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Rajkumar DS, Padmanaban R. Impact of bisphenol A and analogues eluted from resin-based dental materials on cellular and molecular processes: An insight on underlying toxicity mechanisms. J Appl Toxicol 2024. [PMID: 38711185 DOI: 10.1002/jat.4605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Dental resin systems, used for artificial replacement of teeth and their surrounding structures, have gained popularity due to the Food and Drug Administration's (FDA) recommendation to reduce dental amalgam use in high-risk populations and medical circumstances. Bisphenol A (BPA), an endocrine-disrupting chemical, is an essential monomer within dental resin in the form of various analogues and derivatives. Leaching of monomers from resins results in toxicity, affecting hormone metabolism and causing long-term health risks. Understanding cellular-level toxicity profiles of bisphenol derivatives is crucial for conducting toxicity studies in in vivo models. This review provides insights into the unique expression patterns of BPA and its analogues among different cell types and their underlying toxicity mechanisms. Lack of a consistent cell line for toxic effects necessitates exploring various cell lines. Among the individual monomers, BisGMA was found to be the most toxic; however, BisDMA and BADGE generates BPA endogenously and found to elicit severe adverse reactions. In correlating in vitro data with in vivo findings, further research is necessary to classify the elutes as human carcinogens or xenoestrogens. Though the basic mechanisms underlying toxicity were believed to be the production of intracellular reactive oxygen species and a corresponding decline in glutathione levels, several underlying mechanisms were identified to stimulate cellular responses at low concentrations. The review calls for further research to assess the synergistic interactions of co-monomers and other components in dental resins. The review emphasizes the clinical relevance of these findings, highlighting the necessity for safer dental materials and underscoring the potential health risks associated with current dental resin systems.
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Affiliation(s)
- Divya Sangeetha Rajkumar
- Immunodynamics & Interface Laboratory, Centre of Advanced Study in Crystallography and Biophysics, University of Madras, Chennai, India
| | - Rajashree Padmanaban
- Immunodynamics & Interface Laboratory, Centre of Advanced Study in Crystallography and Biophysics, University of Madras, Chennai, India
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Dantagnan CA, Babajko S, Nassif A, Houari S, Jedeon K, François P, Dursun E, Attal JP, Bosco J. Analysis of Resin-Based Dental Materials' Composition Depending on Their Clinical Applications. Polymers (Basel) 2024; 16:1022. [PMID: 38674942 PMCID: PMC11053636 DOI: 10.3390/polym16081022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
The objective of this study was to detail the monomer composition of resin-based dental materials sold in the market in 2023 and to evaluate the proportion of bisphenol A (BPA)-derivatives in relation to their applications. A search on manufacturers' websites was performed to reference resin-based dental materials currently on the European market (including the European Union (EU) and United Kingdom (UK). Their monomer composition was determined using material-safety data sheets and was completed by a search on the PubMed database. Among the 543 material compositions exploitable, 382 (70.3%) contained BPA derivatives. Among them, 56.2% contained BisGMA and 28% BisEMA, the most frequently reported. A total of 59 monomers, of which six were BPA derivatives, were found. In total, 309 materials (56.9%) contained UDMA and 292 (53.8%) TEGDMA. Less than one third of materials identified contained no BPA derivatives. These proportions vary a lot depending on their applications, with materials dedicated to the dental care of young populations containing the highest proportions of BPA-derivative monomers. The long-term effects on human health of the different monomers identified including BPA-derivative monomers is a source of concern. For children and pregnant or lactating women arises the question of whether to take a precautionary principle and avoid the use of resin-based dental materials likely to release BPA by opting for alternative materials.
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Affiliation(s)
- Claire-Adeline Dantagnan
- Innovative Dental Materials and Interfaces Research Unit, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (C.-A.D.); philo.franç (P.F.); (E.D.); (J.B.)
- Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.N.); (S.H.)
| | - Sylvie Babajko
- Biomedical Research in Odontology, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (S.B.); (K.J.)
| | - Ali Nassif
- Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.N.); (S.H.)
- Biomedical Research in Odontology, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (S.B.); (K.J.)
| | - Sophia Houari
- Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.N.); (S.H.)
- Biomedical Research in Odontology, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (S.B.); (K.J.)
| | - Katia Jedeon
- Biomedical Research in Odontology, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (S.B.); (K.J.)
- Rothschild Hospital, 5 rue Santerre, 75012 Paris, France
| | - Philippe François
- Innovative Dental Materials and Interfaces Research Unit, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (C.-A.D.); philo.franç (P.F.); (E.D.); (J.B.)
- Bretonneau Hospital, 23 rue Joseph de Maistre, 75018 Paris, France
| | - Elisabeth Dursun
- Innovative Dental Materials and Interfaces Research Unit, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (C.-A.D.); philo.franç (P.F.); (E.D.); (J.B.)
- Henri Mondor Hospital, 1 rue Gustave Eiffel, 94000 Créteil, France
| | - Jean-Pierre Attal
- Innovative Dental Materials and Interfaces Research Unit, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (C.-A.D.); philo.franç (P.F.); (E.D.); (J.B.)
- Charles Foix Hospital, 7 Avenue de la République, 94200 Ivry sur Seine, France
| | - Julia Bosco
- Innovative Dental Materials and Interfaces Research Unit, Faculty of Dentistry, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; (C.-A.D.); philo.franç (P.F.); (E.D.); (J.B.)
- Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.N.); (S.H.)
