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五百名报告牙科材料不良反应的患者:频率、投诉、症状、过敏。

Five hundred patients reporting on adverse effects from dental materials: Frequencies, complaints, symptoms, allergies.

机构信息

University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany.

University of Regensburg Medical Center, Department of Conservative Dentistry and Periodontology, 93042 Regensburg, Germany.

出版信息

Dent Mater. 2018 Dec;34(12):1756-1768. doi: 10.1016/j.dental.2018.09.012. Epub 2018 Oct 22.

Abstract

OBJECTIVE

Information on patients with real or claimed adverse reactions towards dental materials in large patient cohorts is rare. Therefore, the aim of the present study was to investigate patients reporting on complaints and symptoms to dental materials over a 16-year period.

METHODS

Five hundred patients were characterized by one single dental team regarding age and sex distribution, subjective complaints and objective intraoral symptoms, and allergy status relevant to dental materials.

RESULTS

Elder patients and females predominated. Subjective complaints were reported by 490 patients, ranging from 1 to 12 complaints per patient. Most often, burning mouth (44%), tooth-/jawache (22%) and dry mouth (20%) were reported. In 54% no objective intraoral symptom was diagnosed. The main objective intraoral symptoms were tongue anomalies (lingua plicata or geographica; 14%), gingivitis adjacent to restorations (12%), redness of the palate or the edentulous ridge (7%), oral lichen planus (6%), grayish discolorations, lichenoid contact lesions, and leukoplakia (<5%). Patch testing of 416 (83%) patients revealed that allergy was diagnosed as contributing to the complaints or symptoms in 70 (14%) patients with metals being the most frequent allergens. Gingivitis adjacent to restorations (3.2%), redness of the palate or edentulous ridge (1.4%) and whitish lichen-like lesions (1.8%) were associated to allergy from dental materials.

SIGNIFICANCE

The high number of subjective complaints per patient and their wide variety suggests that most patients seriously suffered. Furthermore, the fact that only 46% of the patients had objective intraoral symptoms demands for an interdisciplinary collaboration to elucidate other than dental causes.

摘要

目的

在大型患者队列中,有关对牙科材料产生真实或声称的不良反应的患者的信息很少。因此,本研究的目的是调查在 16 年内报告对牙科材料有投诉和症状的患者。

方法

由一个单一的牙科团队对 500 名患者进行特征描述,包括年龄和性别分布、主观投诉和口腔内的客观症状以及与牙科材料相关的过敏状况。

结果

老年患者和女性居多。490 名患者报告了主观投诉,每个患者的投诉数量从 1 到 12 不等。最常见的投诉是口腔烧灼感(44%)、牙齿/颌痛(22%)和口干(20%)。54%的患者未诊断出口腔内的客观症状。主要的口腔内客观症状是舌异常(舌褶或地图舌;14%)、修复体附近的牙龈炎(12%)、腭或无牙牙槽嵴发红(7%)、口腔扁平苔藓(6%)、灰白色变色、苔藓样接触性病变和白斑(<5%)。对 416 名(83%)患者进行斑贴试验显示,70 名(14%)患者的过敏被诊断为导致投诉或症状的原因,金属是最常见的过敏原。修复体附近的牙龈炎(3.2%)、腭或无牙牙槽嵴发红(1.4%)和白色苔藓样病变(1.8%)与牙科材料过敏有关。

意义

每个患者的主观投诉数量多且种类繁多,这表明大多数患者都受到了严重影响。此外,只有 46%的患者有口腔内的客观症状,这需要跨学科合作来阐明除牙科原因之外的其他原因。

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