This document discusses contact allergy to denture resins and alternative options. It begins by outlining learning objectives about monomers that cause allergy, chemical characteristics of resin materials, and allergy-free dentures. It then covers the chemical characteristics, biocompatibility, genotoxicity, estrogenic effects, clinical signs of adverse reactions, and treatment protocols for resin allergies. Alternative materials that can be used for those with resin allergies include high-impact polystyrene, polycarbonates, polyvinyl chloride acrylic, and flexible denture bases made of nylon. Safety measures for dentists working with resins are also described.

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Contact Allergy to
Denture Resins
and its
Alternative
Options
Ashish Chaudhary et al IJOICR 2016

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Specific Learning Objectives
Sr. No. Learning Objectives domain level
1. Different types of monomers
which cause allergy
cognitive Must know
2. Chemical characteristics of
different resin materials
cognitive Must know
3. Allergy free dentures , treatment
protocol , symptoms of allergy to
denture resin
Cognitive &
Psychomotor
Must know

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Contents
 Introduction
 Chemical characteristics of denture resin materials
 Biocompatibility
 Genotoxicity
 Oestrogenic effect
 Clinical signs of adverse reaction
 Treatment Protocol
 Alternative Materials
 Discussion
 Critical analysis
 Conclusion

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Introduction
 Polymethylmethacrylate resins are frequently used in
daily dental practice.
 In the oral cavity, properties and functional values of
acrylic resin-based products depend on the
endogenous factors caused by polymerization, i.e.,
- degree of conversion of the monomers,
- method of manipulation
- condition of polymerization,
- exogenous factors like saliva, bacteria, and
mastication

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Allergy to dental resin-based materials is due to reaction in the resin
matrix like monomer

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CHEMICAL CHARACTERISTICS OF
DENTAL RESIN MATERIALS
Monomer
Monomers are small
molecules that during
polymerization reaction
are able to form long
polymeric chains
RINGS REACTIVE
METHACRYLATE
GROUPS PRESENT-Aliphatic
- Aromatic
-Mono functional
- Di functional
- Tri Functional

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POLYMERIZATION REACTION
ACTIVATOR INITIATOR
FREE RADICALS
ACTIVATED MONOMERS
Continuous splitting of
double bonds and addition
of more monomer to the free
electron end.
3D Network of chains
LIGHT CHEMICAL
OR HEAT

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BIOCOMPATIBILITY
 “The ability of a material to perform with an
appropriate host response in a specific application”
 A material with a low degree of conversion will have
more unreacted double bonds and will have a greater
ability to cause a reaction in living tissue

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GENOTOXICITY
 Genotoxicity is the ability of the material to mutate or
break down a deoxyribonucleic acid.
 Direct interaction between nucleotides and resin
monomers, production of DNA damaging intermediates, or
inhibition of DNA repair systems might be responsible for
the mutagenicity of resin monomers.
 TEGMA , UDMA , Formaldehyde.

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ESTROGENIC EFFECT
 Few materials bind to estrogen receptors and cause
similar effects of a sex hormone. They are called
xenoestrogen
 Bisphenol A has been found to be a xenoestrogen

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CLINICAL SIGNS OF ADVERSE
REACTIONS
Jorge Et al Kedarune Et al
5:3 polymer monomer ratio Residual Monomer
has more
cytotoxicity
More ratio means less residual
monomer

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SYMPTOMS
 Glistening red color with a waxy appearance due to
edema. itching or burning sensation.
 Ulceration and necrosis may manifest themselves
due to rupture of the vesicles or bullae.
 During acute stages, there may be an elevation of
body temperature and general malaise
 Symptoms : Dysgeusia
Complaint of bitter or metallic taste in the
mouth

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 The first case of hypersensitivity was reported in
1941.
 This is also called stomatitis venenata.
PATCH TEST : 48 HRS

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TREATMENT PROTOCOL
Most common
adverse Effect is :
Edematous
Tongue which can
obstruct airway

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METHODS OF DECREASING
RESIDUAL MONOMER
JORGE ET AL
Water bath At 55 degrees
for 1 hour
Sheridan Et al
Cytotoxicity
max in first 24
hrs
Soak resins
longer
Patients having allergic reactions to temporary restorations made with
autopolymerizing resins should be provided with prefabricated temporary
crowns

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ALLERGY FREE DENTURES
 High-impact polystyrene: Elastomer graft polymer
with styrene. Similar to polystyrene and injection
molded
 Polycarbonates: Includes glass fiber-reinforced
materials
- high impact strength.
- can be used in allergic patients.

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 Polyvinyl chloride-based acrylic: Consists of vinyl
chloride, vinyl acetate and MMA acid
 This denture acrylic group includes luxene, virlene
which show good dimensional consistency, low water
absorption, and high breaking strength.
 Eclipse prosthetic resin system: Light cure fabricate
denture (Dentsply), indirect buildup method for
fabricating dentures, i.e., monomer free and flask
free.
- can be used for allergic patients.

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20. z  Valplast: Flexible denture base material, i.e., ideal for
partial denture but very rarely used for complete
dentures.
- It is a nylon thermoplastic material which eliminates
the concern about acrylic allergy.
 Metallic denture base:
- Metals used are usually base metal alloys, TiSAl4V.
- The advantages are biocompatibility,
hypoallergenicity, dimensional stability, and good
proprioception

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SAFETY MEASURES FOR DENTISTS
AND HYGEINISTS
 Use of vinyl gloves or latex gloves
 Apply Vaseline adequately
 Medical treatments include topical steroid application
and oral steroids for secondary infections, e.g.,
azathioprine, cyclosporine

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2-hydroxyethylmethacrylate
Ethylene Glycol
Dimethacrylate
Triethylene glycol
Dimethacrylate
MMA
DISCUSSION

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 If acrylates are stored at higher temperatures, the
capacity of the allergen is less. (Anthony Goons et al)
 Direct application of relining materials should be
avoided, which may severely irritate the mucosa.
 Various allergen free materials are mentioned earlier
which should be implimented.
 Heat-cure denture bases have 0.2 to 1% residual
monomer compared with autopolymerizing resins,
which were 5% more (Smith and bains et al)

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CRITICAL ANALYSIS
 The author has very well mentioned about the allergic
reactions seen due to denture wearing.
 The author has also mentioned treatment measures
and other alternatives.

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CONCLUSION
 Acrylic-based resin is intensively used in dentistry as
denture base materials.
 Increasing concerns arise regarding safety in the use
of acrylic to the patients, clinicians, and technicians.
 Therefore, practical knowledge and awareness is
most important when dealing with patients having
allergic reactions to denture base resins and to find
an alternate material for such patients.

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REFERRENCES
 Hochman N, Zalkind M. Hypersensitivity to methyl methacrylate:
mode of treatment. J Prosthet Dent 1997 Jan;77(1):93-96.
 Fleisch AF, Sheffield PE, Chinn C, Edelstein BL, Landrigan PJ.
Bisphenol A and related compounds in dental materials.
Pediatrics 2010 Oct;126(4):760-768.
 Singh JP, Dhiman RK, Bedi RPS, Girish SH. Flexible denture
base material: a viable alternative to conventional acrylic
denture base material. Contemp Clin Dent 2011 Oct-Dec;2(4):
313-317.
 Khindria et al . Evaluation of Denture base Materials . J Prosthet
Dent 2009 apr ; 9(2)

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