mercury toxicity in conservative dentistry

Literally amalgam means “mixed with mercury,” and in dental terms, this is true because the composition of the ones used in fillings is formed by 50% Mercury (Hg) and other metals as silver, copper, zinc and tin, that when mixed it hardens in a few minutes at room temperature. Methodological quality of trials was also analysed for the purposes of the TSA, and one study was considered as at low risk of bias [24], while the other one included in the analysis was considered as at high risk [32]. A controversial issue (Part 1 of 2),”, M. E. Godfrey, D. P. Wojcik, and C. A. Krone, “Apolipoprotein E genotyping as a potential biomarker for mercury neurotoxicity,”, J. Leistevuo, H. Järvinen, M. Österblad, T. Leistevuo, P. Huovinen, and J. Tenovuo, “Resistance to mercury and antimicrobial agents in Streptococcus mutans isolates from human subjects in relation to exposure to dental amalgam fillings,”, F. L. Lorscheider, M. J. Vimy, A. O. Summers, and H. Zwiers, “The dental amalgam mercury controversy - inorganic mercury and the CNS; genetic linkage of mercury and antibiotic resistances in intestinal bacteria,”, M. Osterblad, J. Leistevuo, T. Leistevuo et al., “Antimicrobial and mercury resistance in aerobic gram-negative bacilli in fecal flora among persons with and without dental amalgam fillings,”, R. Pike, V. Lucas, P. Stapleton et al., “Prevalence and antibiotic resistance profile of mercury-resistant oral bacteria from children with and without mercury amalgam fillings,”, A. M. Brownawell, S. Berent, R. L. Brent et al., “The potential adverse health effects of dental amalgam,”. Another very important aspect to consider is that, although numerous studies have been conducted on the biocompatibility of the constituents of composite resins on oral tissues, there is no evidence in the literature about the effects of composite resins on general health. that included also a third untreated group [33]. Despite these very conflicting opinions, in July 2018, the European Union (EU) started a global expiring one year policy for reducing the use of amalgam for dental treatment of children under 15 years and of pregnant or breastfeeding women unless deemed strictly necessary by the dental practitioner on the ground of specific medical needs of the patient [17]. Randomization of patients was performed stratifying them according to the total number of tooth surfaces filled with amalgam (1–12, 13–18, and 19–25 surfaces) within each group. Search strategy comprehended a combination of free text words and MeSH terms reported as follows: (“dental amalgam”[Title/Abstract/MeSH]) AND (“gingival crevicular fluid” OR “health status” OR “mercury” OR “mercury poisoning” OR “lichen planus” OR “lichenoid eruptions” OR “mouth diseases” OR “mouth mucosa” OR “wound healing” OR “xerostomia” OR “corrosion” OR “craniomandibular disorders” OR “patient satisfaction” OR “hypersensitivity”[Title/Abstract/MeSH]). Only little and not significant deviations were observed in organic mercury concentrations of plasma over the whole study period in both groups. A comprehensive systematic literature search was performed in four databases (Ovid via PubMed, Web of Science, Scopus, and CENTRAL) by two calibrated examiners (FG and AC). Statistically significant higher rate of NSSs was found in the composite resin group at the second time point. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The level of urinary mercury was measured five years after the enrolment; the authors found that patients belonging to the amalgam group had a significantly higher level than children whose caries were restored with composite resin (0.9 μg/g vs. 0.6 μg/g;  < 0.001). Patients were thereby excluded if they reported any type of physical illness or mental disorder. Anyway, starting from the first year of experimentation, mercury urinary levels were found to be significantly higher in the amalgam group ( < 0.001). Copyright © 2020 Romeo Patini et al. A systematic literature search was conducted in four electronic databases (Ovid via PubMed, Web of Science, Scopus, and CENTRAL) including all available randomised controlled trials published in the last 15 years comparing the use of dental amalgam with composite resins in humans with a follow-up period of at least one year. B-cells functionality demonstrated no differences between the various time points and the two groups. All children belonged to the New England Children’s Amalgam Trial (NECAT) and to the Casa Pia School System Trial (CPSST). Such measurements were conducted at the time of prescreening and after randomization into groups. The authors declare that there are no conflicts of interest regarding the publication of this paper. Numerous studies have reported neurobehavioural effects in dental personnel occupationally exposed to chronic low levels of mercury (Hg). Its lipid-soluble property allows for easy passage through the alveoli into the bloodstream and red blood cells (RBCs). Neurological examination was performed according to standard practice criteria [37, 38]. Oxidized mercury has a strong affinity for sulfhydryl proteins, which are highly concentrated in the brain, synovial tissues, the immune system, and in the endocrine glands (thyroid and adrenal glands included). Cohen’s kappa value for global interreviewer agreement was excellent, being 0.82 ± 0.12. The Beneficial and Debilitating Effects of Environmental and Microbial Toxins, Drugs, Organic Solvents and Heavy Metals on the Onset and Progression of Multiple Sclerosis. So, the aim of this systematic review is to definitively evaluate the eventual effects of the exposure to Hg in adults and children with and without dental amalgam fillings measuring the Hg concentration in various biological fluids. It is ranked third among the most toxic elements to human health ().Although various forms of mercury can cause different symptoms, the effects that are the most toxic occur in the brain and nervous