Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis.

OBJECTIVES: Resin-based composites (RBCs) evolved into favoured materials for teeth restorations, marking a significant change in dental practice. Despite many advantages, RBCs exhibit various limitations in their physical and chemical properties. Therefore, we assessed the dentists' awareness of possible complications after direct composite restorations and their opinions about this material. METHODS: The online questionnaire was created in English in May 2023. A 16-item survey was dedicated to general dentists and specialists. The first section included four questions related to demographic characteristics. The second section comprised twelve questions and focused on awareness of potential side effects of composite restorations, the most crucial advantages and disadvantages of composite resins, and the frequency of experienced clinical complications after the application of composite materials. RESULTS: A total of 1830 dentists from 13 countries took part in the survey. Dentists most often declared awareness of low adhesion to the dentine (77.5 %) and, most rarely, solubility in oral fluids (42.6 %). Aesthetics was identified as the main advantage of composite fillings (79 %), followed by the possibility of repair (59 %) and adhesion to enamel (57 %). Polymerisation shrinkage was a major disadvantage for most countries (70 % overall). Analysing the declared potential clinical complications for all countries, statistically significant findings were obtained for marginal discolouration (OR=2.982, 95 % CI: 1.321-6.730, p-value=0.009) and borderline significance for secondary caries (OR=1.814, 95 % CI: 0.964-3.415, p-value=0.065). CONCLUSIONS: Dentists value aesthetics and repairability but are aware of shrinkage and experience discolouration. The issue of toxicity and solubility seems to be the least known to dentists. CLINICAL SIGNIFICANCE: Dentists should use RBCs with critical caution due to possible side effects. Despite the undoubted aesthetics of direct composite restorations, it is necessary to remember potential clinical complications such as marginal discolouration or secondary caries.

Adverse reactions to dental biomaterials: Experiences from a specialty clinic.

OBJECTIVES: The Dental Biomaterials Adverse Reaction Unit was initiated by the Norwegian health authorities in 1992 as a response to the public concern regarding the safety of dental amalgam and other dental materials. In this paper, experiences from the Unit are briefly summarized. METHODS: The Norwegian health authorities' strategy included four main topics: (i) development of a manufacturer-independent system for monitoring adverse reactions related to dental materials, (ii) funding of a specialty unit for clinical examinations of referred patients, (iii) development of official guidelines for examination and treatment of patients with health complaints attributed to dental materials, and (iv) funding of an experimental treatment project for patients with health complaints attributed to dental amalgam. RESULTS: From the start, more than 2700 adverse reaction reports were received. In the initial years, amalgam was the most frequent material mentioned in the reports. Reports about polymer-based composite materials have not increased after the prohibition of amalgam in Norway. Clinical examination of referred patients is complex and time consuming, and it is important to consider differential diagnoses. There are methodological challenges associated with the design of experimental treatments used on patients with adverse reactions attributed to dental materials. However, the results from the treatment project indicate lower symptom load after replacement of amalgam with other dental restorative materials. SIGNIFICANCE: Producer independent adverse reaction reporting can provide valuable information about the safety of these materials and could serve as a complement to the mandatory reporting system described in the European medical device regulations (MDR).

Contact allergies to dental materials in patients.

BACKGROUND: Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy. OBJECTIVES: To analyse current sensitization patterns to dental materials in patients with suspected contact allergy. METHODS: This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected participants from 169 834 people tested in 2005-2019 and registered with (i) an affected area of 'mouth' (and 'lips'/'perioral'), (ii) with the dental material in question belonging to one of three groups (dental filling materials, oral implants or dentures or equivalents) and (iii) with patch-testing done in parallel with the German baseline series, (dental) metal series and dental technician series. RESULTS: A total of 2730 of 169 834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) aged ≥ 40 years (92.8%). The sensitization rates with confirmed allergic contact stomatitis in women (n = 444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates [2-hydroxyethyl methacrylate (HEMA) 4.8%] and the substances propolis (6.8%) and 'balsam of Peru' (11.4%). The most relevant acrylates were HEMA, 2-hydroxypropyl methacrylate, methyl methacrylate, ethylene glycol dimethacrylate and pentaerythritol triacrylate. Few men were diagnosed with allergic contact stomatitis (n = 68); sensitization rates in men were highest for propolis (14.9%) and amalgam (13.6%). CONCLUSIONS: Allergic contact stomatitis to dental materials is rare. Patch testing should not only focus on metals such as nickel, palladium, amalgam and gold, but also (meth)acrylates and the natural substances propolis and 'balsam of Peru'.

