Effects of X-rays and magnetic resonance imaging on mercury release from dental amalgam into artificial saliva

No Increased Mercury Release from Dental Restorations at 1.5T, 3T, or 7T MRI

PURPOSE

Dental amalgam contains mercury and is commonly used in dental restorations. The impact of MRI on mercury excretion from dental amalgam is not well understood across clinical field strengths, especially 7T. We investigated the effects of MRI exposure on mercury excretion using fresh, lab-created dental amalgam restorations and in extracted teeth with old, pre-existing restorations.

METHODS

Donated, unfilled human teeth (n = 120) were restored with amalgam before being stored in saline, artificial saliva, or a dry box prior to MRI scanning. The teeth were placed in individual tubes of fresh artificial saliva and scanned at 1.5T, 3T, or 7T or left unscanned as controls. Mercury concentrations were measured 24-30 h later. Donated teeth with pre-existing restorations (n = 40) were stored in artificial saliva, scanned at 7T or left unscanned as controls, and mercury concentration tested.

RESULTS

For teeth extracted and restored in a laboratory, no significant difference was found (F = 2.42, P = 0.072) between mean mercury concentrations of unscanned teeth (13.72 μg/L) and teeth scanned at 1.5T (10.88 μg/L), 3T (12.65 μg/L), or 7T (8.88 μg/L). For teeth extracted with previously placed restorations, no significant difference (P = 0.288) was found between unscanned controls (4.28 μg/L) and teeth scanned at 7T (6.63 μg/L).

CONCLUSION

MRI of dental amalgam does not significantly increase mercury excretion at 1.5T, 3T, or 7T compared to unscanned teeth. This holds true for controlled laboratory restorations as well as for those placed and lived with prior to extraction and scanning, demonstrating no added risk to the clinical patient or research subject.

The effect of magnetic resonance imaging on mercury release from dental amalgam at 3T and 7T

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^-1) 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^-1 of mercury might be released during one 3T investigation; this is substantially lower than the tolerable weekly intake of 4,000 ng kg^-1.

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.

Noise Suppression and Edge Preservation for Low-Dose COVID-19 CT Images Using NLM and Method Noise Thresholding in Shearlet Domain

In the COVID-19 era, it may be possible to detect COVID-19 by detecting lesions in scans, i.e., ground-glass opacity, consolidation, nodules, reticulation, or thickened interlobular septa, and lesion distribution, but it becomes difficult at the early stages due to embryonic lesion growth and the restricted use of high dose X-ray detection. Therefore, it may be possible for a patient who may or may not be infected with coronavirus to consider using high-dose X-rays, but it may cause more risks. Conclusively, using low-dose X-rays to produce CT scans and then adding a rigorous denoising algorithm to the scans is the best way to protect patients from side effects or a high dose X-ray when diagnosing coronavirus involvement early. Hence, this paper proposed a denoising scheme using an NLM filter and method noise thresholding concept in the shearlet domain for noisy COVID CT images. Low-dose COVID CT images can be further utilized. The results and comparative analysis showed that, in most cases, the proposed method gives better outcomes than existing ones.

How Do Different Physical Stressors' Affect the Mercury Release from Dental Amalgam Fillings and Microleakage? A Systematic Review

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.

An overview of the 35 years of research in the oral radiology: a bibliometric analysis

OBJECTIVES

The aim of this study was to provide a bibliometric overview of the oral radiology journal output, contents, and leading trends, and also include a detailed authorship analysis by evaluating the top contributors, and their geographic distributions between 1985 and 2020 years.

METHODS

The databases available on the Scopus and journal's Web Page were searched to identify the all published articles and reports with no restriction regarding publication year or study design. Seven hundred and seventy-seven articles were included and analyzed for the following bibliometric criteria: publication title, authorship, publication year, coauthors, institution of origin, country of origin, collaborating institution and countries, article category, study field, and number of citations based on the Scopus and Google Scholar.

RESULTS

Original article is by far the largest group of study outcome that more than half of the articles were in this category and followed by the case reports (19.8%). The leading countries according to number of the articles were Japan by far (59.8%) followed by Turkey (10.8%) and South Korea (5.2%). The article by Arnheiter, Scarfe, and Farman has received the highest number of citations overall. As first and/or coauthor, Ariji E emerged as a most productive author with 35 publications and Osaka University was determined as the most prominent institutions by publishing the greatest number of articles. More than half of the articles were in the "Diagnosis of Orofacial Diseases" study field.

