Allergic contact dermatitis from dental composite resins due to aromatic epoxy acrylates and aliphatic acrylates.
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.
Kanerva
L
L
Section of Dermatology, Institute of Occupational Health, Helsinki, Finland.
Estlander
T
T
Jolanki
R
R
D000180:Acrylic Resins / Q000009:adverse effects*; D003188:Composite Resins / Q000009:adverse effects; D003756:Dental Hygienists; D003815:Dentists; D003877:Dermatitis, Contact / Q000209:etiology* / Q000517:prevention & control; D009783:Dermatitis, Occupational / Q000139:chemically induced* / Q000517:prevention & control; D005260:Female; D005932:Gloves, Surgical; D006229:Hand Dermatoses / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D010328:Patch Tests
D000180:Acrylic Resins; D003188:Composite Resins