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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 -
Journal of Biomedicine & Biotechnology 2012Human oral mucosa is subjected to many noxious stimuli. One of these substances, in those who have restorations, is dental amalgam which contains mercury. This paper... (Review)
Review
Human oral mucosa is subjected to many noxious stimuli. One of these substances, in those who have restorations, is dental amalgam which contains mercury. This paper focuses on the local toxic effects of amalgam and mercury from dental restorations. Components of amalgam may, in rare instances, cause local side effects or allergic reactions referred to as oral lichenoid lesions (OLLs). OLLs to amalgams are recognised as hypersensitivity reactions to low-level mercury exposure. The use of patch testing to identify those susceptible from OLL is explored, and recommendations for removing amalgam fillings, when indicated are outlined. We conclude that evidence does not show that exposure to mercury from amalgam restorations poses a serious health risk in humans, except for an exceedingly small number of hypersensitivity reactions that are discussed.
Topics: Dental Amalgam; Humans; Hypersensitivity, Delayed; Lichen Planus, Oral; Mercury; Mouth Mucosa; Patch Tests
PubMed: 22888200
DOI: 10.1155/2012/589569 -
International Journal of Environmental... Apr 2020Multiple sclerosis (MS) is an inflammatory neurological disease characterized by autoimmune-mediated demyelination of the central nervous system. Genetic and...
Multiple sclerosis (MS) is an inflammatory neurological disease characterized by autoimmune-mediated demyelination of the central nervous system. Genetic and environmental factors may contribute to the development of MS. This has not been confirmed yet. Dental amalgam has long been controversial in MS due to its mercury content but the toxicological implications of mercury-containing amalgam fillings (AMF) for MS remain to be elucidated. We conducted a case-control study to investigate the association between AMF and the risk of MS from the Taiwanese National Health Insurance Research Database (NHIRD). Case ( = 612) and control ( = 612) groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index by propensity score matched with a 1:1 ratio from 2000 to 2013. Differences between cases and controls was not statistically significant (OR: 0.82, 95% CI = 0.65-1.05). In subjects stratified by gender, MS was also not associated with AMF for women (OR: 0.743, 95% CI = 0.552-1.000) and men (OR: 1.006, 95% CI = 0.670-1.509), respectively. In summary, this Taiwanese nationwide population-based case-control study did not find an association between MS and AMF.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Dental Amalgam; Female; Humans; Male; Mercury; Middle Aged; Multiple Sclerosis; Taiwan; Young Adult
PubMed: 32290568
DOI: 10.3390/ijerph17082637 -
BMC Oral Health Sep 2013Dental amalgam is a source of elemental and inorganic mercury. The safety of dental amalgam in individuals remains a controversial issue. Urinary mercury concentrations...
BACKGROUND
Dental amalgam is a source of elemental and inorganic mercury. The safety of dental amalgam in individuals remains a controversial issue. Urinary mercury concentrations are used to assess chronic exposure to elemental mercury. At present, there are no indications of mercury-associated adverse effects at levels below 5 μg Hg/g creatinine (Cr) or 7 μg Hg/L (urine). The purpose of the present study is to determine the overall urinary mercury level in the Canadian general population in relation to the number of dental amalgam surfaces.
METHODS
Data come from the 2007/09 Canadian Health Measures Survey, which measured urinary mercury concentrations in a nationally representative sample of 5,418 Canadians aged 6-79 years. Urinary mercury concentrations were stratified by sex, age, and number of dental amalgam surfaces.
RESULTS
The overall mean urinary mercury concentration varied between 0.12 μg Hg/L and 0.31 μg Hg/L or 0.13 μg Hg/g Cr and 0.40 μg Hg/g Cr. In general, females showed slightly higher mean urinary mercury levels than men. The overall 95th percentile was 2.95 μg Hg/L, the 99th percentile was 7.34E μg Hg/L, and the 99.9th percentile was 17.45 μg Hg/L. Expressed as μg Hg/g Cr, the overall 95th percentile was 2.57 μg Hg/g Cr, the 99th percentile was 5.65 μg Hg/g Cr, and the 99.9th percentiles was 12.14 μg Hg/g Cr. Overall, 98.2% of participants had urinary mercury levels below 7 μg Hg/L and 97.7% had urinary mercury levels below 5 μg Hg/g Cr. All data are estimates for the Canadian population. The estimates followed by the letter "E" should be interpreted with caution due to high sampling variability (coefficient of variation 16.6%-33.3%).
