-
British Dental Journal May 2022With the phasing down of dental amalgam use in response to the Minamata Convention, it is likely that resin-based composite restoratives will be the dental material of... (Review)
Review
With the phasing down of dental amalgam use in response to the Minamata Convention, it is likely that resin-based composite restoratives will be the dental material of choice for the direct restoration of compromised dentition in the UK, at least for the foreseeable future. The current materials have a finite lifespan, with failures predominately due to either secondary caries or fracture. Consequently, there is considerable in vitro research reported each year with the intention of producing improved materials. This review describes the recent research in materials designed to have low polymerisation shrinkage and increased mechanical properties. Also described is research into materials that are either antimicrobial or are designed to release ions into the surrounding oral environment, with the aim of stimulating remineralisation of the surrounding dental tissues. It is hoped that by describing this recent research, clinicians will be able to gain some understanding of the current research that will potentially lead to new products that they can use to improve patient treatment in the future.
Topics: Composite Resins; Dental Amalgam; Dental Caries; Dental Materials; Dental Restoration, Permanent; Humans
PubMed: 35562465
DOI: 10.1038/s41415-022-4240-8 -
British Dental Journal Nov 2022Phase out of dental amalgam requires investment in prevention measures, research and development of alternative materials, and effective waste management processes. The...
Phase out of dental amalgam requires investment in prevention measures, research and development of alternative materials, and effective waste management processes. The dental profession is supporting the phase-down of dental amalgam but dentists need the full armoury of dental materials and must be trusted to share decision-making with their patients about clinical choices. Unintended consequences of a rapid global phase-out of dental amalgam must be properly understood before it is universally imposed.
Topics: Dental Amalgam; Dental Restoration, Permanent; Mercury
PubMed: 36434231
DOI: 10.1038/s41415-022-5217-3 -
British Dental Journal Nov 2023
Topics: Dental Amalgam; Dental Restoration, Permanent
PubMed: 38001180
DOI: 10.1038/s41415-023-6572-4 -
Dermatologic Clinics Oct 2020Oral pigmented lesions have a wide range of clinical presentations, some of which correlate with cutaneous pigmented lesions. This article highlights these correlates... (Review)
Review
Oral pigmented lesions have a wide range of clinical presentations, some of which correlate with cutaneous pigmented lesions. This article highlights these correlates and underscores important differences that can potentially have clinical impact. Moreover, given a nonspecific presentation of an oral pigmented lesion, the article provides a reference to aid clinicians with differential diagnoses based on clinical features. This article is an overview of pigmented lesions of the oral cavity, including localized reactive pigmented lesions, neoplastic pigmented lesions, and pigmented lesions as sequelae of a systemic disease.
Topics: Addison Disease; Dental Amalgam; Foreign Bodies; Hemochromatosis; Humans; Hyperpigmentation; Lead Poisoning; Melanoma; Melanosis; Mouth Diseases; Mouth Neoplasms; Neuroectodermal Tumor, Melanotic; Neurofibromatoses; Nevus, Pigmented; Peutz-Jeghers Syndrome; Pituitary ACTH Hypersecretion; Sarcoma, Kaposi; Tattooing
PubMed: 32892857
DOI: 10.1016/j.det.2020.05.009 -
Frontiers in Oral Health 2023This paper set out to investigate the relationship between teaching and clinical practice of direct posterior restoration placement at tertiary dental institutions in...
INTRODUCTION
This paper set out to investigate the relationship between teaching and clinical practice of direct posterior restoration placement at tertiary dental institutions in South Africa.
METHODS
A cross-sectional study using a mixed methods approach was conducted, and all the South African dental schools were invited to participate. The quantitative phase of the study analyzed the Conservative Dentistry department's records of direct restorations at a single dental school. The number of amalgam and tooth-colored restorations placed by students in the fourth and fifth year of the program from 2004 to 2019 were compared. During the qualitative phase, semi-structured interviews were held with staff from the four dental schools involved with the teaching of direct posterior restorations.
RESULTS
The predominant direct posterior restoration placed in student clinics over a 15-year period at a South African dental school was tooth colored (75%). Teaching times do not correspond to a decrease in the placement of dental amalgam restorations for both one-surface and two-surface posterior restorations and a concomitant increase in the tooth-colored restorations.
DISCUSSION
Academic staff involved in teaching identified that South Africa's ratification of the Minamata Convention has consequences for dental education and training. However, all schools reported that dental amalgam would continue to be taught in the absence of an appropriate alternative.
PubMed: 37539092
DOI: 10.3389/froh.2023.1118361 -
General Dentistry 2020
Topics: Dental Amalgam; Dental Materials; Oral Health
PubMed: 31859653
DOI: No ID Found -
Human & Experimental Toxicology 2022For more than 150 years, dental amalgam fillings (50% metallic mercury (Hg) by weight) have been used in American dentistry. The US Food and Drug Administration (FDA)...
