Allergic contact dermatitis from dental composite resins due to aromatic epoxy acrylates mid aliphatic acrylates

Abstract

7 patients were occupationally sensitized to dental composite resin products (DCR): 6 dental nurses and 1 dentist. All had a positive patch test to their DCR. 2 independent types of allergy were seen; (a) aromatic epoxy acrylate, and/or (b) aliphatic acrylates. 4 out of 5 patients reacted to BIS-GMA, the most widely used aromatic epoxy acrylate in DCR, but not the dentist. She and 2 dental nurses were allergic to aliphatic acrylates, including triethylene glycol dimethacrylate (TREGDMA) and triethylene diglycol diacrylate (TREGDA). 4 patients were allergic to epoxy resin (ER) (containing mainly MW 340), possibly an impurity in some DCR. 2 patients were also allergic to methyl methacrylate (MMA): the dentist, had been exposed to MMA, but the nurse's exposure was uncertain. 1 patient was also allergic to rubber gloves, 2 to rubber chemicals but not their gloves, and 5 to disinfectants used. diagnosis was delayed as long as 13 years in spite of previous patch testing. Dermatologists need to use the patients' own DCR and the (meth)acrylate series for patch testing. No dental nurses could continue their occupation, but the dentist could occasionally handle DCR if wearing PVC gloves. Dental personnel need to know about the risks of DCR, and use no-touch techniques and protective gloves.

Immediate and delayed allergy from epoxy resins based on diglycidyl ether of bisphenol A.

“…BIS-GMA gave a 3 + reaction , and the other two produced a 2 + reaction. A fourth epoxy acrylate, BIS-MA [2,2,-bis(4-(methacryloxy)phenyl)propane], was negative, as were the other 25 (meth)acrylates tested (25). The series of plastics and glues, including cyanoacrylate, was negative.…”

“…This finding may indicate cross-reactivity between the test substances. Other possibilities for the concomitant positive reactions with the standard epoxy resin and the epoxy aerylates in patch testing reactions ha ve recently been discussed elsewhere (25,36).…”

Bioavailability of Components of Resin-Based Materials Which Are Applied To Teeth

“…Dermatoses were the most frequently diagnosed adverse response. Kanerva et al (1989) reported hand dermatitis in seven individuals who presented to a dermatology clinic in Finland, six of whom were dental assistants and one a dentist. Four patch-tested positive to bis-glycidyl methacrylate (Bis-GMA) and three to triethylene glycol dimethacrylate (TEGDMA), the two principal resin monomers in most commercially available resin composites.…”

Biocompatibility of Resin-Modified Filling Materials

“…Other patients revealed an allergic contact dermatitis to composite resin. The reactions were caused by Bis-GMA and benzoyl peroxide (Carmichael et al, 1997; Kanerva et al, 1989). Seventeen oral lichenoid lesions on the mucosa in contact with composite resin restorations were described by Lind (1998).…”

“…Four of those individuals were hypersensitive to Bis-GMA, and three reacted to TEGDMA; two patients were also hypersensitive to MMA. All of these dental nurses had to stop the practice of their profession (Kanerva et al, 1989).…”