[Dental materials and oral care products that can cause contact allergies]. / Tandheelkundige materialen en mondverzorgingsproducten die contactallergieën kunnen geven.

Various restorative and prosthetic materials, dental implants, medicines and cosmetic materials, such as toothpaste and denture cleaning products, are used in oral care. In principle, these materials can cause contact allergies, which can manifest as lichenoid reaction, cheilitis and angioedema. It is usually a local reaction of the oral mucosa and surrounding tissues, but a systemic reaction can also occur elsewhere in the body. If a patient develops complaints from dental materials that could be due to an allergy, it makes sense to investigate this allergologically, although these do not yet show full specificity or sensitivity. After a positive allergological examination, it is possible to examine more specifically whether the patient's complaints match the test result and it can be decided whether it is sensible to replace the dental material and, if so, which material could be an alternative. After removal of the causative allergens, the complaints should disappear completely.

General diseases and medications in 687 patients reporting on adverse effects from dental materials.

OBJECTIVES: Examination of patients claiming adverse effects from dental materials can be very challenging. Particularly, systemic aspects must be considered besides dental and orofacial diseases and allergies. Therefore, the aim of this study was to investigate a cohort of 687 patients reporting on adverse effects from dental materials focusing on findings related to known general diseases or conditions or medication-related findings with relevance to their subjective complaints. METHODS: Six hundred eighty-seven patients visiting a specialized consultation on claimed adverse effects from dental materials were retrospectively investigated for their subjective complaints, findings related to known general diseases or conditions, medication-related findings, dental and orofacial findings, or allergies with relevance to their subjective complaints. RESULTS: The most frequent subjective complaints were burning mouth (44.1%), taste disorders (28.5%), and dry mouth (23.7%). In 58.4% of the patients, dental and orofacial findings relevant to their complaints could be found. Findings related to known general diseases or conditions or medication-related findings were found in 28.7% or 21.0% of the patients, respectively. Regarding medications, findings related to antihypertensives (10.0%) and psychotropic drugs (5.7%) were found most frequently. Relevant diagnosed allergies toward dental materials were found in 11.9%, hyposalivation in 9.6% of the patients. In 15.1% of the patients, no objectifiable causes for the expressed complaints could be found. CONCLUSIONS: For patients complaining of adverse effects from dental materials, findings related to known general diseases or conditions and medications should be given particular consideration, while still in some patients, no objectifiable causes for their complaints can be found. CLINICAL RELEVANCE: For patients complaining about adverse effects from dental materials, specialized consultations and close collaboration with experts from other medical fields are eligible.

Susceptibility to discoloration of dental restorative materials containing dimethacrylate resin after bleaching.

The aim of this study is to compare the susceptibility to discoloration of dental restorative materials containing dimethacrylate resin after bleaching. In this study, resin-modified glass ionomer, polyacid-modified composite resin, giomer, posterior composite resin, anterior composite resin, bulk fill composite resin, flowable bulk fill composite resin, ormocer, indirect composite resin and hybrid ceramics were used as restorative material containing dimethacrylate resin. 20 samples were prepared from each material in accordance with the manufacturer's instructions. After the baseline colors are measured, the samples were randomly divided into four subgroups as office bleaching, home bleaching and a separate control group for each type bleaching method. Then, the samples were bleached and colored. Color measurements of the samples were repeated after exposure to bleaching and coloring. Then, ΔE00 and whiteness index (WID) were calculated. Data were analyzed using Paired-Samples T Test, two-way ANOVA, Repeated Measures ANOVA and Tukey post-hoc tests. Statistical significance level was taken as p < 0.05. In terms of bleaching systems, Opalescence Boost was found to cause more whitening in materials but more discoloration (p < 0.05). In terms of materials, it was found that the most susceptible materials to coloration were Clearfil Majesty Posterior, Filtek Bulk Fill Posterior Restorative, Filtek Bulk Fill Flowable and Fuji II LC, while the least susceptible materials were CAD/CAM materials (p < 0.05). The bleaching process increases the susceptibility to coloration of materials containing dimethacrylate resin.

