Menu Close

Allergic Reactions to Dental Materials – A Systematic Review

Syed, M., Chopra, R., & Sachdev, V. (2015). Allergic Reactions to Dental Materials - A Systematic Review. Journal of clinical and diagnostic research : JCDR9(10), ZE04–ZE9. https://doi.org/10.7860/JCDR/2015/15640.6589

Utility of various dental materials ranging from diagnosis to rehabilitation for the management of oral diseases are not devoid of posing a potential risk of inducing allergic reactions to the patient, technician, and dentist. This review aims to develop a systematic approach for the selection and monitoring of dental materials available in the market thereby giving an insight to predict their risk of inducing allergic reactions.

To continue reading, follow the link above.

Sources:

  1. Ditrichova D, Kapralova S, Tichy M, Ticha V, Dobesova J, Justova E, et al. Oral lichenoid lesions and allergy to dental materials. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007;151(2):333–39. [PubMed] [Google Scholar]
  2. Fleischmann P. Zur Frage der Gefährlichkeit Kleinster Quecksilbermengen. Dtsch Med Wochenscher. 1928;54:304–07. [Google Scholar]
  3. Karabucak B, Stoopler ET. Root canal treatment on a patient with zinc oxide allergy: a case report. Int End J. 2007;40(10):800–07. [PubMed] [Google Scholar]
  4. Marquardt W, Seiss M, Hickel R, Reichl FX. Volatile methacrylates in dental practices. J Adhes Dent. 2009;11(2):101–07. [PubMed] [Google Scholar]
  5. Blomgren J, Axéll T, Sandahl O, Jontell M. Adverse reactions in the oral mucosa associated with anterior composite restorations. J Oral Pathol Med. 1996;25(6):311–13. [PubMed] [Google Scholar]
  6. Stoeva I, Kisselova A, Zekova M. Allergic contact stomatitis from bisphenol-A-glycidyldimethacrylate during application of composite restorations. A case report. J IMAB-Ann Proc. 2008;book 2:45–46. [Google Scholar]
  7. Johns DA, Hemaraj S, Varoli RK. Allergic contact stomatitis from bisphenol-a-glycidyldimethacrylate during application of composite restorations: A case report. Indian J Dent Res. 2014;25(2):266–68. [PubMed] [Google Scholar]
  8. Goon AT, Isaksson M, Zimerson E, Goh CL, Bruze M. Contact allergy to (meth) acrylates in the dental series in southern Sweden: simultaneous positive patch test reactions patterns and possible screening allergens. Contact Dermatitis. 2006;55(4):219–26. [PubMed] [Google Scholar]
  9. Pegum JS, Medhurst FA. Contact dermatitis from penetration of rubber gloves by acrylic monomer. Br Med J. 1971;2(5754):141–43. [PMC free article] [PubMed] [Google Scholar]
  10. Marks JG, Belsito DV, DeLeo VA, Fowler JF, Fransway AF, Maibach HI, et al. North American Contact Dermatitis Group. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59–62. [PubMed] [Google Scholar]
  11. Wetter DA, Davis MD, Yiannias JA, Cheng JF, Connolly SM, el- Azhary RA, et al. Patch test results from the Mayo Clinic Contact Dermatitis Group, 1998-2000. J Am Acad Dermatol. 2005;53(3):416–21. [PubMed] [Google Scholar]
  12. Tsuchiya H, Hoshino Y, Tajima K, Takagi N. Leaching and cytotoxicity of formaldehyde and methyl methacrylate from acrylic resin denture base materials. J Prosthet Dent. 1994;71(6):618–24. [PubMed] [Google Scholar]
  13. Tsuchiya H, Yamada K, Akagiri M, Tajima K, Miyazaki T, Takagi N, et al. Effect of an ultraviolet light-activated coating material on reduction of the leaching of methyl methacrylate and formaldehyde from denture acrylic resins. Dent Mater J. 1993;12(2):253–58. [PubMed] [Google Scholar]
