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Location of injected polymethylmethacrylate microspheres influences the onset of late adverse effects: an
Luciano Henrique de Jesus1, Laura de Campos Hildebrand1, Manoela Domingues Martins1
1Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Abstract:
Polymethylmethacrylate (PMMA) has been widely used in the correction of wrinkles because of its long-lasting cosmetic improvements. However, side effects and complications may occur, and its clinical appearance on the oral mucosa can be similar to that of inflammatory or neoplastic disease. The aim of this research was to compare the clinical and histopathologic responses to PMMA injected by two different methods. Twenty-two rats received an injection of PMMA using the tunneling technique (gold standard), with subcutaneous deposition of the filler in the face, or a variation of the technique with transcutaneous submucosal deposition of the filler in the cheek. The tissue reaction was analyzed clinically every 24 hours during the first week, then once a week for the following 3 months. Histologic evaluation was based on the local inflammatory response to the filler. No clinical changes were observed during the initial evaluation period (0-14 days). After 14 days, only the submucosal group showed extra-oral enlargement (n=4, 18.2%). Histopathologic analysis revealed nodule formation in four animals (18.2%) in the submucosal group, with no nodules observed in the subcutaneous group. The data obtained in this study demonstrate that the technique used to deliver the filler may influence the risk of adverse reactions.
Insights
The injection technique for polymethylmethacrylate (PMMA) filler impacts adverse reactions. Submucosal deposition in rats showed more complications than subcutaneous tunneling, highlighting the importance of filler delivery methods in cosmetic procedures.
Area of Science:
- Biomaterials Science
- Dermatology
- Oral and Maxillofacial Surgery
Background:
- Polymethylmethacrylate (PMMA) is a long-lasting dermal filler used for cosmetic wrinkle correction.
- Potential complications and misdiagnosis of PMMA fillers necessitate understanding injection techniques.
- Clinical presentation of PMMA on oral mucosa can mimic inflammatory or neoplastic conditions.
Purpose of the Study:
- To compare clinical and histopathologic responses to PMMA filler injected via two distinct methods.
- To evaluate the influence of filler delivery technique on tissue reaction and adverse events.
Main Methods:
- Twenty-two rats were used, receiving PMMA injections via tunneling (subcutaneous) or transcutaneous submucosal techniques.
- Clinical evaluation of tissue reaction occurred daily for the first week, then weekly for 3 months.
- Histopathologic analysis assessed local inflammatory response and nodule formation.
Main Results:
- No immediate clinical changes were noted within the first 14 days post-injection.
- Submucosal injection group exhibited extra-oral enlargement in 18.2% of cases after 14 days.
- Histopathology revealed nodule formation in 18.2% of the submucosal group, absent in the subcutaneous group.
Conclusions:
- The method of PMMA filler delivery significantly influences the risk of adverse reactions.
- Subcutaneous tunneling appears to be a safer technique, minimizing complications like nodule formation.
- Careful consideration of injection technique is crucial for safe and effective PMMA use in cosmetic applications.