Assuring the Safety of Dental Materials: The Usefulness and Application of Standards.

The formal history of standards and dentistry in the United States goes back to World War I and was prompted by the government's need to buy large quantities of dental materials to treat "an army of teeth in disrepair." This article covers the use of scientific research to establish specifications and standards used to evaluate dental materials and products, and how a practitioner can use these standards to assure the safety and performance of the materials that they use in their everyday practice.

The safety and biocompatibility of direct aesthetic restorative materials.

Restorative dental materials are among the most important medical devices in terms of the numbers of patients who benefit and the technical sophistication of the products. Many though contain toxic or noxious substances, including potentially sensitising resin monomers, photoinitiators, acidic polymers and glass or ceramic filler particles. Despite this, dental materials are among the safest medical devices in use today, with very few reports of adverse reactions or injuries among both patients or the dental team. This paper considers the potential for adverse reactions to dental materials, current evidence for harm and finally examines the reasons why in real-world clinical use the likelihood of an adverse event is extremely low. Medical devices regulations, responsible manufacture and clinical vigilance all appear to play important roles in ensuring that dental materials do not cause or present a risk to patients. While this excellent in-practice safety record is welcome, there is now increasing interest in the 'macro' scale biocompatibility of dental materials and their packaging in the environment, subjects that have been relatively neglected until recently. It was concluded that this should be a priority for future research and development and support is needed from governments alongside the manufacturing industry and the profession.

Dental material allergies and oral soft tissue reactions.

Dental materials can cause reactions to the oral mucosa and present to the general dental practitioner. These are often referred to as 'allergies' but are frequently lichenoid reactions. Most of these are related to dental amalgam restorations and can be remedied by replacing the restoration with another suitable material. Other metals, including gold, palladium, nickel and chrome, have also been reported to trigger mucosal changes. Less commonly, issues arise from other restorative materials, including denture acrylics, composites and glass polyalkenoates. Reactions are also reported due to endodontic and sealing materials. It is unclear what role skin 'patch' testing has in managing dental material allergies. This article aims to give the practitioner a clearer picture of dental material allergy issues and how they should be approached in primary dental practice.

Propiedades flexurales y estabilidad de color de materiales restauradores estéticos indirectos / Flexural properties and color stability of indirect esthetic restorative materials

Introducción: Las diferencias en las propiedades mecánicas de los materiales cerámicos y a base de resina plantean la interrogante sobre cuál puede tener un mejor desempeño a largo plazo. Objetivos: Evaluar la resistencia flexural y estabilidad de color de diferentes materiales restauradores estéticos indirectos. Métodos: Los materiales seleccionados fueron Filtek™ Z250 XT (3M ESPE), Ceramage (SHOFU Dental), VITA VM® LC y VITA ENAMIC® (VITA Zahnfabrik), IPS e.max® (Ivoclar-Vivadent) y Zolid FX (Amann Girrbach AG). El ensayo de resistencia flexural (n = 10) fue realizado en una máquina universal de ensayos mecánicos. Las lecturas de color (n = 5) se midieron en un espectrofotómetro VITA Easyshade V®. Resultados: Los materiales totalmente cerámicos mostraron un mejor desempeño mecánico (p < 0,001). Los resultados de estabilidad de color muestran que Ceramage, IPS e.max® y Zolid FX, mostraron una diferencia estadísticamente significativa (p ≤ 0,002) con Filtek Z250 XT, VITA VM® LC y VITA ENAMIC®. Conclusiones: Los materiales totalmente cerámicos presentaron una mayor resistencia flexural y estabilidad de color que los materiales de base polimérica. A pesar de ello, los materiales estéticos indirectos con polímeros en su composición, como Ceramage, se presentan como una alternativa válida, ya que además de tener propiedades mecánicas adecuadas, poseen una estabilidad de color semejante a los materiales cerámicos(AU)