CONCLUSIONS
The mean urinary mercury concentrations in the general Canadian population are significantly lower than the values considered to pose any risks for health.
Topics: Adolescent; Adult; Aged; Body Burden; Canada; Child; Dental Amalgam; Environmental Exposure; Female; Humans; Male; Mercury; Middle Aged; Young Adult
PubMed: 24015978
DOI: 10.1186/1472-6831-13-44 -
The International Journal of... Apr 2014Mercury is among the most toxic nonradioactive elements which may cause toxicity even at low doses. Some studies showed release of mercury from dental amalgam fillings...
Mercury is among the most toxic nonradioactive elements which may cause toxicity even at low doses. Some studies showed release of mercury from dental amalgam fillings in individuals who used mobile phone. This study was conducted to assess the effect of high-field MRI on mercury release from dental amalgam filling. We studied two groups of students with identical tooth decays requiring a similar pattern of restorative dentistry. They were exposed to a magnetic flux density of 1.5 T produced by a MRI machine. 16 otherwise healthy students with identical dental decay participated in this study. They underwent similar restorative dentistry procedures and randomly divided into two groups of MRI-exposed and control arms. Urinary concentrations of mercury in the control subjects were measured before (hour 0) and 48 and 72 hrs after amalgam restoration, using cold vapor atomic absorption spectrometry. Urinary concentrations of mercury in exposed individuals were determined before (hour 0), and 24, 48, 72 and 96 hrs after amalgam restoration. Unlike control subjects, they underwent conventional brain MRI (15 min, 99 slices), 24 hrs after amalgam restoration. The mean±SD urinary mercury levels in MRI-exposed individuals increased linearly from a baseline value of 20.70±17.96 to 24.83±22.91 μg/L 72 hrs after MRI. In the control group, the concentration decreased linearly from 20.70±19.77 to 16.14±20.05 μg/L. The difference between urinary mercury in the exposed and control group, 72 hrs after MRI (96 h after restoration),was significant (p=0.046). These findings provide further support for the noxious effect of MRI (exposure to strong magnetic field)and release of mercury from dental amalgam fillings.
Topics: Adult; Dental Amalgam; Dental Restoration, Permanent; Electromagnetic Fields; Female; Humans; Magnetic Resonance Imaging; Male; Mercury; Spectrophotometry, Atomic; Young Adult
PubMed: 24748001
DOI: No ID Found -
Community Dentistry and Oral... Oct 2018ADHD is multifactorial, including both genetic and environmental factors. The safety of amalgam used in dental treatment has been discussed due to its content of mercury...
BACKGROUND
ADHD is multifactorial, including both genetic and environmental factors. The safety of amalgam used in dental treatment has been discussed due to its content of mercury and potential risks for negative neurodevelopmental consequences in the offspring. The aim of the study was to investigate possible associations between symptoms related to ADHD in children of three and five years of age and prenatal exposure to mercury from mothers' amalgam fillings.
METHODS
Data from the Norwegian Mother and Child Cohort Study (MoBa) were used. Data were collected by questionnaires sent to participating women in week 17 (Q1) and 30 (Q3) of pregnancy and when the child was three (Q6) and five years of age (Q7). Information about exposure to amalgam during pregnancy was obtained from Q3. Information about symptoms related to ADHD was obtained from Q6 and Q7. Valid data were obtained for 42 163 children at three years of age and 23 392 children at five years of age. Logistic regression models, including mothers' age, education, body mass index, parity, smoking and alcohol consumption during pregnancy, were used to estimate the association between ADHD symptoms and prenatal exposure to amalgam fillings.
