Reakcija preosjetljivosti na dentalne preparate

master's thesis

• Title (english): Hypersensitivity reaction to dental materials
• Author: Renata Tomašević
• Mentor: Suzana Ljubojević Hadžavdić (mentor)
• Committee member: Mihael Skerlev (predsjednik povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Committee member: Suzana Ljubojević Hadžavdić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Dentalni preparati kao što su dentalna punjenja, mostovi, krune te proteze su danas u širokoj upotrebi te s njima u kontakt dolaze pacijenti, ali i stomatološko osoblje. Ponekad mogu izazvati imunološku reakciju; najčešće posredovano T stanicama, odgođenu preosjetljivost tipa IV. Odgođena reakcija preosjetljivosti nastaje kao odgovor na određene alergene porijeklom iz dentalnih preparata. Najčešći alergeni su metali iz dentalni legura (zlato tiosulfat, nikal sulfat, živa, paldij klorit) i plastični materijali (akrilati). Klinička prezentacija alergijske reakcije može biti raznolika, mogu postojati subjektivni simptomi i objektivni znakovi. Subjektivni simptomi poput boli, suhoće i gorućih usta obično nisu pokazatelji reakcije preosjetljivosti. Najčešći objektivni simptomi su jednostrani oralni lihen planus i različiti oblici stomatitisa. Ukoliko su prisutni objektivni znakovi nužno je provesti dijagnostičku obradu epikutanim (patch) testom. Epikutani test se smatra „zlatnim standardom” u dijagnostici odgođene preosjetljivosti. Epikutani test se izvodi sa različitim serijama alergena, i očitavaju za to obučeni pojedinci. Kao dodatna obrada se preporučuje biopsija i patohistološka analiza. Stomatološki djelatnici također mogu razviti reakciju preosjetljivosti na materijale iz njihova radnog okruženja. Osim metala i akrilata, čest alergen iz radne okoline je i prirodni gumeni lateks. Klinička prezentacija je obično dermatitis na rukama. Provedena su različita znanstvena istraživanja u kojima su sudjelovali i pacijenti i stomatološko osoblje. Pacijentima s dokazanom preosjetljivošću na dentalne preparate treba ukloniti preparate i zamijeniti ih onim koji ne sadrže dokazane alergene. Stomatološki radnici trebaju izbjegavati alergene prisutne u radnom okolišu , ukoliko to nije moguće trebaju koristiti ne dodirne tehnike tijekom rukovanja s dentalnim materijalima. Terapija prve linije uključuje srednje potentne i visoko potentne topikalne kortikosteroide uz lokane neutralne preparate.

Abstract (english)

Dental materials such as dental fillings, bridges, crowns and dentures are in daily use by both patients and dental personnel. Sometimes these materials may cause immunologic response; usually T cell mediated delayed hypersensivitiy reaction type IV. This hipersensitivity occurs as a response to dental materials' allergenes. The most common allergens are metals released from dental alloys (gold thiosulfate, nickel sulfate, mercury, palladium chloride) and palstic materials (acrylates). Clinical presentation of this allergy reaction is not uniform; subjective symptoms and objective signs may be present. Subjective symptoms such as pain, dryness and burning mouth commonly do not represent allergic reaction. The most frequent objective signs are unilateral oral lichen planus and different types of stomatitis. In presence of objective signs additional diagnostic by patch testing is necessary. Patch test is considered as „gold standard” in diagnostic of delayed hipersensitivity reaction. Different series of allergenes are used in patch testing and the test must be performed and evaluated by trained individuals. Tissue biopsy and patohistology analysis are recommended as well. Dental staff can deploy hipersensitivity reaction to professional allergens. Besides metals and acrylates, frequent professional allergen is natural rubber latex. Hand dermatitis is usual clinical manifestation. Various studies, including both patients and dental personnel, have been performed. If clinical relevant contact allergy to dental materials are present, these materials must be removed and replaced with non-allergic materials. Dental personnel should avoid professionals allergenes and utilize non-touch work techniques. First line of therapy includes moderate and high potent topical corticosteroids with locan neutral creams.

• Keywords: dentalni preparati; alergijska reakcija; klinička relevantnost
• Keywords (english): dental materials; allergy reaction; clinical relevance
• Language: croatian
• URN:NBN: urn:nbn:hr:105:703408
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-05-13 06:38:26