Authors: Oliver Steiner; Komaz Melanie; Goessler Walter; Thomas Peter; Kühn Klaus-Dieter
Addresses: Institute of Chemistry, Analytical Chemistry for Health and Environment, University of Graz, 8010, Graz, Austria ' Department of Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria ' Institute of Chemistry Analytical Chemistry for Health and Environment, University of Graz, Austria ' Department of Dermatology and Allergology, Ludwig-Maximilians-University (LMU), Munich, 80337, Germany ' Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
Abstract: Background: Until today, benzoyl peroxide (BPO) as a potential polymethyl methacrylate (PMMA) cement allergen is the subject of controversial discussion. Question/Purposes: Few cases have been reported in literature and ought to be seen critically. To address this issue, the present study aims to determine BPO and their degradation products biphenyl (BP) and benzoic acid (BA) within hardened cement as well as their elution from cement. Methods: Six ordinary cements characterised by different BPO: DmpT ratio were chosen for the study. Subsequently, cements were tested in-vitro under destructive, physiologic and non- physiologic conditions. Results: BPO was not detectable under destructive and physiological conditions. Cements with a N, N-Dimethyl-para-toluidine (DmpT) surplus contained lower BPO, BP and BA concentrations compared to cements with BPO surplus. Conclusions: Furthermore, the ratio of DmpT:BPO had an impact on the turnover of BPO and its degradation products. Clinical Relevance: Moreover, BPO and BP elution under physiological conditions was not detectable (<0.1 μg/mL in saline solution at a ratio of 1+9 cement to saline solution), calling into question whether BPO is relevant as PMMA cement allergen.
Keywords: PMMA; polymethyl methacrylate; BPO; benzoyl peroxide; allergy; in-vitro; HPLC; high performance liquid chromate-graphic system; low grade infection; COPAL PALACOS.
International Journal of Nano and Biomaterials, 2021 Vol.10 No.1, pp.34 - 49
Received: 14 Apr 2020
Accepted: 27 Aug 2020
Published online: 30 Apr 2021 *