CONCLUSION

This bibliometric analysis provides a comprehensive overall picture of the 35 years of research progress and publication trends in oral radiology.

Effects of magnetic resonance imaging on the microleakage of five restorative materials: An in vitro study

OBJECTIVE

The objective of this study was to assess the effects of 3 T magnetic resonance imaging (MRI) on the microleakage of 5 restorative materials.

METHODS

In total, 100 maxillary molars were randomly assigned to 5 groups (n = 20) for restoration with 5 different materials: amalgam, light-cured glass-ionomer cement, feldspathic porcelain fused to metal, pressed lithium disilicate glass ceramic, and composite resin. In each group, 10 specimens were subjected to MRI, and 10 specimens served as controls with no MRI exposure. Standardized class V cavities were prepared with occlusal margins terminating in enamel and gingival margins terminating in dentin. Microleakage penetration at the enamel and dentin margins was calculated for each group. A chi-square test was used for intergroup comparisons. Statistical significance was established at P < .05.

RESULTS

Microleakage penetration did not differ significantly between specimens subjected to MRI and the controls for any restoration (P ≥ .362 for the enamel margin, P ≥ .067 for the dentin margin) or between specimens treated with different restorative materials (P ≥ .355). No significant differences in microleakage were discovered between the enamel and dentin margins of any of the restorative groups (P ≥ .236).

CONCLUSION

MRI had no effect on the microleakage of the 5 restorative materials.

Managing the phase-down of amalgam amongst Nigerian dental professionals and students: A national survey

BACKGROUND

Amalgam is one of the most reliable dental restorative materials. Health and environmental concerns associated with the mercury content of amalgam have necessitated an amalgam phase-down in clinical practice.

OBJECTIVES

This study investigated the level of awareness and preparedness for the planned amalgam phase-down recommended by the Minamata Convention amongst Nigerian dental students and dentists.

METHODS

This cross-sectional national survey was performed across all geopolitical zones of Nigeria. Data regarding awareness, practice and level of preparedness for amalgam phase-down were obtained using a questionnaire that was distributed amongst clinical dental students and dentists of different cadres, who routinely place dental restorations, in public and private practice. The questionnaires were administered online or were hand delivered. Data were analysed using the chi-square test and Spearman's rank correlation coefficient. A p value ≤ 0.05 was considered statistically significant.

RESULTS

Notably, 845 dental students and dentists participated in the survey. Mean age (±standard deviation) of participants was 30.15 ± 7.67 years, 33.8% were students, and 66.2% were dentists (most dentists [77.1%] were employed at public hospitals). A significant percentage of respondents had poor knowledge of the Minamata Convention (87.7%) and lacked training in the use of alternatives to amalgam (72.0%). Amalgam continues to be commonly used by 39.1% and 31.3% of dental students and dentists, respectively. Only 4.7% of the respondents admitted to following good amalgam phase-down practices. Awareness (P = 0.013) and amalgam phase-down practices (P = 0.011) were significantly higher amongst dentists than amongst dental students.

CONCLUSION

We observed low levels of awareness regarding the Minamata Convention, amalgam phase-down, mercury hygiene practices and training in alternatives to amalgam use amongst Nigerian dental professionals and students.

"Triple M" Effect: A Proposed Mechanism to Explain Increased Dental Amalgam Microleakage after Exposure to Radiofrequency Electromagnetic Radiation

A large body of evidence now indicates that the amount of mercury released from dental amalgam fillings can be significantly accelerated by exposure to radiofrequency electromagnetic fields (RF-EMFs) such as common mobile phones and magnetic resonance imaging (MRI). Studies performed on the increased microleakage of dental amalgam restorations after exposure to RF-EMFs have further supported these findings. Although the accelerated microleakage induced by RF-EMFs is clinically significant, the entire mechanisms of this phenomenon are not clearly understood. In this paper, we introduce "Triple M" effect, a new evidence-based theory which can explain the accelerated microleakage of dental amalgam fillings after exposure to different sources of electromagnetic radiation. Based on this theory, there are saliva-filled tiny spaces between amalgam and the tooth. Exposure of the oral cavity to RF-EMFs increases the energy of these small amounts of saliva. Due to the small mass of saliva in these tiny spaces, a small amount of energy will be required for heating. Moreover, reflection of the radiofrequency radiation on the inner walls of the tiny spaces causes interference which in turn produces some "hot spots" in these spaces. Finally, formation of gas bubbles in response to increased temperature and very rapid expansion of these bubbles will accelerate the microleakage of amalgam. Experiments that confirm the validity of this theory are discussed.

