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Table 1 Studies included in final analysis

From: Is methylmethacrylate toxic during pregnancy and breastfeeding?--- a systematic review

Authors

Title

Type of Study

Application of MMA

Results

Singh et al. (1972) [9]

Embryonic-Fetal Toxicity and Teratogenic Effects of a Group of Methacrylate Esters in Rats

Animal study

22 groups of 5 female rats, underwent intraperitoneal injections of methacrylate esters on various days of gestation and at various doses

Denture bases

Fetuses in group exposed to MMA had significant increase in gross abnormalities such as hemangiomas and had significantly lower birth weight.

No skeletal malformations were observed with any MMA dose used in this study.

McLaughlin et al. (1978) [3]

Methylmathacrylate: A Study of Teratogenicity and Fetal Toxicity of the Vapor in the Mouse

Animal study

32 pregnant mice

14 control

18 exposed to MMA vapor

Total joint arthroplasty

Slight increase in average weight of fetuses in exposed mothers was noted.

No other evidence or fetal toxicity or teratologic effects were found.

Nicholas et al. (1979) [10]

Embryotoxicity and Fetotoxicity from Maternal Inhalation of Methyl Methacrylate Monomer in Rats

Animal study, pregnant rats exposed to MMA vapor

233 fetuses in short exposure

185 fetuses in long exposure

263 fetuses in air control

229 fetuses untreated control

Denture bases

Long exposure to MMA vapor on days 6–15 of gestation had increased incidence of early fetal deaths, hemangiomas, delayed vertebral & sternal ossification and decreased fetal weight and crown-rump length.

MMA exposure did not significantly affect incidence of implantations, resorptions, or number of living fetuses per litter.

Chen et al. (1998) [11]

Free Radicals are Involved in Methymethacrylated-Induced Neurotoxicity in Human Primary Neocortical Cell Cultures

Basic science study

Exposed embryonic brain issue used for neuro-enriched culture to MMA monomer

Dental implants

Neocortical neurons exposed to MMA had increased lactate dehydrogenase (LDH) levels, irregular shrunken cell bodies, lysis, neurotoxicity.

Dahl et al. (1999) [12]

Dental workplace exposure and effect on fertility

Retrospective cohort study

558 female dental surgeons

450 high school teachers with at least 1 child

Dental surgery, including amalgams and other implants

No difference was found in rates of birth defects.

Study does not specifically control for MMA exposure, but addresses dental surgery in general.

Linehan et al. (2006) [13]

Serum and Breast Milk Levels of Methylmethacrylate Following Surgeon Exposure During Arthroplasty

Serum and breast milk analyzed from 2 lactating orthopaedic surgeons after exposure to MMA compared to 2 healthy controls

Total joint arthroplasty

No serum or breast milk sample had detectable MMA levels following inhalational exposure during total joint arthroplasty.

Lindbohm et al. (2007) [14]

Occupational exposure in dentistry and miscarriage

Case controlled retrospective study

222 cases of miscarriage

498 controls (births)

Dental applications

There was a slight but not significant increase in odds for miscarriage for those exposed to MMA in air or polymethylmethacrylate (PMMA) dust.

Homlar et al. (2013) [15]

Serum Levels of Methyl Methacrylate Following Inhalational Exposure to Polymethylmethacrylate Bone Cement

20 healthy volunteers exposed to mixing of PMMA cement in simulated operating room, then serum levels obtained

Joint arthroplasty

MMA was not detected in any of the specimens after exposure during routine mixing of PMMA cement.

Speeckaert et al. (2015) [16]

Airborne Exposure of Methyl Methacrylate During Simulated Total Hip Arthroplasty and Fabrication of Antibiotic Beads

Simulated operating room where the airborne exposure of MMA during total hip arthroplasty and antibiotic beads fabrication was measured

Total hip arthroplasty

Antibiotic beads

MMA levels fell to baseline at an average of 11 min post mixing in all total hip arthroplasty simulations. By these authors’ measurements, the MMA exposure was a small fraction of the Occupational Safety and Health Administration limit during an 8 h limit.