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Kapoor V, Kumar A, Manjunath BC, Yadav V, Sabbarwal B. Comparative evaluation of retention and cariostatic effect of glass ionomer, hydrophobic & hydrophilic resin-based sealants: a systematic review and meta-analysis. Evid Based Dent 2023; 24:41-42. [PMID: 36882497 DOI: 10.1038/s41432-023-00850-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/25/2022] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To compare the effectiveness of hydrophilic resin-based versus hydrophobic resin-based and glass-ionomer pit and fissure sealants. METHODS The review was registered with Joanna Briggs Institute and followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Google Scholar, Virtual Health Library, and Cochrane Central Register of Controlled Trials were searched from 2009-2019 using appropriate keywords. We included randomized controlled trials and randomized split-mouth trials conducted among 6-13-year-old children. The quality of included trials was assessed using modified Jadad criteria and risk of bias using guidelines specified by Cochrane. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were used to assess the overall quality of studies. We used the random-effects model for meta-analysis. Relative risk (RR) and confidence intervals (CI) were calculated & heterogeneity was tested using I² statistic. RESULTS Six randomized clinical trials and five split-mouth trials met the inclusion criteria. The outlier augmenting the heterogeneity was omitted. Based on very-low to low-quality evidence, loss of hydrophilic resin-based sealants was less likely as compared to glass-ionomer fissure sealants (4 trials at 6 months; RR = 0.59; CI = 0.40-0.86), while it was similar or slightly lower than hydrophobic resin-based sealants (6 trials at 6 months; RR = 0.96; CI = 0.89-1.03); (6 trials at 12 months; RR = 0.79; CI = 0.70-0.89); (2 trials at 18 months; RR = 0.77; CI = 0.48-0.25). CONCLUSION This study revealed that retention of hydrophilic resin-based sealants is better than glass ionomer sealants but similar to hydrophobic resin-based sealants. However, higher-quality evidence is necessary to underpin the outcomes.
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Affiliation(s)
- Vinamrata Kapoor
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
| | - Adarsh Kumar
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - B C Manjunath
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Vipul Yadav
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Bhavna Sabbarwal
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Ozkan A, Çakır DA, Tezel H, Sanajou S, Yirun A, Baydar T, Erkekoglu P. Dental Implants and Implant Coatings: A Focus on Their Toxicity and Safety. J Environ Pathol Toxicol Oncol 2023; 42:31-48. [PMID: 36749088 DOI: 10.1615/jenvironpatholtoxicoloncol.2022043467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation, the maxilla or mandible integrates with the surface of the dental implant. This process, called "osseointegration," is an important period to ensure the long-term use of dental implants and prevent implant failures. Metal implants are the most used implant materials. However, they have disadvantages such as corrosion, metal ion release from metal implant surfaces and associated toxicity. To avoid these adverse effects and improve osseointegration, alternative dental implant materials such as ceramics, polymers, composites, and novel surface modification technologies have been developed. The safety of these materials are also of concern for toxicologists. This review will give general information about dental implant materials, osseointegration and successful implantation process. Moreover, we will focus on the new surface coatings materials for of dental implants and their toxicity and safety concerns will be discussed.
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Affiliation(s)
- Atakan Ozkan
- TOBB University of Economics and Technology, Faculty of Engineering, Department of Biomedical Engineering, Ankara, Turkey
| | - Deniz Arca Çakır
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey; Hacettepe University Vaccine Institute, Department of Vaccinology, Ankara, Turkey
| | - Hülya Tezel
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Sonia Sanajou
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Anil Yirun
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Sıhhiye 06100, Ankara, Turkey; Çukurova University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Adana, Turkey
| | - Terken Baydar
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Pinar Erkekoglu
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Sıhhiye 06100, Ankara, Turkey; Hacettepe University Vaccine Institute, Department of Vaccinology, Ankara, Turkey
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Barišić ML, Sarajlija H, Klarić E, Knežević A, Sabol I, Pandurić V. Detection of Leachable Components from Conventional and Dental Bulk-Fill Resin Composites (High and Low Viscosity) Using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Method. Polymers (Basel) 2023; 15:polym15030627. [PMID: 36771928 PMCID: PMC9921113 DOI: 10.3390/polym15030627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/08/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023] Open
Abstract
The aim of this study was to investigate leachable components (monomers) in high and low viscosity dental bulk-fill resin composites and conventional resin composite materials after polymerization. Six bulk-fill and six conventional dental resin composite materials were used in this study. The samples of each material (three sets of triplicates) were cured for 20 s with irradiance of 1200 mW/cm2 with a LED curing unit and immersed in a 75% ethanol solution at 37 °C. The eluates from each triplicate set were analyzed after 24 h, 7 days or 28 days using liquid chromatography coupled with triple quadrupole tandem mass spectrometry (LC-MS/MS). Detectable amounts of 2-Hydroxyethyl methacrylate (HEMA) were found in both Gradia materials and the amount observed across different time points was statistically different (p ˂ 0.05), with the amount in solution increasing for Gradia and decreasing for Gradia Direct flo. Bisphenol A diglycidildimethacrylate (BIS GMA) was found in Filtek and Tetric materials. Triethylene glycol dimethacrylate (TEGDMA) was detected in all materials. On the other hand, there were no statistically significant differences in the amounts of TEGDMA detected across different time points in either of the tested materials. Monomers HEMA, TEGDMA, 4-dimethylaminobenzoic acid ethyl ester (DMA BEE) and BIS GMA in bulk-fill and conventional composites (high and low viscosity) can be eluted after polymerization. The good selection of composite material and proper handling, the following of the manufacturer's instructions for polymerization and the use of finishing and polishing procedures may reduce the elution of the unpolymerized monomers> responsible for the possible allergic and genotoxic potential of dental resin composites.