  14. Bolla SC, Gantha NS, Basha SR. Allergic Reaction to an Acrylic Denture - A Rare Case Report. J Res Adv Dent. 2014;3(2):185–88. [Google Scholar]
  15. Leggat PA, Kedjarune U. Toxicity of methyl methacrylate in dentistry. Int Dent J. 2003;53(3):126–31. [PubMed] [Google Scholar]
  16. Hallstrom U. Adverse reaction to a fissure sealant. Report of a case. J Dent Child. 1993;60(2):143–46. [PubMed] [Google Scholar]
  17. Kal BI, Evcin O, Dundar N, Tezel H, Unal I. An unusual case of immediate hypersensitivity reaction associated with an amalgam restoration. Br Dent J. 2008;205(10):547–50. [PubMed] [Google Scholar]
  18. Bains VK, Loomba K, Loomba A, Bains R. Mercury sensitisation: review, relevance and a clinical report. Br Dent J. 2008;205(7):373–78. [PubMed] [Google Scholar]
  19. Pigatto PD, Guzzi G, Persichini P, Barbadillo S. Recovery from mercury-induced burning mouth syndrome due to mercury allergy. 2004;15(2):75–77. [PubMed] [Google Scholar]
  20. Recommendations in mercury hygiene. J Am Dent Assoc. 1976;92(6):1217. [PubMed] [Google Scholar]
  21. Covington JS, McBride MA, Slagle WF, Disney AL. Quantization of nickel and beryllium leakage from base metal alloys. J Prosthet Dent. 1989;54(1):127–36. [PubMed] [Google Scholar]
  22. Fisher A.A. Contact Dermatitis.2nd Ed. Philadelphia: Lea and Febiger; p. 197. [Google Scholar]
  23. Goldman L. Nickel Eczema. Arch Dermatol Syphilol. 1933;28:688–96. [Google Scholar]
  24. Menne T. Quantitative aspects of nickel dermatitis: sensitization and eliciting threshold concentrations. Sci Total Environ. 1994;148(2-3):275–81. [PubMed] [Google Scholar]
  25. Clayton TH, Wilkinson SM, Rawcliffe C, Pollock B, Clark SM. Allergic contact dermatitis in children: should pattern of dermatitis determine referral? A retrospective study of 500 children tested between 1995 and 2004 in one U.K. centre. Br J Dermatol. 2006;154(1):114–17. [PubMed] [Google Scholar]
  26. Bishara SE, Barrett RD, Selim MI. Biodegradation of orthodontic appliances — Part II Changes in the blood level of Nickel. Am J Orthod Dentofacial Orthop. 1993;103(2):115–19. [PubMed] [Google Scholar]
  27. Noble J, Ahing SI, Karaiskos NE, Wiltshire WA. Nickel allergy and orthodontics, a review and report of two cases. Br Dent J. 2008;204(6):297–300. [PubMed] [Google Scholar]
  28. Andersen KE, Hjorth N, Menné T. The baboon syndrome: systemically induced allergic contact dermatitis. Contact Dermatitis. 1984;10(2):97–100. [PubMed] [Google Scholar]
  29. Jensen CS, Lisby S, Baadsgaard O, Byrialsen K, Menné T. Release of nickel ions from stainless steel alloys used in dental braces and their patch test reactivity in nickel-sensitive individuals. Contact Dermatitis. 2003;48(6):300–04. [PubMed] [Google Scholar]
  30. Janson GR, Dainesi EA, Consolaro A, Woodside DG, de Freitas MR. Nickel hypersensitivity reaction before, during, and after orthodontic therapy. Am J Orthod Dentofacial Orthop. 1998;113(6):655–60. [PubMed] [Google Scholar]
  31. Feasby WH, Ecclestone ER, Grainger RM. Nickel sensitivity in pediatric dental patients. Pediatr Dent. 1988;10(2):127–29. [PubMed] [Google Scholar]
  32. Randall RC. Preformed metal crowns for primary and permanent molar teeth: review of the literature. Pediatr Dent. 2002;24(5):489–500. [PubMed] [Google Scholar]
  33. Barrett RD, Bishara SE, Quinn JK. Biodegradation of orthodontic appliances. Part I. Biodegradation of nickel and chromium invitro. Am J Orthod Dentofacial Orthop. 1993;103(1):8–14. [PubMed] [Google Scholar]
  34. Duarte I, Amorim JR, Perázzio EF, Schmitz Junior R. Metal contact dermatitis: prevalence to nickel, cobalt and chromium. An Bras Dermatol. 2005;80(2):137–42. [Google Scholar]
