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The Journal of Clinical Pediatric... 2015The science of dental materials and restorative care in children and adolescent is constantly evolving, and the ongoing search for ideal restorative materials has led to... (Review)
Review
BACKGROUND
The science of dental materials and restorative care in children and adolescent is constantly evolving, and the ongoing search for ideal restorative materials has led to plethora of research.
AIM
To provide an evidence base to assist dental practitioners choose appropriate restorative care for children and adolescents.
STUDY DESIGN
This evidence-based review appraises this literature, primarily between the years 1995-2013, for efficacy of dental amalgam, composites, glass ionomer cements, compomers, preformed metal crowns and anterior esthetic restorations. The assessment of evidence for each dental material was based on a strong evidence, evidence in favor, expert opinion, and evidence against by consensus of the authors.
RESULTS
There is varying level of evidence for the use of restorative materials like amalgam, composites, glass ionomers, resin-modified glass-ionomers, compomers, stainless steel crowns and anterior crowns for both primary and permanent teeth.
CONCLUSIONS
A substantial amount data is available on restorative materials used in pediatric dentistry; however, there exists substantial evidence from systematic reviews and randomized clinical trials and clinicians need to examine and understand the available literature evidence carefully to aid them in clinical decision making.
Topics: Adolescent; Child; Crowns; Dental Materials; Dental Restoration, Permanent; Evidence-Based Dentistry; Humans
PubMed: 26161599
DOI: 10.17796/1053-4628-39.4.303 -
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 the American Dental... May 2023Amalgam has been used for more than 150 years as a safe and reliable restorative material. The authors described the occurrence of amalgam and nonamalgam restorations in...
BACKGROUND
Amalgam has been used for more than 150 years as a safe and reliable restorative material. The authors described the occurrence of amalgam and nonamalgam restorations in the United States in primary and permanent teeth across age groups and according to sociodemographic characteristics.
METHODS
The authors used clinical examination data from the National Health and Nutrition Examination Survey 2015-2018 for participants 2 years and older (n = 17,040). The authors estimated the prevalence and mean number of amalgam and nonamalgam restorations in primary and permanent teeth according to age groups (2-5 years, 6-11 years, 12-15 years, 16-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥ 80 years), race and ethnicity, federal poverty guideline, education, and pregnancy status.
RESULTS
The prevalence of amalgam restorations ranged from 4% through 69%. Overall, amalgam restorations were more prevalent in children and adolescents from racial and ethnic minority groups and families at lower poverty levels and with lower education. The mean number of teeth with nonamalgam restorations was higher than those with amalgam restorations in primary teeth of children aged 6 through 11 years, permanent teeth of those 12 through 15 years and 20 through 39 years, and women aged 20 through 49 years, regardless of pregnancy status. The mean number of amalgam restorations was higher than that for nonamalgam restorations in older age groups.
CONCLUSIONS
Nonamalgam restorations were the most common in the primary teeth of children older than 5 years and in the permanent teeth of adults younger than 40 years. Amalgam restorations were more common in older adults. Amalgam and nonamalgam restorations were equally common in children younger than 5 years.
PRACTICAL IMPLICATIONS
The study findings suggest a shift from amalgam to alternative restorative materials in the United States.
Topics: Child; Adolescent; Humans; Female; United States; Pregnancy; Child, Preschool; Aged; Dental Restoration, Permanent; Prevalence; Ethnicity; Nutrition Surveys; Minority Groups; Dental Materials; Dental Amalgam; Composite Resins
PubMed: 37105669
DOI: 10.1016/j.adaj.2023.02.016 -
Pregnancy Hypertension Jul 2020The potential association between the presence or replacement of dental amalgams and gestational hypertension (GH) is unclear.
BACKGROUND
The potential association between the presence or replacement of dental amalgams and gestational hypertension (GH) is unclear.
OBJECTIVE
To assess the association between the presence or replacement of dental amalgams and the risk of GH in a prospective cohort study.
METHODS
We assessed dental amalgam status (presence or replacement), blood mercury concentrations, and measured blood pressure (BP) in 1817 pregnant women recruited in 10 Canadian cities. BP was assessed in each trimester of pregnancy and mercury concentrations in 1st and 3rd trimesters. Logistic regression analysis was performed to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between dental amalgam status and GH. Concurrent measures with systolic BP (SBP) and diastolic BP (DBP) were assessing through linear generalized estimating equations.