Comment on Giuseppe Genchi et al. Mercury Exposure and Heart Diseases. Int. J. Environ. Res. Public Health 2017, 14, 74

Cenchi et al. [1] have recently published an article entitled "Mercury Exposure and Heart Diseases" that is published in Int. J. Environ. Res. Public Health 2017, 14, 74; doi:10.3390/ijerph14010074.[...].

Effect of radiofrequency radiation from Wi-Fi devices on mercury release from amalgam restorations

BACKGROUND

Dental amalgam is composed of approximately 50% elemental mercury. Despite concerns over the toxicity of mercury, amalgam is still the most widely used restorative material. Wi-Fi is a rapidly using local area wireless computer networking technology. To the best of our knowledge, this is the first study that evaluates the effect of exposure to Wi-Fi signals on mercury release from amalgam restorations.

METHODS

Standard class V cavities were prepared on the buccal surfaces of 20 non-carious extracted human premolars. The teeth were randomly divided into 2 groups (n = 10). The control group was stored in non-environment. The specimens in the experimental groups were exposed to a radiofrequency radiation emitted from standard Wi Fi devices at 2.4 GHz for 20 min. The distance between the Wi-Fi router and samples was 30 cm and the router was exchanging data with a laptop computer that was placed 20 m away from the router. The concentration of mercury in the artificial saliva in the groups was evaluated by using a cold-vapor atomic absorption Mercury Analyzer System. The independent t test was used to evaluate any significant differences in mercury release between the two groups.

RESULTS

The mean (±SD) concentration of mercury in the artificial saliva of the Wi-Fi exposed teeth samples was 0.056 ± .025 mg/L, while it was only 0.026 ± .008 mg/L in the non-exposed control samples. This difference was statistically significant (P =0.009).

CONCLUSION

Exposure of patients with amalgam restorations to radiofrequency radiation emitted from conventional Wi-Fi devices can increase mercury release from amalgam restorations.

A review on the distribution of Hg in the environment and its human health impacts

In this letter, we have provided some recommendations on the article by Ki-Hyun Kim et al. that is published in the Journal of Hazardous Materials http://dx.doi.org/10.1016/j.jhazmat.2015.11.031.

Increased mercury release from dental amalgam restorations after exposure to electromagnetic fields as a potential hazard for hypersensitive people and pregnant women

Over the past decades, the use of common sources of electromagnetic fields such as Wi-Fi routers and mobile phones has been increased enormously all over the world. There is ongoing concern that exposure to electromagnetic fields can lead to adverse health effects. It has recently been shown that even low doses of mercury are capable of causing toxicity. Therefore, efforts are initiated to phase down or eliminate the use of mercury amalgam in dental restorations. Increased release of mercury from dental amalgam restorations after exposure to electromagnetic fields such as those generated by MRI and mobile phones has been reported by our team and other researchers. We have recently shown that some of the papers which reported no increased release of mercury after MRI, may have some methodological errors. Although it was previously believed that the amount of mercury released from dental amalgam cannot be hazardous, new findings indicate that mercury, even at low doses, may cause toxicity. Based on recent epidemiological findings, it can be claimed that the safety of mercury released from dental amalgam fillings is questionable. Therefore, as some individuals tend to be hypersensitive to the toxic effects of mercury, regulatory authorities should re-assess the safety of exposure to electromagnetic fields in individuals with amalgam restorations. On the other hand, we have reported that increased mercury release after exposure to electromagnetic fields may be risky for the pregnant women. It is worth mentioning that as a strong positive correlation between maternal and cord blood mercury levels has been found in some studies, our findings regarding the effect of exposure to electromagnetic fields on the release of mercury from dental amalgam fillings lead us to this conclusion that pregnant women with dental amalgam fillings should limit their exposure to electromagnetic fields to prevent toxic effects of mercury in their fetuses. Based on these findings, as infants and children are more vulnerable to mercury exposures, and as some individuals are routinely exposed to different sources of electromagnetic fields, we possibly need a paradigm shift in evaluating the health effects of amalgam fillings.