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Affiliation(s)
| | | | - Eva Klarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: (E.K.); (V.P.)
| | - Alena Knežević
- Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Boskovic Institute, 10000 Zagreb, Croatia
| | - Vlatko Pandurić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: (E.K.); (V.P.)
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Lopes-Rocha L, Hernandez C, Gonçalves V, Pinho T, Tiritan ME. Analytical Methods for Determination of BPA Released from Dental Resin Composites and Related Materials: A Systematic Review. Crit Rev Anal Chem 2022; 54:653-668. [PMID: 35776702 DOI: 10.1080/10408347.2022.2093097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Knowing the impacts of bisphenol A (BPA) on human health, this systematic review aimed to gather the analytical methods for the quantification of BPA release of BPA in dental materials in in vitro and in vivo (biological fluids) studies. A brief critical discussion of the impacts of BPA on human health and the possible association with BPA in dental materials was also presented. The research was carried out by three independent researchers, (according to PRISMA guidelines) in PUBMED and SCOPUS databases, by searching for specific keywords and articles published between January 2011 and February 2022. Seventeen articles met the eligibility criteria and were included in this systematic review: 10 in vitro and 7 in vivo. In in vitro studies, the highest amounts of BPA released were from flowable to conventional resins, followed by resin-modified glass ionomer. In contrast, the smallest amount was released from "BPA-free" composites and CAD-CAM blocks. Regarding in vivo studies, a higher concentration of BPA were found in saliva than urine or blood. The best analytical method for trace quantifying BPA is LC-MS/MS (Liquid Chromatography with Tandem Mass Spectrometry) due to its selectivity, low quantification limits, and the unequivocal identification. However, further studies are required to develop faster and more sensitive methods, in order to obtain more reliable results.
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Affiliation(s)
- Lígia Lopes-Rocha
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
| | - Clara Hernandez
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
| | - Virgínia Gonçalves
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
| | - Teresa Pinho
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
- IBMC-Institute of Molecular and Cellular Biology, i3S-Institute of Innovation and Research in Health, Oporto University, Porto, Portugal
| | - Maria Elizabeth Tiritan
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
- Faculty of Pharmacy, University of Porto (FFUP), Portugal. Interdisciplinary Center of Marine and Environmental Research (CIIMAR), University of Porto, Edifício do Terminal de Cruzeiros do Porto de Leixões, Matosinhos, Portugal
- Laboratório de Química Orgânica e Farmacêutica, Departamento de Ciências Químicas, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal
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De Angelis F, Sarteur N, Buonvivere M, Vadini M, Šteffl M, D'Arcangelo C. Meta-analytical analysis on components released from resin-based dental materials. Clin Oral Investig 2022; 26:6015-6041. [PMID: 35870020 PMCID: PMC9525379 DOI: 10.1007/s00784-022-04625-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/11/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents. MATERIALS AND METHODS All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well. RESULTS The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume. CONCLUSIONS Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials. CLINICAL RELEVANCE It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.
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Affiliation(s)
- Francesco De Angelis
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy.
| | - Nela Sarteur
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Matteo Buonvivere
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Mirco Vadini
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Michal Šteffl
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Camillo D'Arcangelo
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
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Karanasiou C, Dionysopoulos D, Naka O, Strakas D, Tolidis K. Effects of tooth bleaching protocols assisted by Er,Cr:YSGG and diode (980 nm) lasers on color change of resin-based restoratives. J ESTHET RESTOR DENT 2021; 33:1210-1220. [PMID: 34498792 DOI: 10.1111/jerd.12817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate color change of three resin-based restorative materials after two laser-assisted in-office tooth bleaching protocols using Er,Cr:YSGG and diode (980 nm) lasers. MATERIALS AND METHODS A nanohybrid composite resin (EP), a Bis-GMA free composite resin (EPBio) and a resin-matrix CAD-CAM ceramic (HC) were tested. Ninety specimens were prepared and stored in artificial saliva. Group 1 received an in-office bleaching treatment using 40% H2 O2. The same bleaching procedure was assisted by Er,Cr:YSGG laser in Group 2 and by a diode laser (980 nm) in Group 3. Color measurements were performed using a double-beam UV-Vis spectrophotometer at four time intervals (before, 24 h, 15 and 30 days), converted to L*, a*, and b* units of the CIELAB color space and assessed on the basis of 50:50% acceptability (ΔΕab * = 2.7 and ΔΕ00 = 1.77) and 50:50% perceptibility (ΔΕab * = 1.2 and ΔΕ00 = 0.81) thresholds. Three-way ANOVA with repeated measurements was used for statistical analysis of the data. RESULTS Color and whiteness changes did not exceed the established 50:50% acceptability thresholds. EP presented the highest color change after the bleaching followed by EPBio and HC (p ≤ 0.05). Three-way ANOVA revealed that type of material and time interval significantly affected color change (p ≤ 0.001). CONCLUSIONS The tested bleaching treatments assisted by Er,Cr:YSGG and diode (980 nm) lasers did not induce unacceptable color and whiteness changes in the resin-based restorative materials. CLINICAL SIGNIFICANCE The tested Er,Cr:YSGG and diode (980 nm) laser-assisted tooth bleaching protocols which may be recommended to accelerate the clinical procedures cannot affect the color of the existing resin-based restorations in case they are accidentally exposed on the bleaching gel and laser irradiation.