RESULTS
Dental amalgam status was weakly statistically correlated with mercury concentrations but there was no evidence of an association with GH in women having 1-4 (aOR = 1.31 (0.92, 1.85)) or ≥ 5 dental amalgams (aOR = 1.32 (0.86, 2.04)), compared to women without amalgam reported at first trimester. Dental amalgam replacement reported in the first or third trimester was similarly not associated with GH (aOR = 0.75 (0.40, 1.42) and 0.73 (0.39, 1.34), respectively) but with SBP (beta = -1.58 (-2.95, -0.02)).
CONCLUSION
We found weak correlations between dental amalgams and blood mercury among pregnant women. However, the presence of dental amalgams or their replacement was not associated with GH but with decreased SBP for the replacement. Further studies are required.
Topics: Adult; Canada; Dental Amalgam; Female; Humans; Hypertension, Pregnancy-Induced; Mercury; Pregnancy; Prospective Studies
PubMed: 32447273
DOI: 10.1016/j.preghy.2020.04.015 -
Dentistry Journal Jan 2023Among the pillars of sustainability in health care units is environmental protection. Although an EU-wide dental amalgam phase-out legislation exists, quantities of this...
UNLABELLED
Among the pillars of sustainability in health care units is environmental protection. Although an EU-wide dental amalgam phase-out legislation exists, quantities of this material are still to be found in the market, dental offices or in the mouths of patients. The purpose of this study is to record the views of dentists and dental students in Greece regarding the use and safety of dental amalgam for people and the environment as well as their attitudes towards its restriction and disposal.
MATERIALS AND METHODS
Two different questionnaires, through Google forms, were filled by each group. Descriptive statistics were used to describe the variables. The chi-square test or the chi-square test with Yates correction was used to examine potential differences per group (-value = 0.05). Overall, 564 people participated in this study; 462 (81.9%) dentists (N1) and 102 (18.1%) dental students (N2).
RESULTS
Both groups agreed that they no longer use dental amalgam often. Dentists (39.8%) and students (36.4%) consider amalgam to have a moderate burden on the environment. This answer differed significantly per year of profession and year of undergraduate studies, respectively, with dentists from 6-25 years in the profession and 4th-year students, being the least aware on the environmental footprint of dental amalgam. Further, professionals (70%) and students (60%) believe that dental amalgam has a hazardous impact on patient's health, at all or to a small extent. For staff health, dentists reported at a moderate degree dangerous impact (32.9%) while students (36.4%), respectively. The impact on patients and staff health, were found to differ significantly per region of practicing dentistry for both groups. Finally, there were suggestions made from both groups about the necessity of information sharing on amalgam and mercury safety and the impact on the environment at the level of professional organizations.
CONCLUSIONS
Students, younger dentists and those living in non-urban regions seem to be more sensitive to the environmental impact of amalgam use, disposal, and health of people. Environmental issues should be addressed thoroughly by professional organizations, enhancing relevant activities for all people involved.
PubMed: 36661558
DOI: 10.3390/dj11010021 -
Stomatologija 2007The studies show a dental practitioner as a subject of a wide variety of physical and psychological ailments. It is induced or aggravated by the work specificity and... (Review)
Review
UNLABELLED
The studies show a dental practitioner as a subject of a wide variety of physical and psychological ailments. It is induced or aggravated by the work specificity and greatly affects the health of dental professionals. Therefore, general health of dentists, especially effect of dental activity on it, is present-day, important and as a matter of fact not well documented subject. The aim of our review is to summarize and ascertain dental practice-related disorders influencing the physical and psychological health of practitioner. Also we would like to highlight the most vulnerable systems of the dental professional and to survey the best methods to overcome these ailments.
RESULTS
There is growing body of evidence that suggests surprisingly high vulnerability within the dental profession to certain disorders and afflictions that can be categorized as practice-related.
CONCLUSIONS
In different countries dentists reported having poor general health and suffer from various health-related problems. To enjoy and be satisfied with their professional and personal lives, dentists must be aware of the importance to maintain good physical and mental health.
Topics: Anesthetics, Inhalation; Burnout, Professional; Carpal Tunnel Syndrome; Dental Amalgam; Dentists; Hepatitis B; Humans; Musculoskeletal Diseases; Nitrous Oxide; Occupational Diseases; Stress, Psychological
PubMed: 17449973
DOI: No ID Found -
Journal of Biomedical Physics &... Jun 2022Approximately 50% of dental amalgam is elemental mercury by weight. Accumulating body of evidence now shows that not only static magnetic fields (SMF) but both ionizing...