RESULTS
No significant associations between number of teeth with amalgam filling, amalgam fillings placed or removed during pregnancy, and symptoms related to ADHD in children of three and five years of age were found.
CONCLUSIONS
In a large, prospective cohort study, we found no indication of increased risk of ADHD-related symptoms in children prenatally exposed to mother's amalgam fillings.
Topics: Adult; Attention Deficit Disorder with Hyperactivity; Child, Preschool; Dental Amalgam; Educational Status; Female; Humans; Logistic Models; Male; Maternal Age; Mercury Poisoning; Norway; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Risk Factors; Surveys and Questionnaires
PubMed: 30084494
DOI: 10.1111/cdoe.12409 -
International Dental Journal Sep 2020There has been considerable controversy concerning the health risks and benefits of using mercury-containing amalgam. This study aimed to evaluate the Turkish dentists'...
OBJECTIVES
There has been considerable controversy concerning the health risks and benefits of using mercury-containing amalgam. This study aimed to evaluate the Turkish dentists' and patients' preference and opinion about amalgam and to assess Internet search trends about amalgam.
METHODS
The study consists of three stages. The first two stages of the study are cross-sectional studies to verify both the patients' perception with amalgam restorations and dentists' attitudes regarding the use of dental amalgam. The third stage of the study evaluated the Internet search trends of Turkish people about mercury and amalgam related concerns between 2004 and 2018.
RESULTS
A total of 320 patients (180 female, 140 male) and 1,211 dentists (533 female, 678 male) participated in this study. Majority of the patients have no idea about the type of dental restorations and effect of dental materials on their health. 188 (58.8%) participants stated that they would not prefer amalgam restoration in their teeth as amalgam is unaesthetic. A total of 24% (291) of the dentists used amalgam routinely; 9.5% (156) of them used amalgam rarely, and 63.1% (764) did not use amalgam at all. The reason for not using amalgam included the patients' desire and unaesthetic properties. According to the Internet search trends, Turkish people do not know as much about amalgam as people in the rest of the world.
CONCLUSION
Awareness about dental amalgam is low among patients studied. Although dentists do not use dental amalgam frequently, they disagree on banning dental amalgam.
PubMed: 32996144
DOI: 10.1111/idj.12610 -
PloS One 2018The aim was to gain knowledge regarding the risk of perinatal death related to exposure to dental amalgam fillings in the mother. (Clinical Trial)
Clinical Trial
OBJECTIVES
The aim was to gain knowledge regarding the risk of perinatal death related to exposure to dental amalgam fillings in the mother.
DESIGN
Population-based observational cohort study.
SETTING
The Norwegian Mother and Child Cohort Study, a Norwegian birth cohort of children born in 1999-2008 conducted by the Norwegian Institute of Public Health.
PARTICIPANTS
72,038 pregnant women with data on the number of teeth filled with dental amalgam.
MAIN OUTCOME MEASURES
Data on perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0-7 days after birth) were obtained from the Medical Birth Registry of Norway.
RESULTS
The absolute risk of perinatal death ranged from 0.20% in women with no amalgam-filled teeth to 0.67% in women with 13 or more teeth filled with amalgam. Analyses including the number of teeth filled with amalgam as a continuous variable indicated an increased risk of perinatal death by increasing number of teeth filled with dental amalgam (crude OR 1.065, 95% CI 1.034 to 1.098, p<0.001). After adjustment for potential confounders (mothers' age, education, body mass index, parity, smoking during pregnancy, alcohol consumption during pregnancy) included as categorical variables, there was still an increased risk for perinatal death associated with increasing number of teeth filled with amalgam (ORadj 1.041, 95% CI 1.008 to 1.076, p = 0.015). By an increased exposure from 0 to 16 teeth filled with amalgam, the model predicted an almost doubled odds ratio (ORadj 1.915, 95% CI 1.12 to 3.28). In groups with 1 to 12 teeth filled with amalgam the adjusted odds ratios were slightly, but not significantly, increased. The group with the highest exposure (participants with 13 or more teeth filled with amalgam) had an adjusted OR of 2.34 (95% CI 1.27 to 4.32; p = 0.007).
