Allergic reactions to acrylics

Abstract

I write in response to the article, “Allergy to auto-polymerized acrylic resin in an orthodontic patient” (Gonçalves TS, Morganti MA, Campos LC, Rizzatto SMD, Menezes LM. Am J Orthod Dentofacial Orthop 2006;129:431-5).Allergic reactions to acrylic materials are certainly real, as we witness in our laboratory (Great Lakes Orthodontics); technicians frequently break out upon exposure to methylmethacrylate monomer. Although significantly less frequent for cured polymers, these reactions can be serious and require careful analysis and description. The authors presented a lucid accounting of their work, which included a good variety of techniques. I believe a few technical points, unrelated to their experimental work, should be mentioned.When discussing immune reactions, “Hamptons” are haptens (the English dental lexicon has enough peculiar words). It is also most unlikely (virtually impossible) for dental acrylic resins to contain formaldehyde; listing formaldehyde as a primary cutaneous antigen in dental acrylics is absurd, and this type of statement should not be allowed to capriciously find its way into the dental literature. Also, benzyl peroxide is not benzoyl peroxide; they are chemically distinct. Benzyl peroxide incorrectly appears on the Internet in regard to acne.Finally, I find it disturbing to advocate overcoming acrylic reactions in sensitive denture patients by intentionally exposing them to additional acrylic. Should this become standard practice? Here, light-cured methylmethacrylate is assumed to be safe—with less residual monomer than heat-cured. The authors also make a point of stating that allergic reactions are not dose-dependent.The issue of allergic reaction remains valid with the increasing number of sensitizing agents surrounding us all. Such nice clinical work should be married with an equally careful analysis. I write in response to the article, “Allergy to auto-polymerized acrylic resin in an orthodontic patient” (Gonçalves TS, Morganti MA, Campos LC, Rizzatto SMD, Menezes LM. Am J Orthod Dentofacial Orthop 2006;129:431-5). Allergic reactions to acrylic materials are certainly real, as we witness in our laboratory (Great Lakes Orthodontics); technicians frequently break out upon exposure to methylmethacrylate monomer. Although significantly less frequent for cured polymers, these reactions can be serious and require careful analysis and description. The authors presented a lucid accounting of their work, which included a good variety of techniques. I believe a few technical points, unrelated to their experimental work, should be mentioned. When discussing immune reactions, “Hamptons” are haptens (the English dental lexicon has enough peculiar words). It is also most unlikely (virtually impossible) for dental acrylic resins to contain formaldehyde; listing formaldehyde as a primary cutaneous antigen in dental acrylics is absurd, and this type of statement should not be allowed to capriciously find its way into the dental literature. Also, benzyl peroxide is not benzoyl peroxide; they are chemically distinct. Benzyl peroxide incorrectly appears on the Internet in regard to acne. Finally, I find it disturbing to advocate overcoming acrylic reactions in sensitive denture patients by intentionally exposing them to additional acrylic. Should this become standard practice? Here, light-cured methylmethacrylate is assumed to be safe—with less residual monomer than heat-cured. The authors also make a point of stating that allergic reactions are not dose-dependent. The issue of allergic reaction remains valid with the increasing number of sensitizing agents surrounding us all. Such nice clinical work should be married with an equally careful analysis. Allergy to auto-polymerized acrylic resin in an orthodontic patientAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 129Issue 3PreviewThis article reports on a 60-year-old woman who had an allergic reaction to methylmethacrylate self-curing acrylic resin during orthodontic treatment. A localized hypersensitive reaction appeared on the palate after an orthodontic retainer was placed. Samples of the acrylic were removed and analyzed with gas chromatography to evaluate the residual monomer level. The residual monomer content was between 0.745% and 0.78%, which did not exceed international standards for this material. Patch tests were performed with several methylmethacrylate resin samples and processed with various techniques; they showed positive reactions. Full-Text PDF Author’s responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 130Issue 2PreviewWe thank Mr Lauren for his interest on our article, in which we presented a patient with an allergy to auto-polymerized acrylic resin. We especially appreciated the considerations on vocabulary, a major drawback when writing in a foreign language. Even though there are some case reports of patients who had allergic reactions to auto-polymerized acrylic resins, dental staff are much more often affected by these allergic reactions than patients, including also respiratory and systemic effects.1 Orthodontists should be aware of allergic reactions in patients and be able to work in a multidisciplinary team capable of formulating a clear diagnosis and pointing out proper alternatives. Full-Text PDF