OBJECTIVE
For more than 150 years, dental amalgam fillings (50% metallic mercury (Hg) by weight) have been used in American dentistry. The US Food and Drug Administration (FDA) acknowledged that amalgams release Hg vapor that may be harmful to certain patients. This study examined the impact of Hg vapor exposure from amalgams in American adults.
METHODS
Amalgam-Hg vapor exposure among 158,274,824 weighted-adult Americans was examined in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Beta (β)-coefficients were calculated for the correlation between the number of amalgam surfaces and daily micrograms (μg) of urinary Hg and daily μg of Hg vapor exposure from amalgams per kilogram (Kg) bodyweight.
RESULTS
About 91 million (57.8%) adults had ≥1 amalgam surface and about 67 million (42.2%) had no amalgams. A β-coefficient = 0.041 significantly correlated the number of amalgam surfaces to daily amounts of urinary Hg. Differences were observed for gender and racial groups. Daily Hg vapor doses from amalgams were in excess of the most restrictive California's Environmental Protection Agency (EPA) safety limit for about 86 million (54.3%) adults and in excess of the least restrictive US EPA safety limit among about 16 million (10.4%) adults. The mean allowable number of amalgam surfaces ranged from 1.28 for adult females under the California's EPA safety limit to 16.23 for adult males under the US EPA safety limit.
CONCLUSION
Given that American adults are receiving significant, ongoing exposure to Hg vapor from amalgams, careful evaluation of the need to reduce use of amalgams should be considered.
Topics: Adult; Dental Amalgam; Female; Gases; Humans; Male; Mercury; Nutrition Surveys
PubMed: 35786065
DOI: 10.1177/09603271221106341 -
Dental Research Journal 2022From the perspectives of longevity, mechanical performance, and economics, amalgam has long been considered the material of choice, especially for certain types of... (Review)
Review
From the perspectives of longevity, mechanical performance, and economics, amalgam has long been considered the material of choice, especially for certain types of restorations in posterior teeth, including replacement therapy for existing amalgam fillings. In spite of numerous advantages over other filling materials, its use has been decreasing in recent years and the alternative tooth-colored filling materials are increasingly used. There is a trend towards minimal interventional, adhesive, techniques in dentistry, which are based on adhesion to tooth structure by chemical interaction and/or micromechanical retention. At the same time, the quality and durability of alternative materials have improved. Mercury is the metallic element of concern used in dental amalgam. Mercury is a well-documented toxicant, with reasonably well-defined characteristics for the major forms of exposure, involving elemental mercury as well as organic and inorganic mercury compounds. Looking into the kind of practice and its popularity among dentists and the patients in India, even we have to comply with the use of amalgam by implementing the best possible ways to minimize the extent of damage to nature.
PubMed: 36407775
DOI: No ID Found -
Neurotoxicology Dec 2020Mercury is a highly potent cell toxin with effects on human and animal nervous systems. Mercury vapour released from dental amalgam is the predominant source of mercury... (Review)
Review
Mercury is a highly potent cell toxin with effects on human and animal nervous systems. Mercury vapour released from dental amalgam is the predominant source of mercury in the human adult and foetal central nervous system in populations of developed countries. Only in small populations with high consumption of methyl mercury containing fish can the contribution from fish consumption reach or surpass that of amalgam fillings. The most severe health risk is that of interference with foetal and child brain development. This effect of mercury vapour exposure has been demonstrated in animal experiments on monkeys and rats and in nerve cell cultures at nanomolar concentrations. The effect is also supported by epidemiological studies on women occupationally exposed to mercury vapour during pregnancy. However, there is no data permitting an assessment of dose-response relations for this effect in humans. In epidemiological studies on populations with occupational exposure to mercury vapour, subclinical effects on kidneys, the immune system, thyroid function, and CNS function have been observed at an exposure level equal to the upper range of the exposure range seen in amalgam bearers and measured as urine excretion rate of inorganic mercury. The cell toxic effect of mercury is likely to be based on the ability of mercury to modify protein tertiary and quaternary structure. As protein structure is genetically determined, there is ample scope for genetic polymorphism to manifest itself in varying sensitivity and reaction to mercury exposure. It is also likely that mercury exposure from dental amalgam exerts side effects like most potent pharmaceuticals. The clinical support for this assumption is reviewed. An incidence of side effects exceeding 10% is unlikely considering available epidemiological evidence. However, an incidence of 1% or below is highly probable. It is recommended that use of amalgam for dental restorations is abandoned and substituted with available less toxic material and that amalgam restorations in children and women of childbearing age should be avoided due to the potential risk of interference by mercury with brain development.
Topics: Animals; Dental Amalgam; Female; Fishes; Humans; Mercury; Occupational Exposure; Pregnancy; Rats; Risk Assessment
PubMed: 35623360
DOI: 10.1016/j.neuro.2020.09.034 -
British Dental Journal Nov 2022
Topics: Dental Amalgam
PubMed: 36434230
DOI: 10.1038/s41415-022-5218-2