Geurtsen W
Department of Conservative Dentistry & Periodontology, Medical University Hannover, Germany.
Crit Rev Oral Biol Med. 2000;11(3):333-55. doi: 10.1177/10454411000110030401.
Increasing numbers of resin-based dental restorations have been placed over the past decade. During this same period, the public interest in the local and especially systemic adverse effects caused by dental materials has increased significantly. It has been found that each resin-based material releases several components into the oral environment. In particular, the comonomer, triethyleneglycol di-methacrylate (TEGDMA), and the 'hydrophilic' monomer, 2-hydroxy-ethyl-methacrylate (HEMA), are leached out from various composite resins and 'adhesive' materials (e.g., resin-modified glass-ionomer cements [GICs] and dentin adhesives) in considerable amounts during the first 24 hours after polymerization. Numerous unbound resin components may leach into saliva during the initial phase after polymerization, and later, due to degradation or erosion of the resinous restoration. Those substances may be systemically distributed and could potentially cause adverse systemic effects in patients. In addition, absorption of organic substances from unpolymerized material, through unprotected skin, due to manual contact may pose a special risk for dental personnel. This is borne out by the increasing numbers of dental nurses, technicians, and dentists who present with allergic reactions to one or more resin components, like HEMA, glutaraldehyde, ethyleneglycol di-methacrylate (EGDMA), and dibenzoyl peroxide (DPO). However, it must be emphasized that, except for conventional composite resins, data reported on the release of substances from resin-based materials are scarce. There is very little reliable information with respect to the biological interactions between resin components and various tissues. Those interactions may be either protective, like absorption to dentin, or detrimental, e.g., inflammatory reactions of soft tissues. Microbial effects have also been observed which may contribute indirectly to caries and irritation of the pulp. Therefore, it is critical, both for our patients and for the profession, that the biological effects of resin-based filling materials be clarified in the near future.
在过去十年中，树脂基牙科修复体的使用数量不断增加。在同一时期，公众对牙科材料引起的局部尤其是全身不良反应的关注度显著提高。已发现每种树脂基材料都会向口腔环境中释放多种成分。特别是，共聚单体三乙二醇二甲基丙烯酸酯（TEGDMA）和亲水性单体甲基丙烯酸2-羟乙酯（HEMA），在聚合后的头24小时内会从各种复合树脂和“粘结”材料（如树脂改性玻璃离子水门汀[GICs]和牙本质粘结剂）中大量渗出。许多未结合的树脂成分可能在聚合后的初始阶段渗入唾液，随后，由于树脂修复体的降解或侵蚀。这些物质可能会在全身分布，并可能对患者造成不良的全身影响。此外，由于人工接触，未聚合材料中的有机物质通过未保护的皮肤吸收，可能会给牙科人员带来特殊风险。越来越多的牙科护士、技术人员和牙医对一种或多种树脂成分（如HEMA、戊二醛、乙二醇二甲基丙烯酸酯[EGDMA]和过氧化二苯甲酰[DPO]）出现过敏反应，这证明了这一点。然而，必须强调的是，除了传统复合树脂外，关于树脂基材料物质释放的报道数据很少。关于树脂成分与各种组织之间的生物相互作用，几乎没有可靠的信息。这些相互作用可能是保护性的，如对牙本质的吸附，也可能是有害的，例如软组织的炎症反应。还观察到微生物效应，这可能间接导致龋齿和牙髓刺激。因此，无论是对我们的患者还是对这个行业来说，在不久的将来阐明树脂基填充材料的生物学效应至关重要。