Introduction: Differences in the mechanical properties of ceramic and resin-based materials pose the question of which of the two will perform better in the long run. Objectives: Evaluate the flexural resistance and color stability of different indirect esthetic restorative materials. Methods: The materials selected were Filtek™ Z250 XT (3M ESPE), Ceramage (SHOFU Dental), VITA VM® LC and VITA ENAMIC® (VITA Zahnfabrik), IPS e.max® (Ivoclar-Vivadent) and Zolid FX (Amann Girrbach AG). The flexural resistance assay (n = 10) was conducted in a universal mechanical testing machine. Color readings (n = 5) were taken with a VITA Easyshade V® spectrophotometer. Results: All-ceramic materials had better mechanical performance (p < 0.001). Color stability results show that Ceramage, IPS e.max® and Zolid FX displayed a statistically significant difference (p ≤ 0.002) with respect to Filtek Z250 XT, VITA VM® LC and VITA ENAMIC®. Conclusions: All-ceramic materials exhibited greater flexural resistance and color stability than polymer-based materials. However, indirect esthetic materials with polymers in their composition, such as Ceramage, are presented as a valid alternative, due to their appropriate mechanical properties and their color stability, which is similar to that of ceramic materials(AU)

Occupational Contact Dermatitis in Dental Personnel: A Retrospective Analysis of the North American Contact Dermatitis Group Data, 2001 to 2018.

BACKGROUND: Dental personnel are at risk of developing occupational contact dermatitis. OBJECTIVES: The aims of the study were to determine prevalence of occupational contact dermatitis in dental personnel referred for patch testing and to characterize relevant allergens and sources. METHODS: The study used a retrospective, cross-sectional analysis of the North American Contact Dermatitis Group (NACDG) data, 2001-2018. RESULTS: Of 41,109 patients, 585 (1.4%) were dental personnel. Dental personnel were significantly more likely than nondental personnel to be female (75.7% vs 67.4%, P < 0.0001), have occupationally related dermatitis (35.7% vs 11.5%, P < 0.0001), and/or have primary hand involvement (48.6% vs 22.5%, P < 0.0001). More than one quarter of dental personnel (62/585, 27.7%) had 1 or more occupationally related allergic patch test reaction(s). There were 249 occupationally related reactions to NACDG screening allergens, most commonly glutaraldehyde (18.1%), thiuram mix (16.1%), and carba mix (14.1%). The most common sources of NACDG screening allergens were gloves (30.7%), dental materials (26.6%), and sterilizing solutions (13.1%). Seventy-three dental personnel (12.5%) had 1 or more positive patch test reactions to occupationally related allergen(s)/substances not on the screening series. Occupationally related irritant contact dermatitis was identified in 22.2% (n = 130) of dental personnel, most commonly to nonskin soaps/detergents/disinfectants (32.0%). CONCLUSIONS: Occupational contact dermatitis is common in dental personnel referred for patch testing. Comprehensive testing beyond screening series is important in these patients.

In-vivo-wear in composite and ceramic full mouth rehabilitations over 3 years.

The aim of this study was to quantify and to compare the wear rates of premolar (PM) and molar (M) restorations of lithium disilicate ceramic (LS2) and an experimental CAD/CAM polymer (COMP) in cases of complex rehabilitations with changes in vertical dimension of occlusion (VDO). Twelve patients with severe tooth wear underwent prosthetic rehabilitation, restoring the VDO with antagonistic occlusal coverage restorations either out of LS2 (n = 6 patients, n = 16 posterior restorations/patient; N = 96 restorations/year) or COMP (n = 6 patients; n = 16 posterior restorations/patient; N = 96 restorations/year). Data was obtained by digitalization of plaster casts with a laboratory scanner at annual recalls (350 ± 86 days; 755 ± 92 days; 1102 ± 97 days). Each annual recall dataset of premolar and molar restorations (N = 192) was overlaid individually with the corresponding baseline dataset using an iterative best-fit method. Mean vertical loss of the occlusal contact areas (OCAs) was calculated for each restoration and recall time. For LS2 restorations, the mean wear rate per month over 1 year was 7.5 ± 3.4 µm (PM), 7.8 ± 2.0 µm (M), over 2 years 3.8 ± 1.6 µm (PM), 4.4 ± 1.5 µm (M), over 3 years 2.8 ± 1.3 µm (PM), 3.4 ± 1.7 µm (M). For COMP restorations, the mean wear rate per month over 1 year was 15.5 ± 8.9 µm (PM), 28.5 ± 20.2 µm (M), over 2 years 9.2 ± 5.9 µm (PM), 16.7 ± 14.9 µm (M), over 3 years 8.6 ± 5.3 µm (PM), 9.5 ± 8.0 µm (M). Three COMP restorations fractured after two years and therefore were not considered in the 3-year results. The wear rates in the LS2 group showed significant differences between premolars and molars restorations (p = 0.041; p = 0.023; p = 0.045). The wear rates in COMP group differed significantly between premolars and molars only in the first two years (p < 0.0001; p = 0.007). COMP restorations show much higher wear rates compared to LS2. The presented results suggest that with increasing time in situ, the monthly wear rates for both materials decreased over time. On the basis of this limited dataset, both LS2 and COMP restorations show reasonable clinical wear rates after 3 years follow-up. Wear of COMP restorations was higher, however prosthodontic treatment was less invasive. LS2 showed less wear, yet tooth preparation was necessary. Clinicians should balance well between necessary preparation invasiveness and long-term occlusal stability in patients with worn dentitions.