  35. Peeters MS, Schroeter AL, Van Hale HM, Broadbent JC. Pacemaker contact sensitivity. Contact Dermatitis. 1984;11(4):214–18. [PubMed] [Google Scholar]
  36. Yamauchi R, Morita A, Tsuji T. Pacemaker dermatitis from titanium. Contact Dermatitis. 2000;42(1):52–3. [PubMed] [Google Scholar]
  37. Sicilia A, Cuesta S, Coma G, et al. Titanium allergy in dental implant patients: a clinical study on 1500 consecutive patients. Clin Oral Implants Res. 2008;19(8):823–35. [PubMed] [Google Scholar]
  38. Hensten-Pettersen A. Casting alloys: side-effects. Adv Dent Res. 1992;6:38–43. [PubMed] [Google Scholar]
  39. Lhotka CG, Szekeres T, Fritzer-Szekeres M, et al. Are allergic reactions to skin clips associated with delayed wound healing? Am J Surg. 1998;176(4):320–23. [PubMed] [Google Scholar]
  40. Egusa H, Ko N, Shimazu T, Yatani H. Suspected association of an allergic reaction with titanium dental implants: a clinical report. J Prosthet Dent. 2008;100(5):344–47. [PubMed] [Google Scholar]
  41. Mitchell DL, Synnott SA, Van Dercreek JA. Tissue reaction involving an intraoral skin graft and CP titanium abutments: a clinical report. Int J Oral Maxillofac Implants. 1990;5(1):79–84. [PubMed] [Google Scholar]
  42. Nawaz F, Wall BM. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome: suspected association with titanium bioprosthesis. Am J Med Sci. 2007;334(3):215–18. [PubMed] [Google Scholar]
  43. Müller K, Valentine-Thon E. Hypersensitivity to titanium: clinical and laboratory evidence. Neuroendocrinol Lett. 2006;27(suppl 1):31–35. [PubMed] [Google Scholar]
  44. Harloff T, Hönle W, Holzwarth U, Bader R, Yhomas P, Schuh A. Titanium allergy or not? “Impurity” of titanium implant materials. 2010;2(4):306–10. [Google Scholar]
  45. Forte G, Petrucci F, Bocca B. Metal allergens of growing significance: epidemiology, immunotoxicology, strategies for testing and prevention. Inflamm Allergy Drug Targets. 2008;7(3):145–62. [PubMed] [Google Scholar]
  46. Okamura T, Morimoto M, Fukushima D, Yamane G. A skin patch test for the diagnosis of titanium allergy. J Dent Res. 1999;78(5):1135. [Google Scholar]
  47. Sagomonyants KB, Jarman-Smith ML, Devine JN, Aronow MS, Gronowicz GA. The invitro response of human osteoblasts to polyetherether ketone (PEEK) substrates compared to commercially pure titanium. 2008;29(11):1563–72. [PubMed] [Google Scholar]
  48. Spina A, Levine HJ. Latex allergy: A review for the dental professional. Oral Surg Oral Med Oral Path Oral Rad Endod. 1999;87(1):5–11. [PubMed] [Google Scholar]
  49. Kean T, McNally M. Latex hypersensitivity: a closer look at considerations for dentistry. J Can Dent Assoc. 2009;75(4):279–82. [PubMed] [Google Scholar]
  50. Nainar SM. Dental management of children with latex allergy. Int J Paediatr Dent. 2001;11(5):322–26. [PubMed] [Google Scholar]
  51. Hamann CP, DePaola LG, Rodgers PA. Occupation-related allergies in dentistry. J Am Dent Assoc. 2005;136(4):500–10. [PubMed] [Google Scholar]
  52. Tan BB, Lear JT, Watts J, Jones P, English JS. Perioperative collapse: prevalence of latex allergy in patients sensitive to anaesthetic agents. Contact Dermatitis. 1997;36(1):47–50. [PubMed] [Google Scholar]
  53. Chin S, Ferguson J, Bajurnow T. Latex allergy in dentistry. Review and report of case presenting as a serious reaction to latex dental dam. Aus Dent J. 2004;49(3):146–48. [PubMed] [Google Scholar]
  54. Rankin KV, Jones DL, Rees TD. Incidence of latex reactions in an adult dental patient population. J Dent Res. 1993;72:202. Abstr 786. [Google Scholar]
