Do adverse effects of dental materials exist?: What are the consequences, and how can they be diagnosed and treated?
Do adverse effects of dental materials exist?: What are the consequences, and how can they be diagnosed and treated?
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DOI：
10.1111/j.1600-0501.2007.01481.x
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发表时间：
2007-06-01
影响因子：
4.3
通讯作者：
Hensten, Arne
中科院分区：
文献类型：
--
作者：
Schedle, Andreas;Ortengren, Ulf;Hensten, Arne
目标：所有牙科生物材料都会不同程度地向口腔环境释放物质。各种临床前生物相容性测试系统已被引入，旨在评估牙科材料的潜在风险。牙科材料释放物质的潜在致病作用已被证明。对于生物材料的生物相容性来说，不仅重要的是在与身体接触时释放最少的可扩散物质，而且材料还必须满足其设计的功能。这也很大程度上取决于材料特性及其处理特性。本综述的目的是对患者和人员不良反应的现状进行概述。材料和方法：使用明确的搜索策略进行系统评价，以评估 1996 年至 2006 年期间发表的所有 MEDLINE 文献。结果：现有文献的汇编表明，大多数研究都是针对患者与人员进行的。牙科材料的不良反应确实会发生，但患病率和发生率很难获得。结果基本上基于队列研究。临床试验，特别是随机对照试验，在所有研究中只占少数，但复合研究和结合研究除外，其中临床试验而非随机对照试验代表了大多数研究。手稿中患者和工作人员是分开对待的。汞合金研究显示与材料相关的诊断经过验证的程度最低。即使已经报道了与聚合物树脂基材料的不良反应相关的客观症状，术后敏感性在有关复合材料/粘合的报告中占主导地位。经验证的牙科人员职业影响显示过敏/毒性反应的发生率较低。刺激性手部湿疹似乎比一般人群更常见。结论：患者和人员相关的研究质量参差不齐，可以改进。需要对材料的内容进行更好的描述。牙科材料不良影响的登记将有助于检测低发生率事件的发生。
Objectives: All dental biomaterials release substances into the oral environment to a varying degree. Various preclinical biocompatibility test systems have been introduced, aiming at an evaluation of the potential risks of dental materials. Potential pathogenic effects of released substances from dental materials have been demonstrated. For the biocompatibility of a biomaterial, it is not only important that minimal diffusable substances are released when it is in body contact - the material must also fulfill the function for which it has been designed. This is also very much dependent on the material properties and its handling properties. The aim of this review was to generate an overview of the present status concerning adverse reactions among patients and personnel.Materials and methods: A systematic review was performed using a defined search strategy in order to evaluate all MEDLINE-literature published between 1996 and 2006.Results: The compilation of the literature available has revealed that the majority of studies have been carried out on patients compared with personnel. Adverse reactions towards dental materials do occur, but the prevalence and incidence are difficult to obtain. The results were essentially based on cohort studies. Clinical trials, especially randomized-control led trials, are in the minority of all studies investigated, with the exception of composite and bonding studies, where clinical trials, but not randomized-controlled trials, represent the majority of studies. Patients and personnel were treated separately in the manuscript. Amalgam studies show the lowest degree of verified material-related diagnosis. Even if objective symptoms related to adverse reactions with polymer resin-based materials have been reported, postoperative sensitivity dominates reports concerning composites/bondings. Verified occupational effects among dental personnel show a low frequency of allergy/toxic reactions. Irritative hand eczema seemed to be more common than in the general population.Conclusions: Patient- and personnel-related studies are of variable quality and can be improved. There is a need for a better description of the content of materials. A registry for adverse effects of dental materials would be useful to detect the occurrence of low-incidence events.