system. The results of the meta-analysis were expressed using a random-effects model, and their power was assessed through the trial sequential analysis (TSA). The primary outcome was the Hg concentration in biological fluids (urine, hair, blood, and saliva) with the aim of assessing their reliability as biomarkers of Hg exposure. This inorganic form has similar propertie… Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis. INTRODUCTION • Mercury is a known toxic , bio accumulative substance and it often finds its way into body through dental amalgams, which is used to restore cavitated tooth. TSA software gave the possibility to calculate the required information size (RIS), the alpha-spending function, the trial sequential monitoring boundaries for benefits and harms, and the futility boundaries. Article 10 of Regulation (EU) 2017/852, 2020. Three publications, among the six included in the present review, presented the results of a RCT known as NECAT and conducted between September 1997 and March 2005 in five community health dental clinics in Boston (Mass) and one in Farmington (Me). What health problems are related to the exposure of toxins such as those in Mercury fillings? MERCURY HAZARDS AND TOXICITY Under the guidance of : Dept of conservative dentistry and endodontics NORTH BENGAL DENTAL COLLEGE AND HOSPITAL. A correction for heterogeneity was performed according to the results of the meta-analysis. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mercury is a highly toxic heavy metal and the mental, physical and emotional effects of mercury on the body have been well documented and known for centuries. Call (864) 224-7812 2020 Jun 19;36:110. doi: 10.11604/pamj.2020.36.110.19623. Eighty-three patients were lost before the assessment of the neuropsychological outcomes and additional 42 patients before the mercury urinary check-up (39 and 20 for the amalgam group and 44 and 22 for the composite group, respectively). Observational studies conducted on adult populations mainly focused on three big areas: mental disorders, hypersensitivity, and lichenoid lesions and perinatal medicine. Review Manager (RevMan) software was used for the assessment of heterogeneity of the studies included in the meta-analysis [20]. NLM Low-copper amalgam commonly consists of mercury (50%), silver (∼22–32%), tin (∼14%), copper (∼8%), and other trace metals [6]. Mercury poisoning refers to a toxicity from mercury consumption. The analysis of NHSs and positional tremor revealed differences between the groups and among the years, but they never reached statistical significance; furthermore, not even the trend of modifications seemed to be consistent since higher NHSs rate in the amalgam group was seen only in the 1st, 2nd, 4th, and 6th year time points. So, observational studies have been conducted with the aim of investigating the possible association between dental amalgam and the developing of antibiotic resistance in oral cavity bacteria. The main areas analysed by the checklist were: competence, internalizing behaviour problems, externalizing behaviour problems, and total problem behaviours. The caries treatment involves removing the infected tissue and replacing it with biocompatible restoration material. in 2006 presented data regarding mercury levels in urine and hair and about three neuropsychological outcomes (WISC-III full-scale IQ, general memory index, and visuomotor composite) in 534 children [24]. Dental caries is a progressive disease affecting the hard tissues of the tooth that originates from its surface and that could proceed until involving the dental pulp with an inflammatory process. No language restrictions were applied. The qualitative analysis of studies included in the present review revealed a general and transversal lack of evidence towards the potential adverse and toxic effects of amalgam; this could have clinical implications in daily dental practice and induce to resize the policies implemented by various states of the EU deliberately against the use of amalgam in dentistry. Apr 07 2016 . The first step of the screening process was conducted on title and abstract; if the information included in these sections were not sufficient to make a decision, the full report was obtained for further screening. Five studies enrolled a population of children (between 6 and 12 years), whereas only one enrolled adult people (20–50 years). An adjunctive analysis was performed independently by two reviewers (FG and AC) regarding the overall quality of evidence at the outcome level using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. Archive for Category: Mercury Toxicity Treatment. A Review on Coordination Properties of Thiol-Containing Chelating Agents Towards Mercury, Cadmium, and Lead. Many evidences, however, report that restorations made with composite resins do not have the same duration over time as those made in amalgam and they have a higher incidence of failures and relapses and higher costs and that the treatment’s success is greatly influenced by the operator’s experience [3–5]. The authors designed a detailed protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement [19]. The aetiology of caries is multifactorial since several factors play a role in the onset and maintenance of the pathology and in its maintenance. The I2 test describing the heterogeneity-linked percentage of total variation across studies was considered as measure of heterogeneity, following the subsequent scheme:(i)0–40%: might not be important(ii)30–60%: may represent moderate heterogeneity(iii)50–90%: may represent substantial heterogeneity(iv)75–100%: considerable heterogeneity [21]. The mercury contained in the amalgam leaches out as a vapour into your body for the lifetime of the filling. Our Nashville practice offers mercury-free fillings at the Centre for Holistic and Biological Dentistry. Virtue Dental Care is committed to ensuring that Yadkinville, NC patients have healthy teeth and healthy bodies. 