  55. Smart ER, Macleod RI, Lawrence CM. Allergic reactions to rubber gloves in dental patients: report of three cases. Br Dent J. 1992;172(12):445–47. [PubMed] [Google Scholar]
  56. Khamaysi Z, Bergman R, Weltfriend S. Positive patch test reactions to allergens of the dental series and the relation to the clinical presentations. Contact Dermatitis. 2006;55(4):216–18. [PubMed] [Google Scholar]
  57. Woods J, Lambert S, Platts-Mills TA, et al. Natural Rubber Latex Allergy: spectrum, diagnostic approach, and therapy. J Emerg Med. 1997;15(1):71–85. [PubMed] [Google Scholar]
  58. Fisher AA. Contact urticaria and anaphylactoid reactions to corn starch surgical glove powder. Contact Dermatitis. 1987;16(4):224–25. [PubMed] [Google Scholar]
  59. Wakelin SH, White IR. Natural rubber latex allergy. Clin Exp Dermatol. 1999;24(4):245–48. [PubMed] [Google Scholar]
  60. Tomazic VJ. Adverse reactions to natural rubber latex. User facility Reporting Bulletin No.19. 1997:1–3. [Google Scholar]
  61. Schatz M, Fung DL. Anaphylactoid and anaphylactic reactions due to anaesthetic agents. Clin Rev Allergy. 1986;4(2):215–18. [PubMed] [Google Scholar]
  62. Eggleston ST, Lush LW. Understanding allergic reactions to local anaesthetics. Ann Pharmacother. 1996;30(7-8):851–57. [PubMed] [Google Scholar]
  63. Chen AH. Toxicity and allergy to local anaesthesia. J Calif Dent Assoc. 1998;26(9):683–92. [PubMed] [Google Scholar]
  64. Noble DS, Pierce GFM. Allergy to lignocaine. A case history. 1961;281:1436. [PubMed] [Google Scholar]
  65. Bateman PB. Multiple allergy to local anaesthetics including prilocaine. J Med Aust. 1974;2(12):449–52. [PubMed] [Google Scholar]
  66. Johnson WT, De Stigter T. Hypersensitivity to procaine, tetracaine, mepivacaine and methylparaben: report of a case. J Am Dent Assoc. 1983;106(1):53–56. [PubMed] [Google Scholar]
  67. Luebke NH, Walker JA. Discussion of sensitivity to preservatives in anaesthetics. J Am Dent Assoc. 1978;97(4):656–57. [PubMed] [Google Scholar]
  68. Schwartz HJ, Sher TH. Bisulphite sensitivity manifesting as allergy to local dental anaesthesia. J Allergy Clin Immunol. 1985;75(4):525–27. [PubMed] [Google Scholar]
  69. Rood JP. Adverse reaction to dental local anaesthetic injection — ‘allergy’ is not the cause. Br Dent J. 2000;189(7):380–84. [PubMed] [Google Scholar]
  70. Canfield DW, Gage TW. A Guideline to Local Anaesthetic Allergy Testing. Anaesth Prog. 1987;34(5):157–63. [PMC free article] [PubMed] [Google Scholar]
  71. Schatz M. Adverse reactions to local anaesthetics. Immunol Allergy Clin North Am. 1992;12:585–609. [Google Scholar]
  72. Schwartz HJ, Gilbert IA, Lenner KA, et al. Metabisulfite sensitivity and local dental anaesthesia. Ann Allergy. 1989;62(2):83–86. [PubMed] [Google Scholar]
  73. Bhole MV, Manson AL, Seneviratne SL, Misbah SA. IgE-mediated allergy to local anaesthetics: separating fact from perception: a UK perspective. Br J Anaesth. 2012;108(6):903–11. [PubMed] [Google Scholar]
  74. Speca SJ, Boynes SG, Cuddy MA. Allergic reactions to local anaesthetic formulations. Dent Clin North Am. 2010;54(4):655–64. [PubMed] [Google Scholar]
  75. Gall H, Kaufmann R, Kalveram CM. Adverse reactions to local anaesthetics: analysis of 197 cases. J Allergy Clin Immunol. 1996;97(4):933–37. [PubMed] [Google Scholar]
  76. Gonzalez-Delgado P, Anton R, Soriano V, Zapater P, Niveiro E. Cross-reactivity among amide-type local anaesthetics in a case of allergy to mepivacaine. J Investig Allergol Clin Immunol. 2006;16(5):311–13. [PubMed] [Google Scholar]
