ABSTRACT
I. Summary 341
II. Introduction 342
III. Acrylics 342
A. Prostheses 343
B. Dental Composite Resins (DCRs) 345 C. Dentin Bonding Compounds 347
D. Glass Ionomers 352
E. Other Features of Acrylics 353
1. Penetration of Acrylics through Gloves 353 2. Purity of Dental Acrylic Resins 357 3. Replacement of Acrylics 357 4. Active Sensitization 358
5. Patch Testing with “Own” Acrylics 360
6. False-Negative Patch Test Reactions with “Own” Acrylics 360
7. Immediate Hypersensitivity 361
8. Conjunctivitis 361 9. Formaldehyde Leaching from Cured Acrylics 362
10. Paresthesia 362
11. Paronychia 362
12. Nail Dystrophy 362
13. Risk of Acrylics to Dental Patients 362 14. Which Acrylics Should Be Used for Patch Testing? 363 IV. Activators and Inhibitors 363
A. N,N-Dimethyl-p-Toluidine (DMT) 363 B. 4-Tolyl Diethanolamine 363
C. Benzoyl Peroxide 364
D. Camphoroquinone 364
E. Hydroquinone and Methylhydroquinone (Inhibitors) 364 V. Plasticizers 365
VI. Epoxy Acrylates 365
VII. Epoxy Resin Compounds 364
VIII. UV-Absorbers 366
A. 2-Hydroxy-4-Methoxy-Benzophenone 366
B. 2-(2-Hydroxy-5-Methylphenyl) Benzotriazole 366 References 367
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I. SUMMARY
Occupational hand dermatitis caused by acrylates has been reported in the dental profession since the 1950s, initially in dental technicians from methyl methacrylate. Since the 1980s increasing numbers of dental personnel have been exposed to acrylates and have developed occupational allergic contact dermatitis (ACD) from many different acrylates in dental composite resins, dental bonding agents, and, in rare cases, from glass ionomer. The most common clinical sign is dermatitis on the fingertips (pulpitis), often accompanied by paresthesia. Other typical features are itching, erythema, scaling, fissures, pain, vesicles, bullae, and hyperkeratosis. If exposure continues the hand eczema becomes more widespread. ACD from acrylates can reliably be diagnosed with patch testing, but there is no single acrylate that can screen for acrylate allergy, and therefore many different acrylates need to be used. Patch testing should never be performed with
undiluted dental acrylic because this may cause active sensitization. Because even a single exposure may sensitize, and acrylics penetrate most disposable gloves, it is important to use no-touch techniques when handling dental acrylics.
