The cement mainly consists of PMMA (over 95%). The mail causal agent of resin material is generally known as resin monomer including MMA. Polymerized PMMA can still release residual monomer. Polymer powder also can cause inflammation because of tissue reaction to particulate. You can find great amount of article about this issue.
PMMA is the cured polymer which uses MMA (methyl methacrylate monomer) plus other components (crosslinkers, activators, catalysts, inhibitors, dyes, pigments, fillers, and copolymers). The experience with bone cement is a transient depression of breathing which disappears quickly. It is well known and easily countered during surgery by supporting breathing and pulse, something which is always done during general anesthesia. PMMA as a group has been used in dentistry and prosthetics with very few problems since the 1930s for removable dentures, other tooth replacement materials, and artificial limbs. Occasional allergies to MMA occur but are also rare (there are people allergic to gold!). PMMA on the industrial side is known as Plexiglas, Perspex, and Lucite.
Certainly, the BCIS not always happens. However, BCIS still exist. Dental resin allergy also stil exist. That is why there is numerous article about PMMA cytotoxicity. This means PMMA material has a room to improve in biocompatibility, which is the work for biomateria scientist.
I think the question was originally about the side effects of PMMA when it comes into contact with the skin. The answer was directed mainly on the effect of bone cement. The issue is different of course as when you manufacture an artificial limb; it is not going “in the majority of cases’ to be implanted into the human body. The mere application of PMMA that is ‘let us assume’ totally polymerized to the human skin may bear no long term problems to the majority of cases.
The application of PMMA in dentistry is different as the material is subjected to fluctuations in pH levels, temperatures and salivations which will affect the decomposition and dissolutions rates. These conditions are lacking under artificial limbs.
in the matter of fact the issue needs comprehensive discussion as some new research work indicated that addition of PMMA nano particles reduces the cytotoxicity of silicone layers. pls see the attachment
Generally most of the polymers are passive and donot cause skin irritation. But certain times, the unreacted monomer if any in the polymer poses health problems. Moreover, certain additives that are used in the polymers (including PMMA) cause allergy in some individuals. For this reason, the polymers used in the medical field have to be free from these things to the maximum possible extent.
PMMA elutes MMA during its setting phase. The reaction between the monomer liquid and the polymer powder is exothermic in nature. Animal studies have proven that monomers can lead to carcinogenesis. However, PMMA is routinely used as a bone cement in orthopedics and as denture materials in dentistry presently. The critical concentration of the residual monomer might play a critical role in allergic reactions.
Most of the answers are targeted towards PMMA bone cement, which of course will be polymerized directly at the surgical site with the hazards of residual monomer.
I personally see the question targeted towards the application and contact of PMMA to the skin.
In this regard we may be discussing the use of some readymade appliances which are made of PMMA that is industrially polymerized. Such appliance will have very little amount of residual monomer and roughness if any. Those are the two main reasons for allergic reactions
Institute for Systems and Computer Engineering, Technology and Science (INESC TEC)
In my point of view, after polymerization PMMA is no more toxic. From my implant pathology experience, PMMA particles do not induce an extensive inflammatory response. Typically, it is observed macrophage activation and fusion followed by tissue fibrosis (foreign body reaction type).
Focusing on your application (skin-external), the mechanical properties of PMMA may be points of concerns due to its high Young modulus and fragility. The surface that will contact with skin should be soft to not promote wound formation.
PMMA has been used for removable partial and complete dentures since the 1930s. True, rare allergies present themselves, but properly cured dentures are used worldwide by the millions. Patients who wear their dentures 24 hours/day, however, often develop fungus infections under the dentures which looks like an allergic reaction since the reaction occurs precisely under the imprint of the denture. Extended wearing a maxillary denture can progress to papillary hyperplasia with extreme overgrowth of the palatal mucosa. Removal of the denture while sleeping and antifungal medications can reverse the lesions. It is almost never an allergic reaction. Skin reactions to PMMA are also rare.
I agree with Professor Gettleman. PMMA is widely used for removable partial and complete dentures fabrication. Fungus infections are usual in patients who use the denture for long periods, however, antifungal medications can reverse this situation. On the other hand, alergenic reactions to PMMA are not usual.
Inhalation: May be harmful if inhaled. May cause respiratory tract irritation.
Skin: May be harmful if absorbed through the skin. May cause skin irritation.
Eyes: May cause eye irritation.
Ingestion: May be harmful if swallowed.
Description of Necessary First-Aid Measures:
Inhalation: Move person to fresh air; if effects occur, consult a physician
Skin: Wash skin with plenty of water. Seek first-aid or medical attentions as needed. If molten material comes in contact with skin, do not apply ice but cool under-ice water of running stream of an eater. DO NOT attempt to remove the material from skin. Removal could result in severe tissue damage. Seek medical attention immediately. Suitable emergency safety shower facility should be immediately available
Eyes: Flush eyes thoroughly with water for several minutes. Remove contact lenses after the initial 1-2 minutes and continue flushing for several additional minutes. If effects occur, consult a physician, preferably an ophthalmologist.
Ingestion: If swallowed, seek medical attention. May cause a gastrointestinal blockage. Do not give laxatives. Do not induce vomiting unless directed to do so by medical personnel.