  77. Venemalm L, Degerbeck F, Smith W. IgE-mediated reaction to mepivacaine. J Allergy Clin Immunol. 2008;121(4):1058–59. [PubMed] [Google Scholar]
  78. Baluga JC, Casamayou R, Carozzi E, López N, Anale R, Borges R, et al. Allergy to local anaesthetics in dentistry. Myth or reality? Allergo lImmunopathol (Madr) 2002;30(1):14–19. [PubMed] [Google Scholar]
  79. Giovannitti JA, Bennett CR. Assessment of allergy to local anaesthetics. J Am Dent Assoc. 1979;98(5):701–06. [PubMed] [Google Scholar]
  80. Fasting S, Gisvold SE. Serious intraoperative problems: A five year review of 83,844 anaesthetics. Can J Anaesth. 2002;49(6):545–53. [PubMed] [Google Scholar]
  81. Sambrook PJ, Smith W, Elijah J, Goss AN. Severe adverse reactions to dental local anaesthetics: systemic reactions. Aust Dent J. 2011;56(2):148–53. [PubMed] [Google Scholar]
  82. Schatz M. Skin testing and incremental challenge in the evaluation of adverse reactions to local anaesthetics. J Allergy ClinImmunol. 1984;74(4 Pt 2):606–16. [PubMed] [Google Scholar]
  83. Oral and Dental Expert Group. Therapeutic Guidelines: Oral and Dental. Version I. Melbourne: Therapeutics Guidelines Limited, 2007.
  84. Latorre N, Silvestre JF, Monteagudo AF. Allergic Contact Dermatitis Caused by Formaldehyde and Formaldehyde Releasers. Actas Dermosifiliogr. 2011;102(2):86–97. [PubMed] [Google Scholar]
  85. De Groot A, White IR, Flyvholm MA, Lensen G, Coenrads P-J. Formaldehyde-releasers in cosmetics: relationship to formaldehyde contact allergy. Part 2 Patch test relationship to formaldehyde contact allergy, experimental provocation tests, amount of formaldehyde released, and assessment of risk to consumers allergic to formaldehyde. Contact Dermatitis. 2010;62:18–31. [PubMed] [Google Scholar]
  86. De Groot AC, Flyvholm MA. Formaldehyde-releasers: relationship to formaldehyde contact allergy. Contact allergy to formaldehyde and inventory of formaldehyde-releasers. Contact Dermatitis. 2009;61:63–85. [PubMed] [Google Scholar]
  87. Cronin E. Formaldehyde is a significant allergen in women with hand eczema. Contact Dermatitis. 1991;25(5):276–82. [PubMed] [Google Scholar]
  88. Agner T, Flyvholm MA, Menné T. Formaldehyde allergy: A follow-up study. Am J Contact Dermat. 1999;10(1):12–17. [PubMed] [Google Scholar]
  89. Tas E, Pletscher M, Bircher AJ. IgE mediated urticaria from formaldehyde in a dental root canal compound. J Investig Allergol Clin Immunol. 2002;12(2):130–33. [PubMed] [Google Scholar]
  90. Haïkel Y, Braun JJ, Zana H, Boukari A, de Blay F, Pauli G. Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in a root canal sealant. J Endod. 2000;26(9):529–31. [PubMed] [Google Scholar]
  91. Braun JJ, Zana H, Purohit A, Valfrey J, Scherer PH, HaBkel Y, et al. Anaphylactic reactions to formaldehyde in root canal sealant after endodontic treatment: four cases of anaphylactic shock and three of generalized urticaria. 2003;58(11):1210–15. [PubMed] [Google Scholar]
  92. Kijima A, Nishino H, Umeda J, Kataoka Y. Type 1 allergy to formaldehyde in root canal sealant after dental treatment: two case reports and review of the literature. 2007;56(11):1397–402. [PubMed] [Google Scholar]
  93. Silvestre JF, Albares MP, Blanes M, Pascual JC, Pastor N. Allergic contact gingivitis due to eugenol present in a restorative dental material. Contact Dermatitis. 2005;52(6):341. [PubMed] [Google Scholar]
  94. Deshpande A, Verma S, Macwan C. Allergic Reaction Associated with the use of Eugenol Containing Dental Cement in a Young Child. Austin J Dent. 2014;1(2):1007. [Google Scholar]