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Affiliation(s)
- Christina Karanasiou
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Dionysopoulos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Naka
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitris Strakas
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Tolidis
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sathissarat JH, Chu L, Danso R, Rawls HR, Whang K. Development of a difunctional oxirane and multifunctional acrylate interpenetrating polymer network composite system with antimicrobial properties. J Appl Polym Sci 2021. [DOI: 10.1002/app.50773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Lianrui Chu
- Department of Developmental Dentistry the University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Robert Danso
- Department of Comprehensive Dentistry the University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - H. Ralph Rawls
- Department of Comprehensive Dentistry the University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Kyumin Whang
- Department of Comprehensive Dentistry the University of Texas Health Science Center at San Antonio San Antonio Texas USA
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Kaya Ozden H, Karadag AS. Could endocrine disruptors be a new player for acne pathogenesis? The effect of bisphenol A on the formation and severity of acne vulgaris: A prospective, case-controlled study. J Cosmet Dermatol 2021; 20:3573-3579. [PMID: 34379355 DOI: 10.1111/jocd.14364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 07/19/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Acne is one of the most common skin diseases in the adolescent period. Bisphenol A (BPA) is the most frequently observed endocrine-disrupting chemicals that we are exposed to in daily life. BPA can affect acne pathogenesis with similar biological activity on androgenic receptors. AIMS To investigate whether BPA levels play a role in the development and severity of acne in adults. METHODS Fifty-one adults with acne and 50 healthy controls, whose ages varied between 18 and 25 years and applied to our dermatology outpatient clinic, were evaluated. A questionnaire containing dietary and lifestyle habits for BPA exposure was filled. BPA and BPA glucuronides were analyzed in the LC-MS/MS system in the first-morning urine samples of the patients. Statistical significance was set at p < 0.05. RESULTS The median levels of total BPA were significantly higher in the acne group compared with the control group (7.94 (4.69-20.32) vs. 5.62 (1.52-21.05) µg/g creatinine, respectively; p = 0.04)). The acne severity was positively associated with the BPA values (p = 0.00 rs = 0.534). Higher BPA level was noticed in younger acne onset age (p = 0.012 r = -0.349) When the inquiry questions were evaluated, no difference was found between the study groups regarding BPA exposure risk (p > 0.05). CONCLUSION BPA could be a factor in acne development and its severity. Therefore, it may be beneficial to prevent BPA exposure and raise awareness in the adolescence and post-adolescence period, in which industrial products such as junk food and plastic bottled water are used more frequently.
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Affiliation(s)
- Hatice Kaya Ozden
- Department of Dermatology, Derince Training and Research Hospital, Kocaeli, Turkey
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de Oliveira RF, Abuna GF, Roulet JF, Geraldeli S, Sinhoreti MAC. Effect of an elastomeric urethane monomer on BisGMA-free resin composites containing different co-initiators. Clin Oral Investig 2021; 26:957-967. [PMID: 34286399 DOI: 10.1007/s00784-021-04078-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the mechanical, chemical, optical, and adhesive properties of BisGMA-free experimental resin composites containing Exothane-24-an elastomeric urethane monomer-and different co-initiators. MATERIALS AND METHODS A blend of urethane dimethacrylate (UDMA), extended dimethacrylate urethane (PEG 400), triethylene glycol dimethacrylate (TEGDMA), and camphorquinone was prepared. Two different co-initiators-dimethyl aminoethyl methacrylate (DMAEMA) or 4-N alcohol, N-dimethylamine phenylethyl (DMPOH)-were added to the blend. Exothane-24 monomer was added to the blend for each co-initiator and four groups were established as follows: DMAEMA; DMAEMA + Exothane; DMPOH; and DMPOH + Exothane. Specimens were photo-activated using a multi-wave LED light-curing unit (VALO; 954 mW/cm2 of irradiance). Mechanical (ultimate tensile strength, flexural strength, flexural modulus and hardness), chemical (degree of conversion, hardness reduction, water sorption and solubility), optical (color change), and adhesive (microtensile bond strength) properties were analyzed. Data were submitted to two-way ANOVA and Tukey's test (α = 0.05). RESULTS The resin composite containing DMPOH and Exothane-24 showed similar or superior performance to those of the other experimental composites for mechanical and chemical properties, except for flexural strength. It also showed less color change and greater micro-tensile bond strength. CONCLUSIONS Among the combinations tested, the BisGMA-free resin composite containing Exothane-24 combined with the DMPOH co-initiator showed the best mechanical, chemical, optical, and adhesive properties. Clinical relevance Exothane-24 monomer and DMPOH co-initiator could be useful in the formulation of BisGMA-free resin composites in order to minimize exposure to BPA.
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Affiliation(s)
- Robson Ferraz de Oliveira
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Gabriel Flores Abuna
- Division of Biomedical Materials, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Jean-François Roulet
- Restorative Dental Science Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Saulo Geraldeli
- Division of Biomedical Materials, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Mário Alexandre Coelho Sinhoreti
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, University of Campinas, Vila Rezende, Limeira Avenue, Areiao, Piracicaba, São Paulo, 90113414-903, Brazil.
