LAUSR

A 66-year-old woman was referred to our dermatology clinic for evaluation of stomatitis. The patient described episodes of erosions, and a painful burning sensation of the oral mucosa following exposure to a newly acquired occlusal splint made from Orthocryl (DENTAURUM GmbH & Co. KG, Ispringen, Germany). Symptoms of discomfort and soreness in the mouth started after the first night of exposure, and after a second night of exposure, the patient developed burning pain and multiple erosions in the mouth. No systemic symptoms were reported. She consulted her dentist who noted erythema and erosions at sites of contact with the occlusal splint on the left and right buccal mucosa (Figure 1). On advice from the dentist the patient stopped using the product and her symptoms slowly resolved without treatment after 7 days. She was otherwise healthy with no known history of previous acrylic nail use. Because of bruxism she had been using other occlusal splints for the past 20 years without any reactions. According to the material safety data sheet (MSDS) the product consisted of an acrylic polymer-based powder with declared polymethylmethacrylate and a monomer-based liquid with methyl methacrylate (MMA) and ethylene glycol dimethacrylate (EGDMA). The occlusal splint was prepared at a local orthodontic laboratory where the Orthocryl liquid and powder were mixed, manually molded on a tooth model using a “doughing technique”, and subsequently polymerized in a pressure vessel filled with warm water. The product was disinfected but was not eluted in water for 3 days before use, as recommended. Patch tests were performed with the European baseline series, the Gentofte Hospital extended test series, a dental screening series containing acrylics, and with scrapings from the occlusal splint using Finn chambers (SmartPractice, Phoenix, Arizona) on Scanpor tape (Norgesplaster, Vennesla, Norway). Readings were performed on day