Allergy to dental materials with special reference to the use of amalgam and polymethylmethacrylate.

The increase in new clinical materials with questionable biological properties and the corresponding increase in awareness in patients to health hazards from dental materials are two important problems of modern clinical dentistry. Based upon evidence from clinical research the hypersensitivity problems related to the use of silver amalgam and acrylic denture base materials are reviewed to define possible risk groups among dental patients. In silver amalgam therapy the main risk group is patients with contact lesions in the oral mucosa adjacent to the restorations, as this group exhibits a high frequency of skin sensitivity to mercury and other base materials in dental amalgam. Among denture wearers a corresponding risk group has been observed among patients with previous allergic diseases and burning mouth syndrome. In these cases a high incidence of skin sensitivity reactions to denture allergens has been observed, usually to methylmethacrylate monomer and formaldehyde. Some possible pathogenic mechanisms leading to a contact allergy of the oral mucosa in these patient groups are discussed.