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12
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De Nys S, Duca RC, Vervliet P, Covaci A, Boonen I, Elskens M, Vanoirbeek J, Godderis L, Van Meerbeek B, Van Landuyt KL. Bisphenol A as degradation product of monomers used in resin-based dental materials. Dent Mater 2021; 37:1020-1029. [PMID: 33896600 DOI: 10.1016/j.dental.2021.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE There is still much debate about the release of bisphenol-A (BPA) from dental materials. Therefore, this study aimed to quantify BPA present as an impurity in both BPA-based and non-BPA-based monomers and to evaluate whether these monomers may degrade to BPA upon salivary, bacterial, and chemical challenges. METHODS BPA was determined in three different amounts (1, 2, and 3 μmol) of each monomer (TEGDMA, UDMA, mUDMA, BisGMA, BisEMA-3, -6, -10, -30, BisPMA, EBPADMA urethane, BADGE, and BisDMA). Next, the monomers (3 μmol) were immersed in whole human pooled saliva collected from adults, Streptococcus mutans (2 × 107 CFU/mL), and acidic (0.1 M HCl), alkaline (0.1 M NaOH), and control media. The amount of BPA was quantified using a specific and highly sensitive UPLC-MS/MS method including derivatization of BPA by pyridine-3-sulfonyl chloride. RESULTS The monomers BisGMA and BisEMA-3 contained trace amounts (0.0006% and 0.0025%, respectively) of BPA as impurities of their synthesis process. BPA concentrations increased when the monomers BisGMA, BisEMA-3, BisEMA-6, BisEMA-10, BisPMA and BADGE were exposed to saliva and S. mutans, indicating degradation of a small amount of monomer into BPA. In addition, BisPMA and BADGE degraded into BPA under alkaline conditions. The conversion rate of the monomers into BPA ranged between 0.0003% and 0.0025%. SIGNIFICANCE Impurities and degradation of BPA-based monomers may account for the release of BPA from resin-based dental materials. Even though the detected amounts of BPA due to monomer impurity were small, manufacturers of dental materials can reduce the BPA content by using only monomers of the highest purity. Considering the overall current trend towards BPA-free materials, it may be recommendable to investigate whether non-BPA based monomers can be used in dental resin-based materials.
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Affiliation(s)
- Siemon De Nys
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, 3000 Leuven, Belgium
| | - Radu Corneliu Duca
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, National Health Laboratory (LNS), 3555 Dudelange, Luxembourg
| | - Philippe Vervliet
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, D.S.551, 2610 Wilrijk, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, D.S.551, 2610 Wilrijk, Belgium
| | - Imke Boonen
- Laboratory of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Belgium
| | - Marc Elskens
- Laboratory of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Belgium
| | - Jeroen Vanoirbeek
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, 3000 Leuven, Belgium
| | - Kirsten L Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, 3000 Leuven, Belgium.
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13
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Lopes-Rocha L, Ribeiro-Gonçalves L, Henriques B, Özcan M, Tiritan ME, Souza JCM. An integrative review on the toxicity of Bisphenol A (BPA) released from resin composites used in dentistry. J Biomed Mater Res B Appl Biomater 2021; 109:1942-1952. [PMID: 33834604 DOI: 10.1002/jbm.b.34843] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/02/2021] [Accepted: 03/28/2021] [Indexed: 11/11/2022]
Abstract
The main aim of this study was to perform an integrative review on the release of bisphenol A (BPA) from resin-matrix composites and potential toxic effects. A bibliographic search was performed on the PubMed platform using the following keywords: "Bisphenol A" OR "BPA" AND "resin composite" OR "composite resin" AND "toxicity" OR "cytotoxicity" OR "release". Inclusion criteria involved in vitro and in vivo studies on the release and toxicity of BPA. Results highlighted the release of BPA from resin-matrix composites due to insufficient polymerization and/or degradation of the polymeric matrix. BPA is part of the organic matrix of resin-matrix composites and may be hydrolysed in human saliva, although studies report that low doses might not be detected by traditional chemical analysis. Studies exposing zebrafish embryos to different concentrations of Bis-GMA, showed 55% mortality at 10 μM Bis-GMA while 30% mortality was recorded at 1 μM Bis-GMA. In patients, a BPA concentration of around 2.09 × 10-2 μg/ml was found in the saliva after placement of lingual orthodontic retainers with resin-matrix composites. Also, the BPA molecule can be swallowed and absorbed by the oral/gastrointestinal mucosa, which might result in systemic toxicity. The degradation of resin-matrix composites and release of BPA in oral environment are dependent on the organic matrix content and on the polymerization method. A increased release of BPA can lead to the absorption into oral and gastrointestinal mucosa with high risks of local and systemic toxicity.
