Field E A
Department of Clinical Dental Sciences, University of Liverpool, UK.
J Dent. 1997 May-Jul;25(3-4):209-14. doi: 10.1016/s0300-5712(96)00013-9.
To critically review the potential hazards associated with the use of powdered, natural rubber latex (NRL) gloves in dental practice and to report some practical difficulties which may be encountered when handling dental materials with powdered NRL gloves.
Articles published in the international literature over the last 10 years.
A number of recent studies in the medical and surgical literature have confirmed that NRL proteins leach out of latex gloves and bind to surgical glove powders. The most serious, potential hazard associated with the continued use of powdered NRL gloves in dental practice is that of latex sensitization by exposure to aerosolized NRL proteins. Hand dermatitis is now recognized as an occupational hazard in dentistry and has been associated with the continuous wearing of protective gloves. Studies, in the dermatological literature, have suggested that glove powders may exacerbate an irritant dermatitis and enhance the potential for adverse reactions to other components of NRL gloves. The surgical literature has already highlighted the risks of post-operative granuloma formation, due to glove powder contamination of the surgical wound. The possible effects of powder contamination of dental implant sites, on the outcome and success of implants has yet to be established. Recent in vitro studies have investigated the effect of latex glove contamination on the shear-bond strength of porcelain laminate veneers: one study demonstrated that starch powder significantly affected the bond strength, whereas the other showed that latex glove contamination of the porcelain surface did not have any significant effect. Long-term, in vivo studies are now required.
Dental practitioners should consider the potential health risks which are associated with the use of powdered NRL in dental practice. Powder contamination may affect the long-term results and success of clinical procedures in dentistry.
严格审查牙科实践中使用粉末状天然橡胶乳胶（NRL）手套的潜在危害，并报告使用粉末状NRL手套处理牙科材料时可能遇到的一些实际困难。
过去10年国际文献中发表的文章。
医学和外科文献中的一些最新研究证实，NRL蛋白会从乳胶手套中渗出并与手术手套粉末结合。在牙科实践中持续使用粉末状NRL手套最严重的潜在危害是通过接触雾化的NRL蛋白导致乳胶致敏。手部皮炎现在被认为是牙科的一种职业危害，并且与持续佩戴防护手套有关。皮肤病学文献中的研究表明，手套粉末可能会加重刺激性皮炎，并增加对NRL手套其他成分不良反应的可能性。外科文献已经强调了由于手术伤口被手套粉末污染而导致术后肉芽肿形成的风险。牙科种植部位粉末污染对种植体的结果和成功率的可能影响尚未确定。最近的体外研究调查了乳胶手套污染对瓷贴面剪切粘结强度的影响：一项研究表明淀粉粉末显著影响粘结强度，而另一项研究表明瓷表面的乳胶手套污染没有任何显著影响。现在需要进行长期的体内研究。
牙科从业者应考虑在牙科实践中使用粉末状NRL所带来的潜在健康风险。粉末污染可能会影响牙科临床程序的长期结果和成功率。
