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Anaphylaxis due to formaldehyde released from root-canal disinfectant
Makoto Kunisada1, Atsuko Adachi, Hiroshi Asano
1Department of Dermatology, Hyogo Prefectural Kakogawa Hospital, 770-1, Awazu, Kakogowa-cho, Kakogawa, 675-8555, Japan.
Contact Dermatitis
|December 21, 2002
Summary
Anaphylaxis occurred 8 hours after dental treatment due to a root canal disinfectant containing paraformaldehyde. This highlights the risk of delayed allergic reactions to formaldehyde in dental materials.
Area of Science:
- Dentistry
- Allergy and Immunology
Background:
- Root canal disinfectants are crucial in endodontic therapy.
- Paraformaldehyde is a common component in some root canal sealers.
Observation:
- A 50-year-old woman experienced anaphylaxis 8 hours post-treatment with a paraformaldehyde-containing root canal disinfectant.
- Allergy testing revealed high formaldehyde-specific IgE and immediate-type reactions to formaldehyde and paraformaldehyde.
- Delayed-type hypersensitivity to formaldehyde, paraformaldehyde, and eugenol was also observed.
Findings:
- The patient's delayed anaphylaxis was potentially caused by gradual formaldehyde release from paraformaldehyde and its diffusion through dentin.
- Literature review indicated that approximately 50% of reported anaphylaxis cases from formaldehyde in root canal disinfectants manifest over 2 hours post-treatment.
Implications:
- Dental professionals should consider formaldehyde-containing root canal disinfectants as potential allergens.
- Delayed anaphylaxis after dental procedures warrants thorough investigation, even if symptoms appear hours later.
- Awareness of delayed hypersensitivity reactions to common dental materials is essential for patient safety.