Allergy to N,N‐dimethyl‐p‐toluidine in dental materials

Because of the potential for exposure to N,N-dimethyl-p-toluidine (DMPT) in medical devices and the lack of toxicity and carcinogenicity information available in the literature, the National Toxicology Program conducted toxicity and carcinogenicity studies of DMPT in male and female F344/N rats and B6C3F1/N mice. In these studies, a treatment-related macrocytic regenerative anemia characterized by increased levels of methemoglobin and Heinz body formation developed within a few weeks of DMPT exposure in rats and mice. DMPT induced nasal cavity, splenic, and liver toxicity in rats and mice at 3 months and 2 years. DMPT carcinogenic effects were seen in the liver of male and female rats and mice, the nasal cavity of male and female rats, and the lung and forestomach of female mice. In rodents, DMPT is distributed to many of the sites where toxic and carcinogenic effects occurred. DMPT-induced oxidative damage at these target sites may be one mechanism for the treatment-related lesions. Methemoglobinemia, as seen in these DMPT studies, is caused by oxidation of the heme moiety, and this end point served as an early alert for other target organ toxicities and carcinogenic responses that followed with longer term exposure.

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“…Allergic responses to DMPT have also been reported (Tosti et al 1990; Vazquez, Levenfeld, and Roman 1998; Verschueren and Bruynzeel 1991). …”

Section: Introductionmentioning

confidence: 99%

“…Toxicity to DMPT has been reported in children after accidental DMPT poisoning accompanied by methemoglobinemia (Kao et al 1997; Potter et al 1988). Allergic responses to DMPT have also been reported (Tosti et al 1990; Vazquez, Levenfeld, and Roman 1998; Verschueren and Bruynzeel 1991).…”

Section: Introductionmentioning

confidence: 99%

N,N-Dimethyl-p-toluidine, a Component in Dental Materials, Causes Hematologic Toxic and Carcinogenic Responses in Rodent Model Systems

et al. 2013

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“…Regulation leaves it open to them to 'determine the rights and duties associated with social security insurance as well as the conditions for benefit entitlement'. 68 By contrast, the judgment handed down by the Court in TSN concerns an area where the Union legislator has actually reached a legislative compromise on the definition of a minimum standard of harmonisation with respect to paid annual leave guarantees.…”

mentioning

confidence: 99%

Minimum Harmonisation and Fundamental Rights: A Test-Case for the Identification of the Scope of EU Law in Situations Involving National Discretion?: ECJ (Grand Chamber) 19 November 2019, Joined Cases C-609/17 and C-610/17, TSN

Tecqmenne¹

2020

European Constitutional Law Review

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In its judgment in the TSN case delivered on 19 November 2019, the Grand Chamber of the European Court of Justice (the Court) had to determine whether, in adopting national measures on paid annual leave that are more generous than the minimum of four weeks' paid annual leave laid down in an EU Directive 1 , EU member states are bound to comply with the Charter of Fundamental Rights of the EU (the Charter) and, in particular, the requirements of the right to paid annual leave enshrined in its Article 31(2). Perhaps somewhat surprisingly, the Court held that the enactment of more protective paid leave rules cannot be regarded as falling within the scope of EU law. As a result, the member states do not have to ensure compliance with the fundamental rights laid down in the Charter when they adopt such measures. With this judgment, the Grand Chamber of the Court fine-tuned its interpretation of the scope of EU law as referred to in Article 51(1) of the Charter. According to that provision, as interpreted by the Court in Åkerberg Fransson, the Charter binds the member states only when they act within the scope of

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“…Allergic contact stomatitis has rarely been reported as a cause of denture‐related stomatitis 8,9 . It should be suspected in patients with a denture‐related stomatitis that occurs shortly after introducing a new or recently repaired denture.…”

mentioning

confidence: 99%

“…Monomer fluid, methyl methacrylate, and the polymer powder polymethyl methacrylate are combined to make “dough” that is formed into the correct shape. The dough is then hardened into shape by adding catalysts such as benzoyl peroxide and the accelerator N, N‐dimethyl‐p‐toluidine 8 . If the polymerization reaction is not complete, residual methyl methacrylate monomer can be released from the denture in the mouth and produce an allergic contact stomatitis when new dentures are introduced 9,10 .…”

mentioning

confidence: 99%

Denture Stomatitis

Chen

Zirwas

2007

Skinmed

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A 70-year-old woman presented for evaluation of an eruption localized to the area covered by her partial upper denture. Her medical history and physical examination were otherwise unremarkable. She originally had a metal upper partial denture, which she used for many years without difficulty. Four years before presentation, she developed a painful eruption affecting only the tissue covered by the upper partial denture. Contact dermatitis to metal was suspected, and a new upper partial denture constructed primarily of acrylates was fashioned. When she transitioned to the new denture, the inflammation in her oral mucosa persisted and perhaps worsened, despite an excellent fit. Examination revealed striking erythema and mild edema sharply localized to the areas where the partial upper denture contacted the gum ridge. Patch testing was performed and revealed allergies to multiple acrylates, including methyl methacrylate. A swab from the gums was sent for yeast culture. No Candida was detected. Based on suspected candidal overgrowth on the denture, the patient was advised to begin applying nystatin ointment between the gums and the denture, and to start soaking the dentures nightly in chlorhexidine 0.12% solution. In addition, because the relevance of the acrylate allergy was unclear, her dentist was contacted and it was recommended that the dentures be boiled to induce polymerization of any residual un-reacted methacrylate monomers. The patient had a 90% improvement in the clinical appearance and in symptoms at an 8-week follow-up appointment. Due to logistic issues, the dentures had not yet been boiled. The improvement, despite the dentures not having been boiled, was felt to demonstrate that the acrylate allergy was not relevant. The patient has continued to slowly show further improvement over 6 months of follow-up.

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Allergy to N,N‐dimethyl‐p‐toluidine in dental materials

Cited by 21 publications

References 5 publications

N,N-Dimethyl-p-toluidine, a Component in Dental Materials, Causes Hematologic Toxic and Carcinogenic Responses in Rodent Model Systems

N,N-Dimethyl-p-toluidine, a Component in Dental Materials, Causes Hematologic Toxic and Carcinogenic Responses in Rodent Model Systems

Minimum Harmonisation and Fundamental Rights: A Test-Case for the Identification of the Scope of EU Law in Situations Involving National Discretion?: ECJ (Grand Chamber) 19 November 2019, Joined Cases C-609/17 and C-610/17, TSN

Denture Stomatitis

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