Methacrylate Allergy Restoration — ORE Part 1 MCQ

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HardDental MaterialsMethacrylate Allergy RestorationORE Part 1

An adult patient requires restoration of a posterior tooth in a stress-bearing area. Patch testing has confirmed allergy to methacrylate monomers. The restoration will not require resin bonding. Which material is the most appropriate?

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Correct answer: B — Dental amalgam

B. Dental amalgam is correct. The decisive finding is confirmed methacrylate allergy. Conventional and flowable composites contain methacrylate-based resin monomers; therefore, their routine use would expose the patient to the identified allergen. A polyacid-modified composite resin (compomer) also has resin/methacrylate chemistry. Resin-modified glass-ionomer cement contains a resin component, commonly HEMA, and is likewise unsuitable. SDCEP recognises allergy or local adverse reaction to components of resin-composite or glass-ionomer materials as a circumstance in which amalgam may be justified. In this adult patient, amalgam is methacrylate-free and can withstand posterior occlusal loading. The explicit statement that resin bonding is unnecessary is important because resin adhesives or resin cements could themselves contain methacrylate monomers.

Reference: Scottish Dental Clinical Effectiveness Programme. Restricting the Use of Dental Amalgam in Specific Patient Groups: Implementation Advice, 2021. https://www.sdcep.org.uk/media/tk1ef0hm/sdcep-dental-amalgam-implementation-advice.pdf