Microfiltración marginal de resinas de relleno masivo y nanohíbrida en molares deciduos / Marginal microleakage of bulk fill and nanohybrid resins in deciduous teeth

Introducción: En la atención odontológica a niños es crucial seleccionar materiales restaurativos con buen rendimiento clínico y corto tiempo de aplicación, especialmente en pacientes con capacidad de atención limitada. Las resinas compuestas, con el mejoramiento de sus propiedades físicas y mecánicas, constituyen hoy uno de los materiales de mayor elección por el odontopediatra. Las resinas de relleno masivo son una alternativa atractiva para las restauraciones en el sector posterior. Objetivo: Comparar el grado de microfiltración marginal de resinas de relleno masivo y nanohíbrida en molares deciduos. Métodos: Estudio experimental, in vitro, en cuarenta molares deciduos; exodonciados por motivos terapéuticos, divididos en dos grupos. Grupo I: resina nanohíbrida con técnica incremental (Tetric® N Ceram - Ivoclar Vivadent) y Grupo II: resina de relleno masivo con técnica monoincremental (Tetric® N Ceram bulk fill - Ivoclar Vivadent). Se realizó un proceso de termociclado manual de 500 ciclos, entre 5 ºC ± 2 ºC y 55 ºC ± 2 ºC. Las muestras fueron sumergidas en azul de metileno al 0,5 por ciento durante 24 horas a 37 ºC. Se analizaron con el microscopio estereoscópico de luz a 40X. Resultados: Todas las muestras presentaron microfiltración. Con el uso de resina nanohíbrida, el 25 presentó microfiltración leve; el 30 por ciento, moderada; y el 45 por ciento, severa. En el grupo de la resina de relleno masivo, el 30 por ciento presentó microfiltración leve; el 35 por ciento, moderada; y el 35 por ciento, severa. No se encontró diferencia significativa entre ambos grupos (p = 0,55). Conclusiones: Ambas resinas, de relleno masivo y nanohíbrida, presentaron similar microfiltración marginal in vitro, en molares deciduos; por lo que la técnica de relleno masivo, por su fácil y rápida aplicación en un solo tiempo, es una buena alternativa en la rehabilitación dental odontopediátrica(AU)

Introduction: In children's dental care it is crucial to select restorative materials of proven clinical quality and a short application period, particularly with patients of limited attention capacity. Due to their improved physical and mechanical properties, composite resins are currently one of the materials of choice for children's dental care. Bulk fill resins are an attractive alternative for posterior restorations. Objective: Compare the degree of marginal microleakage of bulk fill and nanohybrid resins in deciduous teeth. Methods: An experimental in vitro study was conducted of 40 deciduous teeth extracted for therapeutic reasons, which were divided into two groups. Group I: nanohybrid resin by incremental technique (Tetric® N Ceram - Ivoclar Vivadent) and Group II: bulk fill resin by monoincremental technique (Tetric® N Ceram bulk fill - Ivoclar Vivadent). A manual 500-cycle thermocycling procedure was performed at 5ºC ± 2ºC to 55ºC ± 2ºC. The samples were soaked in 0.5 percent methylene blue at 37ºC for 24 hours and analyzed under a light stereo microscope at 40X. Results: Microleakage was present in all the samples. In the nanohybrid resin group, microleakage was mild in 25 percent, moderate in 30 percent and severe in 45 percent. In the bulk fill resin group, microleakage was mild in 30 percent, moderate in 35 percent and severe in 35 percent. No significant difference was found between the groups (p = 0.55). Conclusions: Both resins, bulk fill and nanohybrid, presented similar in vitro marginal microleakage in deciduous molars. The bulk fill technique is therefore a good alternative for children's dental rehabilitation, due to its easy and fast application in a single session(AU)

Patch test of dental materials in Oral Lichen Planus with considering the role of saliva.

