857238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 11/24/2022] Open
Abstract
Methods A systematic literature search was conducted in four electronic databases (Ovid via PubMed, Web of Science, Scopus, and CENTRAL) including all available randomised controlled trials published in the last 15 years comparing the use of dental amalgam with composite resins in humans with a follow-up period of at least one year. The primary outcome was the Hg concentration in biological fluids (urine, hair, blood, and saliva) with the aim of assessing their reliability as biomarkers of Hg exposure. The risk of bias was assessed through the Cochrane Collaboration tool and the overall quality of evidence through the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. The results of the meta-analysis were expressed using a random-effects model, and their power was assessed through the trial sequential analysis (TSA). Results From the initial 2555 results, only 6 publications were included in the review: five were considered as having high risk of bias, whereas one as having moderate risk. Only two articles were eligible for quantitative analysis. The meta-analysis gathered data from 859 patients but was nevertheless not significant (p = 0.12). The TSA confirmed this evidence revealing that it was due to a lack of statistical power since the required information size (RIS) threshold is not reached. Conclusions The existing evidence revealed that there are not enough data to support the hypothesis that restorations with dental amalgam can cause nephrotoxicity when compared with composite resins restorations.
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Lugović-Mihić L, Ilić I, Budimir J, Pondeljak N, Mravak Stipetić M. COMMON ALLERGIES AND ALLERGENS IN ORAL AND PERIORAL DISEASES. Acta Clin Croat 2020; 59:318-328. [PMID: 33456120 PMCID: PMC7808231 DOI: 10.20471/acc.2020.59.02.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses current knowledge on the potential allergic reactions to different dental materials in patients with oral and perioral diseases. Aside from allergies to various dental materials, similar non-allergic, non-immune contact reactions (irritant or toxic) can occur. Among dental materials, the most frequent allergens are alloys, followed by rubber materials, polymers and acrylates. Allergic reactions to dental alloys that contain nickel, cobalt and amalgam are especially frequent since dentists use them for prosthetic and other restorations. There is a broad spectrum of clinical presentations of oral and perioral diseases possibly related to allergies, such as lichenoid reactions, cheilitis, perioral dermatitis, burning sensations, etc. Despite some limitations, patch test is crucial in the diagnosis and recognition of causative allergens because it reveals contact allergies, and is still superior in differentiating allergic and irritant contact reactions. It is important to examine patient medical histories (e.g., occurrence of symptoms after dental therapy or food consumption), and in consultation with their dentist, carry out allergy tests to specific dental allergens which are used or planned to be used in subsequent treatment.
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Affiliation(s)
| | - Ivana Ilić
- 1Department of Dermatovenereology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Jozo Budimir
- 1Department of Dermatovenereology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Nives Pondeljak
- 1Department of Dermatovenereology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marinka Mravak Stipetić
- 1Department of Dermatovenereology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Abstract
The diagnosis and treatment of mucosal disease with an allergic pathogenesis are challenging. Oral allergy is often a hypersensitivity reaction with variable symptoms and physical exam findings. Clinical diagnosis requires a history of prior allergen exposure, a delay from exposure to clinical findings, and improvement following allergen removal. The past decades have seen great contributions to the field of oral allergy. The aim of this review is to provide an approach to the diagnosis and treatment of oral dermatologic disease with a focus on diseases with an investigated allergic pathogenesis.
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Kim TW, Kim WI, Mun JH, Song M, Kim HS, Kim BS, Kim MB, Ko HC. Patch Testing with Dental Screening Series in Oral Disease. Ann Dermatol 2015; 27:389-93. [PMID: 26273153 PMCID: PMC4530147 DOI: 10.5021/ad.2015.27.4.389] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 11/03/2014] [Accepted: 11/10/2014] [Indexed: 11/16/2022] Open
Abstract
Background The oral mucosa is constantly exposed to several irritants and allergens including dental materials, but the role of contact allergy in oral disease is obscure. Objective To analyze positive patch test results in patients with oral diseases and evaluate the clinical relevance of oral diseases with contact allergy to dental materials. Methods We retrospectively analyzed patch test results with dental screening series in 44 patients with oral disease from 2004~2011. Results Oral diseases included oral lichen planus (54.5%), cheilitis (27.3%), burning mouth syndrome (9.1%), and others (9.1%). Thirty-one of 44 patients (70.5%) had positive reactions to one or more allergens. The most commonly detected allergens were gold sodium thiosulfate (25.0%) and nickel sulfate (25.0%), followed by potassium dichromate (22.7%), cobalt (15.9%), palladium (6.8%), mercury (4.5%), copper (4.5%), and methylhydroquinone (4.5%). Six of 24 patients with oral lichen planus had a symptom in areas adjacent to dental materials and positive patch test reactions to allergens contained in the suspected dental materials. Conclusion Patch tests with dental screening series are worth considering for oral diseases, especially for oral lichen planus.
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Affiliation(s)
- Tae-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea
| | - Woo-Il Kim
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Je-Ho Mun
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea
| | - Margaret Song
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea. ; Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea. ; Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea. ; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Pigatto PD, Spadari F, Ronchi A, Guzzi G. Salivary trace elements levels and BMS. J Oral Pathol Med 2014; 43:561-2. [DOI: 10.1111/jop.12165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Paolo D. Pigatto
- Department of Bioscience for Health; Dermatological Clinic; IRCCS Galeazzi Hospital; University of Milan; Milan Italy
| | - Francesco Spadari
- Department of Biomedical; Surgical and Dental Sciences; Unit of Oral Pathology and Medicine; Ospedale Maggiore Policlinico Fondazione Ca' Granda IRCCS; University of Milan; Milan Italy
| | - Anna Ronchi
- Laboratory of Environmental and Toxicology Testing “S. Maugeri” IRCCS; Pavia Italy
| | - Gianpaolo Guzzi
- Italian Association for Metals and Biocompatibility Research - A.I.R.M.E.B.; Milan Italy
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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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Raap U, Stiesch M, Reh H, Kapp A, Werfel T. Investigation of contact allergy to dental metals in 206 patients. Contact Dermatitis 2009; 60:339-43. [DOI: 10.1111/j.1600-0536.2009.01524.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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