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Affiliation(s)
- Lígia Lopes-Rocha
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra, PRD, Portugal.,Institute for Research and Advanced Training in Health Sciences and Technologies (IINFACTS), CESPU, Gandra PRD, Portugal
| | - Lara Ribeiro-Gonçalves
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra, PRD, Portugal
| | - Bruno Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Dept. of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.,Centre for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, Guimarães, Braga, Portugal
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Maria Elizabeth Tiritan
- Institute for Research and Advanced Training in Health Sciences and Technologies (IINFACTS), CESPU, Gandra PRD, Portugal.,Laboratory of Organic and Pharmaceutical Chemistry (LQOF), Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Júlio C M Souza
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra, PRD, Portugal.,Centre for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, Guimarães, Braga, Portugal
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14
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Gul P, Celik N, Ozgeris FB, Demirkaya-Miloglu F, Kiziltunc A, Seven N. Effects of Bisphenol A Released From Composite Fillings on Reproductive Hormone Levels in Men. Int Dent J 2021; 71:343-351. [PMID: 33583564 PMCID: PMC9275326 DOI: 10.1016/j.identj.2020.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives Composite resins are the most preferred filling material because of their excellent aesthetic qualities. However, a filling material should also be biocompatible as well as aesthetic. The aim of this study was to determine the serum and saliva bisphenol-A (BPA) levels and to examine the effects of serum BPA on reproductive hormone levels after healthy men were treated with composite fillings. Methods Eighteen healthy males each received 2 composite restorations. Saliva and blood samples of subjects were collected before resin application and 1 day and 1, 3, and 5 weeks after the resin was applied. BPA amounts in samples were detected using high-performance liquid chromatography (HPLC). Serum gonadotropins, testosterone, sex hormone binding globulin, free androgen index, and oestrogen levels were measured with radioimmunological assay kits. Statistical analysis of data was made using Friedman, Wilcoxon signed ranks and Mann-Whitney U tests (α = 0.05). Results The amount of BPA released from composite resins over time was not significantly elevated in either saliva or serum (P > 0.5). In addition, serum BPA levels were significantly higher than saliva BPA levels for both composites (P < .05), but saliva and serum BPA levels were not statistically different when comparing the 2 composites (P > .05). Conclusions BPA from composite resins used in this study did not significantly alter serum hormone levels.
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Affiliation(s)
- Pinar Gul
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
| | - Neslihan Celik
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Fatma Betul Ozgeris
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey
| | - Fatma Demirkaya-Miloglu
- Department of Analytical Chemistry, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
| | - Ahmet Kiziltunc
- Department of Biochemistry, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Nilgun Seven
- Department of Restorative Dentistry, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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15
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Risk assessment of predicted serum concentrations of bisphenol A in children and adults following treatment with dental composite restoratives, dental sealants, or orthodontic adhesives using physiologically based pharmacokinetic modeling. Regul Toxicol Pharmacol 2020; 120:104839. [PMID: 33301868 DOI: 10.1016/j.yrtph.2020.104839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/26/2020] [Accepted: 12/03/2020] [Indexed: 01/16/2023]
Abstract
Bisphenol A (BPA) is a chemical used to manufacture bisphenol A glycidyl methacrylate (BisGMA). BisGMA has been used for decades in dental composite restoratives, sealants, and adhesives. Based on published studies, exposure to low concentrations of BPA are possible from dental and orthodontic devices. The serum BPA concentrations arising from such devices and oral doses were predicted using a PBPK model in children and adult females based on 1) published extraction data for cured and uncured 3M ESPE Filtek Supreme Ultra Flowable, 3M ESPE Filtek Bulk Fill Restorative, and 3M ESPE Clinpro Sealant and 2) published 20% ethanol/water and water rinsate data following orthodontic application with 3M ESPE Transbond MIP Primer and 3M ESPE Transbond XT Adhesive. Predicted oral exposure to BPA arising from these dental and orthodontic devices is low (median <10 ng/treatment) and predicted serum BPA concentrations were also low (<10-4 nM). Even the maximum predicted exposure in this study (533.2 ng/treatment) yields a margin of exposure of 7.5 relative to the EFSA t-TDI (4 μg/kg-day) and is only 2.8% of the daily BPA exposure for the US population in a 58-kg woman (15,660 ng/day). Therefore, the exposure to BPA arising from the 3M ESPE dental and orthodontic devices evaluated in this study is negligible relative to daily BPA exposure in the general population and these potential BPA sources do not constitute a risk to patients.
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16
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Fugolin AP, de Paula AB, Dobson A, Huynh V, Consani R, Ferracane JL, Pfeifer CS. Alternative monomer for BisGMA-free resin composites formulations. Dent Mater 2020; 36:884-892. [PMID: 32402514 PMCID: PMC7305961 DOI: 10.1016/j.dental.2020.04.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/24/2020] [Accepted: 04/20/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Water sorption, high volumetric shrinkage, polymerization stress, and potential estrogenic effects triggered by leached compounds are some of the major concerns related to BisGMA-TEGDMA co-monomer systems used in dental composites. These deficiencies call for the development of alternative organic matrices in order to maximize the clinical lifespan of resin composite dental restorations. This study proposes BisGMA-free systems based on the combination of UDMA and a newly synthesized diurethane dimethacrylate, and evaluates key mechanical and physical properties of the resulting materials. METHODS 2EMATE-BDI (2-hydroxy-1-ethyl methacrylate) was synthesized by the reaction between 2-hydroxy-1-ethyl methacrylate with a difunctional isocyanate (1.3-bis (1- isocyanato-1-methylethylbenzene) - BDI). The compound was copolymerized with UDMA (urethane dimethacrylate) at 40 and 60wt%. UDMA copolymerizations with 40 and 60wt% TEGDMA (triethylene glycol dimethacrylate) were tested as controls, as well as a formulation based in BisGMA (bisphenol A-glycidyl methacrylate)-TEGDMA 60:40% (BT). The organic matrices were made polymerizable by the addition of DMPA (2.2-dimethoxyphenoxy acetophenone) and DPI-PF6 (diphenyliodonium hexafluorophosphate) at 0.2 and 0.4wt%, respectively. Formulations were tested as composite with the addition of 70wt% inorganic content consisting of barium borosilicate glass (0.7μm) and fumed silica mixed in 95 and 5wt%, respectively. All photocuring procedures were carried out by a mercury arc lamp filtered to 320-500nm at 800mW/cm2. The experimental resin composites were tested for kinetics of polymerization and polymerization stress in real time. Flexural strength, elastic modulus, water sorption, and solubility were assessed according to ISO 4049. Biofilm formation was analyzed after 24h by luciferase assay. Data were statistically analyzed by one-way ANOVA and Tukey's test (α≤0.05). RESULTS In general, the addition of 2EMATE-BDI into the formulations decreased the maximum rate of polymerization (RPMAX), the degree of conversion at RPMAX (DC at RPMAX), and the final degree of conversion (final DC). However, these reductions did not compromise mechanical properties, which were comparable to the BT controls, especially after 7-day water incubation. The incorporation of 60wt% 2EMATE-BDI reduced water sorption of the composite. 2EMATE-BDI containing formulations showed reduction in polymerization stress of 30% and 50% in comparison to BT control and TEGDMA copolymerizations, respectively. Biofilm formation was similar among the tested groups. SIGNIFICANCE The use of the newly synthesized diurethane dimethacrylate as co-monomer in dental resin composite formulations seems to be a promising option to develop polymers with low-shrinkage and potentially decreased water degradation.