Lichen planus is the most common skin disease that affects the oral mucosa. Oral Lichen Planus is a T-cell-mediated autoimmune disorder. In the current study, for the first time, an oral cavity condition in skin patch tests with adding saliva is simulated. In addition, the patch results are compared with healthy subjects. Forty-one OLP patients and 63 healthy subjects were enrolled in the study. All participants were provided with patch tests, including allergens, in combination with saliva in chambers. Allergens from the European baseline (standard) series selected according to the most prevalent positive results in the previous study were applied. Positive results of Mercury and Cobalt tests were significantly higher in the case group. In this study, the differentiation of patients with lichen planus and lichenoid was identified according to the Van der Meij & Van der Waal criteria. The patch test was conducted for healthy individuals as well. The most important of all was the use of patients' saliva in the patch test, done for the first time in this field. In the case of OLP, a patch test can help identify positive reactions to dental materials; thus, the replacement of dental restorations may be needed.

In vitro three-dimensional organotypic culture models of the oral mucosa.

Three-dimensional, organotypic models of the oral mucosa have been developed to study a wide variety of phenomena occurring in the oral cavity. Although a number of models have been developed in academic research labs, only a few models have been commercialized. Models from academic groups offer a broader range of phenotypes while the commercial models are more focused on the oral and gingival mucosa. The commercialized models are manufactured under highly controlled conditions and meet the requirements of quality standards, which leads to high levels of reproducibility. These in vitro models have been used to evaluate the irritancy of oral care products such as toothpastes, mouthwashes, and mucoadhesives. The effects of cigarette smoke on oral cavity tissues have been studied and compared to those of e-cigarettes. Oral tissue models have facilitated investigation of the mechanisms of oral mucositis and oral candidiasis and have been used to examine transbuccal drug delivery rates and the absorption of nanoparticles. Infection studies have investigated the effects of HIV-1 along with the effects of commensal and pathogenic bacteria. More recently, a differentiated oral tissue model has been shown to express the ACE2 receptor, which is known to be important for the receptor-mediated entry of the SARS-CoV-2 coronavirus into human cells and tissues. Hence, oral mucosal models may find application in determining whether viral infection of the oral mucosa is possible and whether such infection has implications vis-a-vis the current COVID-19 pandemic. As is apparent, these models are used in a broad variety of applications and often offer advantages versus animal models in terms of reproducibility, avoiding species extrapolation, and the ethical concerns related to human and animal experimentation. The goals of this paper are to review commercially available models of the human buccal and gingival mucosa and highlight their use to gain a better understanding of a broad range of phenomena affecting tissues in the oral cavity.

Ten years of contact allergy from acrylic compounds in an occupational dermatology clinic.

BACKGROUND: Contact allergy from acrylic compounds is a "hot topic". Knowledge on the exact chemical composition of acrylic products is superficial. AIMS: To retrospectively describe patients with allergic reactions to acrylic compounds. METHODS: We included patients who had been tested with acrylate patch test series and displayed allergic reactions to at least one acrylic compound. Chemical analyses were often performed when safety data sheets of implicated products failed to reveal acrylic compounds to which the patient tested positive. RESULTS: In 2010-2019 a total of 55 patients met the inclusion criteria. Eight cases of allergic contact dermatitis were due to anaerobic sealants, seven to dental products, three to windscreen glues, seven to eyelash glues and/or nail products in the beauty sector, three to UV-cured printing inks, two to paints/lacquers, and one to polyester resin system. The origin of these contact allergies was occupational with the exception of four beauty sector workers who had developed eyelid symptoms from eyelash extensions glued onto their own eyelashes. We invariably detected methacrylate monomers in 15 chemical analyses of 12 different anaerobic sealants. CONCLUSIONS: Safety data sheets of anaerobic sealants often lack warnings for skin sensitization, although these products regularly contain sensitizing methacrylates.

