Mechanism of Metal Sensitization in Dental Patients and Dental Health Professionals

在我们的生活环境中，由于各种形式的金属过敏原，皮肤和粘膜损伤明显增加。许多此类案件都是通过大众媒体报道的。牙科研究人员和从事各种牙科合金工作的人员必须对此类疾病有正确的看法和透彻的了解。然而，口腔环境中牙科合金致敏的发生率和致敏机制尚未揭示。在这项研究中，受试者包括接受金属修复体的牙科患者，牙科医生、牙科技师或牙科保健员等牙科工作人员，以及从未进行过金属修复体或在日常生活中几乎没有接触金属的人。对受试者的出生地、近5年居民区、既往过敏史及其症状、斑贴试验结果、口腔状况以及口腔内金属修复体的存在与金属致敏率的关系进行了调查。在临床应用前，对仪器的稳定性、检出限和不同介质对发射X射线的影响进行了测定。XRFS被证明不仅能够分析散装金属，而且能够分析液体、浆料、粉末、皮革制品、纺织品或那些需要进行非破坏性分析的样品。从怀疑对金属过敏的患者的口腔内金属修复体或生活环境中收集的2500多个样本进行了分析，以检测金属过敏原。

There has been a notable increase in dermal and mucosal lesions due to various forms of metal allergens within our living environment. Number of such cases have been reported through mass media. Researcher and staff of dental field dealing with various types of dental alloys must have a right perspective and a thorough knowledge towards such disease. However, incidence rate nor mechanism of sensitization by dental alloys within an oral environment has not yet been revealed.In this study, the subjects were dental patients who have metal restorations, dental staff such as dentist, dental technician, or dental hygienist, and individuals who never had metal restorations or had a little chance to contact metals in their daily lives. Birth place, residential area for the recent 5 years, past history of any allergies and their symptoms, patch test results, oral conditions, and relationship between the presence of intraoral metal restorations and the sensitization rate by these metals were investigated for these subjects.An X-ray fluorescence spectroscope(XRFS) was used for the metal analysis in this study. Stability, detection limit, and the effects of different types of media towards the emitted X-ray were determined for the apparatus preceding its clinical application. The XRFS was proved to be capable of analyzing not only bulk metals, but also liquids, pastes, powders, leather goods, textiles, or those samples which require non-destructive analysis. Over 2500 samples collected from the intraoral metal restorations or living environments of the patients suspected as having metal allergies were analyzed to detect the metal allergens.