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Affiliation(s)
- Ana P Fugolin
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Andreia B de Paula
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Adam Dobson
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Vincent Huynh
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Rafael Consani
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Jack L Ferracane
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States
| | - Carmem S Pfeifer
- Department of Restorative Dentistry/Division of Biomaterials and Biomechanics, 2730 SW Moody Avenue, Portland, OR 97201, United States.
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17
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McKinney CM, Leroux BG, Seminario AL, Kim A, Liu Z, Samy S, Sathyanarayana S. A Prospective Cohort Study of Bisphenol A Exposure from Dental Treatment. J Dent Res 2020; 99:1262-1269. [PMID: 32579872 DOI: 10.1177/0022034520934725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Laboratory studies show that bisphenol A (BPA) leaches from bisphenol A-glycidyl methacrylate (bisGMA)-based dental materials. We aimed to quantify the extent to which children are exposed to BPA from dental treatment with bisGMA materials, by amount of treatment and type of sedation. We hypothesized that posttreatment urinary BPA (uBPA) concentrations would be higher among patients with more surfaces treated with bisGMA-based materials and among patients receiving general anesthesia compared with pretreatment concentrations. We conducted a prospective cohort study in 211 children, 4 to 12 y old, who had no prior resin-based dental treatment. We measured uBPA concentrations twice before treatment and at 2 d and 1, 4, and 16 wk posttreatment. We abstracted treatment data (surfaces treated) from the chart. We generated descriptive statistics and compared pre- and posttreatment uBPA concentrations using generalized estimating equations. Participants were 51% female, 46% non-White, and 74% publicly insured. The median age was 6 y. The mean number of tooth surfaces exposed to BisGMA materials (composites/sealants) was 7.5 (SD 5.3). Overall, uBPA concentrations were 86% higher (95% confidence interval [CI] 42% to 143%, P < 0.001) at 2 d posttreatment compared with pretreatment concentrations. The uBPA concentrations 2 d posttreatment versus pretreatment tended to be higher (112%, 95% CI 53% to 194%) among those receiving treatment on >4 surfaces than those receiving treatment on ≤4 surfaces (50%, 95% CI -2% to 130%). Two days after treatment, uBPA was significantly higher than pretreatment concentrations in children receiving nitrous oxide but not in those receiving general anesthesia. Among all findings, uBPA concentrations returned to baseline by 4 wk. Children experience short-term increases in BPA from dental treatment. The impact of relatively high, short-term BPA exposure on child health is unknown. Given the widespread use of BisGMA-based dental materials and that chronic low-dose BPA exposure may adversely affect child health, strategies that minimize BPA exposure could potentially improve child health.
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Affiliation(s)
- C M McKinney
- Seattle Children's Research Institute, Seattle, WA, USA.,School of Medicine, University of Washington, Seattle, WA, USA.,School of Dentistry, University of Washington, Seattle, WA, USA
| | - B G Leroux
- School of Dentistry, University of Washington, Seattle, WA, USA.,School of Public Health, University of Washington, Seattle, WA, USA
| | - A L Seminario
- School of Dentistry, University of Washington, Seattle, WA, USA.,School of Public Health, University of Washington, Seattle, WA, USA
| | - A Kim
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - Z Liu
- School of Public Health, University of Washington, Seattle, WA, USA
| | - S Samy
- School of Public Health, University of Washington, Seattle, WA, USA
| | - S Sathyanarayana
- Seattle Children's Research Institute, Seattle, WA, USA.,School of Medicine, University of Washington, Seattle, WA, USA
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Pérez-Mondragón AA, Cuevas-Suárez CE, González-López JA, Trejo-Carbajal N, Meléndez-Rodríguez M, Herrera-González AM. Preparation and evaluation of a BisGMA-free dental composite resin based on a novel trimethacrylate monomer. Dent Mater 2020; 36:542-550. [DOI: 10.1016/j.dental.2020.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/10/2019] [Accepted: 02/04/2020] [Indexed: 01/09/2023]
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19
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Once Resin Composites and Dental Sealants Release Bisphenol-A, How Might This Affect Our Clinical Management?-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091627. [PMID: 31075949 PMCID: PMC6539392 DOI: 10.3390/ijerph16091627] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.