Monolithic and Minimally Veneered Zirconia Complications as Implant-Supported Restorative Material: A Retrospective Clinical Study up to 5 Years.

OBJECTIVE: Long-term clinical data on the success and complication rates of monolithic or minimally veneered zirconia implant-supported restorations are lacking. Hence, the purpose of this retrospective clinical study was to analyze the complications of monolithic or partially veneered zirconia implant-supported restorations up to 5 years follow-up. Material and Methods. Single crowns, bridges, and full-arch rehabilitations were included. The selection process was achieved by reviewing data from the prosthetic laboratory and excluding cases in which zirconium and full-ceramic coating restorations were used. A total of 154 restorations were included (82 monolithic and 72 with buccal ceramic stratification). All the complications encountered, and the solutions applied, were explained. RESULTS: A total of 93 restorative units had a follow-up of between 24 and 60 months, and 61 restoration units had a follow-up of between 12 and 24 months. A total of 7 complications were encountered (14.58% of cases; 95.45% per prosthetic unit). The technical complication rate was 2.08% (one case of minor chipping in one prosthetic unit); regarding the mechanical complications, four decementations (8.33% of the cases) and two screw loosening (4.17% of the cases) were encountered. CONCLUSIONS: Considering the limitations of this study, it can be concluded that monolithic or partially veneered zirconia implant-supported restorations have a good clinical behavior during a follow-up period of up to 5 years.

In vivo Microbial Diversity Analysis on Different Surfaces of Dental Restorative Materials via 16S rDNA Sequencing.

BACKGROUND This study aimed to provide precise material selection guidance for proper clinical restoration and treatment of plaque-related oral diseases, such as dental caries and periodontal diseases. MATERIAL AND METHODS Four groups (n=24) of restorative material sheets (n=24) were prepared using 3M Z350 composite resin (ZR), zinc phosphate cement (ZPC), glass-ionomer (GI), and ICON permeable resin (IPR). Six volunteers wore a plaque-collection device equipped with the 4 restorative material sheets for 48 hours. Plaque samples were collected, and Miseq sequencing was applied to obtain template DNA fragments for microbial diversity analysis. The data were analyzed with nonparametric tests. RESULTS The microbial diversity on the ZPC surface was significantly lower than that on GI and IPR surfaces. The abundance of Firmicutes and Streptococcus on the ZPC surface was significantly higher than on the surfaces of GI and IPR. In contrast, the abundance of Porphyromonas on the surface of ZPC was significantly lower than that on GI and IPR surfaces. (P<0.05). CONCLUSIONS The results of the present study might serve as a basis for material selection under different oral microbial conditions to provide more accurate treatments and restorative procedures in the oral cavity.

Exposures to Dental Products, Stomatological Preparations, and in Dental Care and Toothache reported to the PIC Erfurt (1997 to 2017).

We examined human exposures to dental products (EDP), stomatological preparations (ESP), and in the context of dental care (EDC) or toothache (ETA) registered by the Poisons Information Centre (PIC) Erfurt from 1997 to 2017. Dental products like dental technical and filling materials belong to medical devices. Stomatological preparations were classified according to the ATC code and symptom severity to the Poisoning Severity Score (PSS). In total, 156 cases of EDP (136 cases with different tooth filling materials), 1167 cases of ESP (55.6% fluoride containing products), 979 cases of EDC, and 331 cases of ETA were registered. Symptom severity in EDP and ESP were asymptomatic or mild. In ETA and EDC, however, 35 cases with moderate and 5 cases with severe symptoms were detected. 5 moderate and 3 severe cases were caused by prolonged paracetamol overdose. Severe bleeding occurred following tooth extraction in a 41 year-old phenprocoumon treated patient after self-medication with acetylsalicylic acid and metamizole. Gingival injection of lidocaine plus epinephrine in a 37 year-old healthy woman resulted in severe bradycardia and cardiac arrest. Acute toxicity of EDP and ESP appears to be low. Prolonged paracetamol overdose because of toothache, and some dental treatment can result in severe symptoms.