  95. Kaufman AY, Solomonov M, Galieva D, Abbott PV. Allergic reaction to the tetracycline component of Ledermix paste: a case report. Int Endod J. 2014;47(11):1090–97. [PubMed] [Google Scholar]
  96. Kaufman AY, Keila S. Hypersensitivity to sodium hypochlorite. J Endod. 1989;15(5):224–26. [PubMed] [Google Scholar]
  97. Calliskan MK, Turkun M, Alper S. Allergy to sodium hypochlorite during root canal therapy: a case report. Int Endod J. 1994;27(3):163–67. [PubMed] [Google Scholar]
  98. Dahl BL. Tissue hypersensitivity to dental materials. J Oral Rehabil. 1978;5(2):117–20. [PubMed] [Google Scholar]
  99. Batchelor JM, Todd PM. Allergic contact stomatitis caused by a polyether dental impression material. Contact Dermatitis. 2010;63(5):296–97. [PubMed] [Google Scholar]
  100. Mittermuller P, Szeimies RM, Landthaler M, Schmalz G. A rare allergy to a polyether dental impression material. Clin Oral Invest. 2012;16(4):1111–16. [PubMed] [Google Scholar]
  101. Mobeeriek AA, Eshiekh HA. Adverse effect of polysulphide impression material: Case report. The Saudi dental journal. 1998;10:86–88. [Google Scholar]
  102. Gangemi S, Spagnolo EV, Cardia G, Minciullo PL. Fatal anaphylactic shock due to a dental impression material. Int J Prosthodont. 2009;22(1):33–34. [PubMed] [Google Scholar]
  103. Armstrong DK, Biagioni P, Lamey PJ, Burrows D. Contact hypersensitivity in patients with orofacial granulomatosis. Am J Contact Dermat. 1997;8(1):35–38. [PubMed] [Google Scholar]
  104. Guttman-Yassky E, Weltfriend S, Bergman R. Resolution of orofacial granulomatosis with amalgam removal. J Eur Acad Dermatol Venereol. 2003;17(3):344–47. [PubMed] [Google Scholar]
  105. Lazarov A, Kidron D, Tulchinsky Z, Minkow B. Contact orofacial granulomatosis caused by delayed hypersensitivity to gold and mercury. J Am Acad Dermatol. 2003;49(6):1117–20. [PubMed] [Google Scholar]
  106. Kanerva L, Lahtinen A, Toikkanen J, et al. Increase in occupational skin diseases of dental personnel. Contact Dermatitis. 1999;40:104–08. [PubMed] [Google Scholar]
  107. Kanerva L, Alanko K, Estlander T, et al. Statistics on occupational contact dermatitis from (meth)acrylates in dental personnel. Contact Dermatitis. 2000;42:175–76. [PubMed] [Google Scholar]
  108. Alanko K, Susitaival P, Jolanki R, Kanerva L. Occupational skin diseases among dental nurses. Contact Dermatitis. 2004;50:77–82. [PubMed] [Google Scholar]
  109. Hamann CP, Rodgers PA, Sullivan KM. Occupational allergens in dentistry. Curr Opin Allergy Clin Immunol. 2004;4(5):403–09. [PubMed] [Google Scholar]
  110. Bakula A, Lugovic-Mihic L, Situm M, Turcin J, Sinkovic A. Contact Allergy in the mouth: Diversity of Clinical Presentations And Diagnosis Of Common Allergens Relevant To Dental Practice. Acta Clin Croat. 2011;50(4):553–61. [PubMed] [Google Scholar]
  111. McParland H, Warnakulasuriya S. Oral lichenoid contact lesions to mercury and dental amalgam-A Review. J Biomed Biotechnol. 2012;2012:589569. [PMC free article] [PubMed] [Google Scholar]
  112. Stejskal J, Stejskal VDM. The role of metals in autoimmunity and the link to neuroendocrinology. Neuro Endocrinol Lett. 1999;20(6):351–64. [PubMed] [Google Scholar]
  113. Stejskal V. MELISA - An in vitro tool for the study of metal allergy. ToxicolIn Vitro. 1994;8(5):991–1000. [PubMed] [Google Scholar]
  114. Strejskal VDM, Danersund A, Lindvall A, Hudecek R, et al. Metal-specific lymphocytes: biomarkers of sensitivity in man. Neuroendocrinol Lett. 1999;20(5):289–98. [PubMed] [Google Scholar]