CONCLUSION
The current findings suggest that the risk of perinatal death could increase in a dose-dependent way based on the mother's number of teeth filled with dental amalgam. However, we cannot exclude that the relatively modest odds ratios could be a result of residual confounding. Additional studies on the relationship between exposure to dental amalgam fillings during pregnancy and perinatal death are warranted.
Topics: Adult; Dental Amalgam; Dental Restoration, Permanent; Female; Follow-Up Studies; Humans; Infant, Newborn; Models, Biological; Norway; Perinatal Death; Perinatal Mortality; Pregnancy; Risk Factors
PubMed: 30532171
DOI: 10.1371/journal.pone.0208803 -
Journal of Dentistry Dec 2022To measure mercury release from standardised hydroxyapatite/amalgam constructs during MRI scanning and investigate the impact of static field strength and radiofrequency...
OBJECTIVES
To measure mercury release from standardised hydroxyapatite/amalgam constructs during MRI scanning and investigate the impact of static field strength and radiofrequency (RF) power on mercury release.
METHODS
Amalgam was placed into 140 hydroxyapatite disks and matured for 14-days in artificial saliva. The solution was replaced, and samples split into five groups of 28 immediately prior to MRI. One group had no exposure, and the remainder were exposed to either a 3T or 7T MRI scanner, each at high and low RF power. Mercury concentration was measured by inductively coupled plasma mass spectrometry. Groups were compared using one-way ANOVA, and two-way ANOVA for main effects/ interaction of field strength/ RF power.
RESULTS
Mercury concentration was increased in the 7T groups (high/ low: 15.43/ 11.33 ng mL) and 3T high group (3.59) compared to control (2.44). MRI field strength significantly increased mercury release (p < .001) as did RF power (p = .030). At 3T, mercury release was 20.3 times lower than during maturation of dental amalgam, and for the average person an estimated 1.50 ng kg of mercury might be released during one 3T investigation; this is substantially lower than the tolerable weekly intake of 4,000 ng kg.
CONCLUSION
Mercury release from amalgam shows a measurable increase following MRI, and the magnitude changes with magnetic field strength and RF power. The amount of mercury released is small compared to release during amalgam maturation. Amalgam mercury release during MRI is unlikely to be clinically meaningful and highly likely to remain below safe levels.
Topics: Humans; Dental Amalgam; Mercury; Magnetic Resonance Imaging; Hydroxyapatites
PubMed: 36228805
DOI: 10.1016/j.jdent.2022.104322 -
SAGE Open Medicine 2021Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and...
Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and the risk of reported asthma diagnoses in American adults. A total of 97,861,577 weighted-persons with one or more dental amalgam surfaces (exposed group) and 31,716,558 weighted-persons with one or more other dental surfaces (no dental amalgams, unexposed group) were examined in the 2015-2016 National Health and Nutrition Examination Survey. All persons were 20-80 years old and with known reported asthma status (only newly diagnosed asthma cases were examined). Survey logistic regression and survey frequency modeling in SAS were employed to evaluate the relative incidence rate of reported asthma diagnoses among those in the exposed group compared to the unexposed group. Covariates of gender, race, socioeconomic status, educational status, country of birth, and tobacco exposure were considered. Survey logistic modeling revealed a significantly increased incidence rate of reported asthma in the exposed group as compared to the unexposed group in unadjusted (4.46-fold) and adjusted (4.84-fold) models. A dose-response relationship was observed for the risk of reported asthma per dental amalgam filling surface in unadjusted (1.073) and adjusted (1.076) models. Survey frequency modeling revealed that the frequency of reported asthma (per 10,000 weighted-person years) was 3.66-fold significantly increased in the exposed group (2.06) as compared to the unexposed group (0.56). Increased dental amalgam exposure was associated with an increased risk of reported asthma diagnoses in American adults, but future studies should further evaluate this relationship.
PubMed: 34691469
DOI: 10.1177/20503121211048677