Positive patch test reactions to allergens of the dental series and the relation to the clinical presentations

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.

Occupational Contact Dermatitis Amongst Dentists and Dental Technicians

“…Th us, Khamaysi et al included dental personnel with hand dermatitis in the research of contact allergic reactions, but only 39% of them were positive on patch test, mostly to metals, i.e. nickel, gold, palladium and cobalt 31 . It was shown that hand dermatitis in dental workers is relatively commonly caused by metal allergies, although it is possible that dental instruments alone are not the only source of activation but rather a key factor in the occurrence of CD 31 .…”

“…Metals were, therefore, next to latex, another common potential cause of contact allergic dermatitis 31,32 . Th us, Khamaysi et al included dental personnel with hand dermatitis in the research of contact allergic reactions, but only 39% of them were positive on patch test, mostly to metals, i.e.…”

“…nickel, gold, palladium and cobalt 31 . It was shown that hand dermatitis in dental workers is relatively commonly caused by metal allergies, although it is possible that dental instruments alone are not the only source of activation but rather a key factor in the occurrence of CD 31 . Lee et al have also reported similar results in 49 dental technicians in Korea 33 .…”

An unusual case of immediate hypersensitivity reaction associated with an amalgam restoration

“…1 Among restorative materials, amalgam is the most common dental material that induces hypersensitivity reactions of oral mucosa. 1,2 The mercury component of the alloy has been mostly held responsible for adverse immunological effects, with occasional reactions to other components such as copper, tin or zinc. 1,2 Hypersensitivity reactions to mercury associated with amalgam restorations comprise an array of clinical manifestations on oral mucosa.…”

“…1,2 The mercury component of the alloy has been mostly held responsible for adverse immunological effects, with occasional reactions to other components such as copper, tin or zinc. 1,2 Hypersensitivity reactions to mercury associated with amalgam restorations comprise an array of clinical manifestations on oral mucosa. The most common type presents as a lichenoid reaction which involves a delayed, type IV and cell-mediated hypersensitivity response.…”