Can Ali, Karabacak Deniz Eyice, Yalcin Basak Keskin, Demir Semra, Buyukozturk Suna, Colakoglu Bahauddin, Gelincik Aslı
From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul, Faculty of Medicine, Istanbul University, Istanbul, Turkey; and.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
Allergy Asthma Proc. 2023 Mar 1;44(2):136-144. doi: 10.2500/aap.2023.44.220074.
Allergy to dental materials in prostheses and implants that leads to dental device dysfunction is a challenging problem. In this prospective study, we aimed to investigate the diagnostic role and impact of dental patch test (DPT) results on the outcome of proceeding dental procedures with the collaboration of our allergy clinic and dental clinics. A total of 382 adult patients with oral or systemic signs or symptoms due to the applied dental materials were included. A DPT with 31 items was administered. The clinical findings after dental restoration according to the test results were assessed in the patients. The most common positivity detected in the DPT was due to metals, among which nickel (29.1%) was the leading cause. The frequency of self-reported allergic diseases and metal allergy was significantly higher in patients with at least one positive result in the DPT (p = 0.004 and p < 0.001, respectively). Clinical improvement after the removal of dental restoration was seen in 82% of the patients who had a positive DPT result, whereas this rate was 54% among paatients with negative DPT results (p < 0.001). The only factor that predicted improvement after restoration was the positivity in the DPT result (odds ratio 3.96 [95% confidence interval, 0.21-7.09]; p < 0.001). Our study showed that a self-reported metal allergy was an important finding to predict allergic reactions to dental devices. Therefore, patients should be questioned for the presence of metal allergy-related signs and symptoms before exposure to the dental materials to prevent possible allergic reactions. Furthermore, DPT results are valuable to guide dental procedures in real life.
假牙和植入物中牙科材料过敏导致牙科器械功能障碍是一个具有挑战性的问题。在这项前瞻性研究中，我们旨在与我们的过敏诊所和牙科诊所合作，研究牙科贴片试验（DPT）结果在后续牙科手术结果中的诊断作用和影响。总共纳入了382名因使用牙科材料而出现口腔或全身体征或症状的成年患者。进行了一项包含31项的DPT。根据测试结果评估了患者牙齿修复后的临床发现。DPT中检测到的最常见阳性反应是由金属引起的，其中镍（29.1%）是主要原因。在DPT中至少有一项阳性结果的患者中，自我报告的过敏性疾病和金属过敏的发生率显著更高（分别为p = 0.004和p < 0.001）。DPT结果为阳性的患者中，82%在去除牙齿修复后临床症状有所改善，而DPT结果为阴性的患者中这一比例为54%（p < 0.001）。预测修复后改善情况的唯一因素是DPT结果为阳性（优势比3.96 [95%置信区间，0.21 - 7.09]；p < 0.001）。我们的研究表明，自我报告的金属过敏是预测对牙科器械过敏反应的重要发现。因此，在接触牙科材料之前，应询问患者是否存在与金属过敏相关的体征和症状，以预防可能的过敏反应。此外，DPT结果在现实生活中对指导牙科手术很有价值。
