Dental Bonding Agent: Allergy Contact Dermatitis: Report of 3 Cases

Special Article - Dental Materials

Austin J Dent. 2017; 4(6): 1089.

Dental Bonding Agent: Allergy Contact Dermatitis: Report of 3 Cases

Zeina Berri¹, Mohammed Alshehri², Norman Firth³ and Omar Kujan³*

¹Department of Oral Medicine and Diagnostic Sciences, Al-Farabi College for Dentistry and Nursing, Al-Farabi Colleges, Saudi Arabia

²Department of Dentistry, College of Medicine and University Hospitals, King Saud University, Saudi Arabia

³School of Dentistry, The University of Western Australia, Australia

*Corresponding author: Omar Kujan, School of Dentistry, The University of Western Australia, M512, 17 Monash Avenue, Nedlands,WA6009, Australia

Received: July 04, 2017; Accepted: August 10, 2017; Published: September 04, 2017

Abstract

Dental bonding agents containing (Meth) acrylates are well-known for inducing allergic contact dermatitis in dental personnel. We report three cases of contact dermatitis, which developed in response to exposure to allergenic components of dental bonding agent. This case report highlights the inadequacy of hand gloves in protection against (Meth) acrylates. It also suggests measures that may help minimize the risk of (Methacrylates) hypersensitivity reactions in dental professionals.

Keywords: Contact dermatitis; Dentistry; Adhesive dental materials; Dental bonding

Introduction

The recent advances in the dental adhesive materials have transformed the scope of current dental practice, also driven by the huge demands for aesthetic solutions [1,2]. Therefore, dental professionals are now heavily exposed to the use of these advanced adhesives during their daily routine work [3]. Almost all types of dental bonding agents contain (Meth) acrylates [4].

Allergic contact dermatitis (ACD) is known as a noninfectious inflammatory disease of the skin characterised by the delayed hypersensitivity reactions that is known as type IV T-cell-mediated hypersensitivity reaction [5]. Several materials in dentistry including products containing (Meth) acrylates are well-known for provoking allergic reactions [6]. It is estimated that 5-10% of all ACD reports in dental professionals are due to contact with (Meth) acrylates [7]. We report three cases of ACD in dental interns due to the use of dental bonding agent containing (Meth) acrylates during a period of six months. The purpose of this case report is to promote the awareness of the risks of dealing with materials containing allergens such as (Meth) acrylates despite wearing latex or vinyl hand gloves.

Case Presentation

Three different cases have been reported at Al-Farabi Colleges for Dentistry and Nursing, Riyadh, Saudi Arabia due to dental bonding agent contact with the skin during the month of March 2015. The bonding agent used was Natural Bond DE (DFL INDÚSTRIA E COMéRCIO S/A, Rio de Janeiro, Brazil).

Dental Interns were performing operative dentistry Class I and Class II restorations with composite resin. During the procedure, bonding agents are used to bond the composite resin to the tooth structure micromechanically. The interns were practicing all standard measures of infection control including gloves and maintaining cleanliness of the working area. During the procedure, the bonding agent came in contact with the gloves for around 20-40 minutes until the procedure was completed. All three interns were healthy with no history of allergies to any drug or food.

Case 1

A 23-year-old female dental intern, who used vinyl gloves to perform a dental restoration for the patient, experienced itching and redness of the dorsum of her left hand when she removed her gloves. A week following the initial injury at the beginning of March 2015, signs and symptoms of eczematous rash started evolving: elevated dark red papules in an area of redness, rashes, and pruritus of the area (Figure 1A). She didn’t develop rashes or other lesions elsewhere. The lesions resolved after using topical corticosteroids for two weeks. A follow-up examination after two months revealed no signs of the previously reported lesions (Figure 1B).