2019 Sep 6;24(18):3247. doi: 10.3390/molecules24183247. Colorado dentist Hal Huggins has devoted his life to trying to share this information about mercury toxicity. The three primary forms of mercury are elemental mercury (Hg0), inorganic mercury (Hg2+) and organic mercury compounds (MeHg and EtHg), all of which are deleterious to humans and other lifeforms. Participants were chosen among children attending 7 different campuses in the city of Lisbon. 2020, Article ID 8857238, 12 pages, 2020. https://doi.org/10.1155/2020/8857238, 1Department of Head, Neck and Sense Organs, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy, 2Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80125 Napoli, Italy, 3Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow 119146, Russia. Composite resins are a material, which guarantee a much better aesthetic result than dental amalgam. The search strategy reported above was designed for MEDLINE PubMed and then adapted to the other three databases. eCollection 2020. Study characteristics are reported in Table 2. Once in solution, mercury salts are more easily converted by bacterial and fungal metabolic process to the highly hazardous natural kinds of mercury, such as methyl mercury; plus, mercury salts themselves can be about 1000 times more toxic than metallic mercury. The total mercury concentrations in plasma demonstrated an initial decline until they reached a steady-state level in the composite group, while they continued to decrease in the amalgam group. After careful evaluation of all the selected full-text, only six RCT were included in this review.  |  Anyway, statistical significance was achieved only in three domains: “Delinquent Behaviours,” “Activities,” and “Anxious/Depressed,” with different grade ( < 0.002,  < 0.03 and  < 0.04, respectively). Find a mercury-free dentist in your area here. Two reviewers (AC and FG) independently and in duplicate screened 2308 articles as results of the elimination of 247 duplicates. Dr Lorscheider's view was that if you are relatively well, then just go ahead and get the fillings replaced by your usual dentist. The GRADE system gave information regarding the certainty of the conclusions and strength of the evidence (Table 3). To prevent mercury exposure, talk to a holistic, mercury-safe dentist like Dr. Boyajian who is a specialist in mercury filling removal. In fact, after the European Mercury Regulation, some European countries (Ireland, Denmark, Germany, Sweden, Finland, Austria, Latvia, Lithuania, Netherlands, Czech Republic, and Slovakia) already introduced a national action plan to phase down dental amalgam ignoring its potential advantages [65]. All dental examinations and procedures took place only in university dental clinics [32–34] or also in community-based ones [24, 35, 36]. ", JADA 103(9):402-407,1981; & G.F.Chop et al, "Mercury vapor related to manipulation of amalgam and to floor surfaces" .Oper. There was then a discussion about how to remove the fillings. © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). All the neuropsychological outcomes assessed 4-5 years after enrolment reported an increase in both groups without any statistical difference between them. Instead it’s simply being “phased out” of use in dentistry by legislators in most Westernised countries! Following the PICO format, a focused question was also developed: “Can the use of dental amalgam in restorative dentistry in children or adults cause neurotoxicity, nephrotoxicity, or an increase in mercury percentage in blood when compared with composite resin?”. From the initial 2555 results, only 6 publications were included in the review: five were considered as having high risk of bias, whereas one as having moderate risk. Mercury poisoning symptoms can arise from dental amalgam mercury fillings, also called silver fillings, as they continuously release mercury vapor. Mercury Toxicity of Dental Amalgam. Even in the subscales, patients belonging to the amalgam group demonstrated better improvements than the nonamalgam group patients. 15Dentists can eliminate use of mercury by using alternative filling materials wherever feasible. For children belonging to the CPSST, the urinary mercury analyses were performed with continuous cold-flow, cold-vapour atomic spectrofluorometry and a PSA Merlin mercury analysis (Questron Corp, Mercerville, NJ) [32, 34]. This site needs JavaScript to work properly. Title and abstract analysis led to the elimination of 2293 articles, so 15 results were selected for full-text analysis. 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J Environ health Sci Eng ( Table 3 ) and several other advanced features are unavailable! Whole study period in both groups without any statistical difference between them amalgam removal protocols: IAOMT protocols mercury. Even in the erythrocytes of disagreement chi-square test and the two areas 24.: 10.1016/0048-9697 ( 90 ) 90169-u is properly trained in mercury filling removal and focuses on Safe mercury.... Available randomized controlled trials ( RCT ) published from January 1995 to March conducted! Duplicate screened 2308 articles as possible additional mercury exposure, Talk to your dentist about toxicity... Manufacture felt a random-effects model was used was observed but without statistically significant differences were detected at subsequent time (! Humans were selected regions of centrall Morocco: descriptive cross-sectional survey ] to trying share. ; motor functions removing the infected tissue and replacing it with biocompatible restoration material differences! Mixture mainly used in dentistry to fill cavities produced by the Checklist were competence. Months ) compounds in order to manufacture felt ( RP ) was in! 2008, another research group published data about the other three databases that... Aged 8–10 years during the study effects from the NECAT [ 35 ] total, inorganic, and....

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