BACKGROUND
Approximately 50% of dental amalgam is elemental mercury by weight. Accumulating body of evidence now shows that not only static magnetic fields (SMF) but both ionizing and non-ionizing electromagnetic radiations can increase the rate of mercury release from dental amalgam fillings. Iranian scientists firstly addressed this issue in 2008 but more than 10 years later, it became viral worldwide.
OBJECTIVE
This review was aimed at evaluating available data on the magnitude of the effects of different physical stressors (excluding chewing and brushing) on the release of toxic mercury from dental amalgam fillings and microleakage.
MATERIAL AND METHODS
The papers reviewed in this study were searched from PubMed, Google Scholar, and Scopus (up to 1 December 2019). The keywords were identified from our initial research matching them with those existing on the database of Medical Subject Headings (MeSH). The non-English papers and other types of articles were not included in this review.
RESULTS
Our review shows that exposure to static magnetic fields (SMF) such as those generated by MRI, electromagnetic fields (EMF) such as those produced by mobile phones; ionizing electromagnetic radiations such as X-rays and non- Ionizing electromagnetic radiation such as lasers and light cure devices can significantly increase the release of mercury from dental amalgam restorations and/or cause microleakage.
CONCLUSION
The results of this review show that a wide variety of physical stressors ranging from non-ionizing electromagnetic fields to ionizing radiations can significantly accelerate the release of mercury from amalgam and cause microleakage.
PubMed: 35698539
DOI: 10.31661/jbpe.v0i0.2009-1175 -
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 -
International Journal of Dentistry 2011Objective. The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental...
Objective. The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental amalgam. Materials and Methods. Two key-words "dental amalgam" and "toxicity" were used to search publications on dental amalgam biocompatibility published in peer-reviewed journals written in English. Manual search was also conducted. The most recent declarations and statements were evaluated using information available on the internet. Case reports were excluded from the study. Results. The literature show that mercury released from dental amalgam restorations does not contribute to systemic disease or systemic toxicological effects. No significant effects on the immune system have been demonstrated with the amounts of mercury released from dental amalgam restorations. Only very rarely have there been reported allergic reactions to mercury from amalgam restorations. No evidence supports a relationship between mercury released from dental amalgam and neurological diseases. Almost all of the declarations accessed by the internet stated by official organizations concluded that current data are not sufficient to relate various complaints and mercury release from dental amalgam. Conclusions. Available scientific data do not justify the discontinuation of amalgam use from dental practice or replacement with alternative restorative dental materials.
PubMed: 22145006
DOI: 10.1155/2011/981595 -
European Journal of Dentistry Mar 2020The aim of this study was to assess: (1) the perceptions of dentists in Saudi Arabia concerning the amalgam controversy, (2) their attitude toward the ethical...
OBJECTIVE
The aim of this study was to assess: (1) the perceptions of dentists in Saudi Arabia concerning the amalgam controversy, (2) their attitude toward the ethical responsibility of patient information, and (3) patients' knowledge and attitude toward the use of dental amalgam.
MATERIALS AND METHODS
A total of 1,139 dentists were sampled on convenience by electronic survey. The questionnaire contained questions about the safety of dental amalgam, use of amalgam, case selection, alternate materials, and informing their patients about risks of amalgam. Also, 425 patients were sampled on convenience and information collected on their knowledge about amalgam and its acceptance in their oral cavities.
RESULTS
A total of 201 dentists and 425 patients participated in the study. A total of 60% of dentists and specialists declared it safe. A total of 32.4% (31) of general dental practitioners and 41% (43) specialists considered it a moral obligation to inform patients about the potential health risks associated with amalgam. Mercury toxicity was identified as the most common health hazard. About 57.3% dentists and 36.2% specialists opted for superior longevity as the principle advantage. Majority of patients (52.2%) in Saudi Arabia had no knowledge about dental amalgam. While 23.1% (98) had concern about poor color, 8.7% (30) knew it contained silver while only 7.8% (27) patients were aware of its mercury content.
CONCLUSION
Majority of dentists in Saudi Arabia found it safe to use amalgam while the patients had little knowledge about the possible issues with amalgam. It is recommended to improve public awareness about impact of mercury containing products on the environment.
PubMed: 32396969
DOI: 10.1055/s-0040-1709829