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20
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Vervliet P, Den Plas JV, De Nys S, Duca RC, Boonen I, Elskens M, Van Landuyt KL, Covaci A. Investigating the in vitro metabolism of the dental resin monomers BisGMA, BisPMA, TCD-DI-HEA and UDMA using human liver microsomes and quadrupole time of flight mass spectrometry. Toxicology 2019; 420:1-10. [DOI: 10.1016/j.tox.2019.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/16/2019] [Accepted: 03/20/2019] [Indexed: 12/30/2022]
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21
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Marzouk T, Sathyanarayana S, Kim AS, Seminario AL, McKinney CM. A Systematic Review of Exposure to Bisphenol A from Dental Treatment. JDR Clin Trans Res 2019; 4:106-115. [PMID: 30931707 DOI: 10.1177/2380084418816079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Dental composite restorations and dental sealants containing bisphenol A glycidyl methacrylate (BisGMA) are commonly used materials in dentistry. Bisphenol A (BPA) is used to manufacture BisGMA and can be a by-product in BisGMA-based dental materials. BPA is an endocrine-disrupting chemical that may affect reproductive, psychological, cognitive, and endocrine-related health. We conducted a systematic review of clinical studies that measured urinary BPA (uBPA) concentrations before and after dental treatment to evaluate the extent to which individuals are exposed to BPA from dental treatment. METHODS Eligibility included studies that measured uBPA concentrations before and after dental treatment with any type of resin-based dental material. We searched PubMed, Cochrane, Web of Science, Virtual Health Library, Science Direct, ProQuest, and Clinical Trials with no date or language restrictions to identify published studies. We summarized eligible studies across participant characteristics, amount of treatment, and time of follow-up measures. Because methods of measuring uBPA varied, our primary outcome was the direction and percentage change between baseline and 24 h posttreatment and at later time points as available. RESULTS We identified 1,190 abstracts and 7 eligible studies: 4 in children and 3 in adults. In all studies, BPA concentrations increased 24 h after treatment. The 2 studies with the largest sample sizes found statistically significant increases >40% in uBPA concentrations at 24 h posttreatment (both P values <0.01). The 1 study to examine uBPA concentrations beyond 1 mo posttreatment found that concentrations returned to baseline by 14 d after treatment and remained at baseline 6 mo after treatment. CONCLUSIONS Our findings suggest that uBPA concentrations increase 24 h after dental treatment. One study showed that uBPA concentrations return to baseline by 14 d. Additional research is needed to determine the magnitude of change from pre- to post-dental treatment and the trajectory of uBPA concentrations posttreatment. KNOWLEDGE TRANSFER STATEMENT BPA is an endocrine-disrupting chemical that may have negative human health effects. Our findings suggest that urinary BPA concentrations increase in the short term after dental treatment. The extent to which such an increase may affect the health of patients remains an open question, particularly since there are no established thresholds for safety or harm related to BPA exposure.
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Affiliation(s)
- T Marzouk
- 1 Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - S Sathyanarayana
- 2 Department of Pediatrics / Seattle Children's Research Institute, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - A S Kim
- 3 Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA
| | - A L Seminario
- 3 Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA.,4 Department of Global Health, University of Washington, Seattle, WA, USA
| | - C M McKinney
- 5 Division of Craniofacial Medicine, Department of Pediatrics / Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
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Berge TLL, Lygre GB, Lie SA, Björkman L. Polymer-based dental filling materials placed during pregnancy and risk to the foetus. BMC Oral Health 2018; 18:144. [PMID: 30134965 PMCID: PMC6103982 DOI: 10.1186/s12903-018-0608-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/13/2018] [Indexed: 12/28/2022] Open
Abstract
Background Tooth-coloured polymer-based dental filling materials are currently the first choice for dental restorative treatment in many countries. However, there are some concerns about their safety. It has been shown that substances known as endocrine disrupters, which might pass through the placental barrier, are released from these materials within the first hours after curing. Thus, the placement of polymer-based dental fillings in pregnant women may put the vulnerable foetus at risk. Large epidemiological studies exploring the risk of having polymer-based dental materials placed during pregnancy are lacking. The aim of this study was to investigate the association between the placement of polymer-based dental fillings during pregnancy and adverse birth outcomes. Methods This study is based on data from the large Norwegian Mother and Child Cohort Study (MoBa). The information about dental treatment during pregnancy was obtained from questionnaires sent to the participating women during weeks 17 and 30 of pregnancy. Reported placement of “white fillings” was used as exposure marker for having received polymer-based dental filling materials. Only singleton births were included in the present study. Data were linked to the Medical Birth Registry of Norway. Logistic regression models that included the mother’s age, level of education, body mass index, parity, and smoking and alcohol consumption during pregnancy were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Different adverse birth outcomes were of interest in the present study. Results Valid data were available from 90,886 pregnancies. Dentist consultation during pregnancy was reported by 33,727 women, 10,972 of whom had white fillings placed. The adjusted logistic regression models showed no statistically significant association between having white dental fillings placed during pregnancy and stillbirth, malformations, preterm births, and low or high birth weight. Conclusions In this study, women who reported white fillings placed during pregnancy had no increased risk for adverse birth outcomes compared with women who did not consult a dentist during pregnancy. Thus, our findings do not support the hypothesis of an association between placement of polymer-based fillings during pregnancy and adverse birth outcomes.
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Affiliation(s)
- Trine Lise Lundekvam Berge
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Hordaland, Norway.
| | | | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lars Björkman
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway.,Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Preparation and characterization of Bis-GMA-free dental composites with dimethacrylate monomer derived from 9,9-Bis[4-(2-hydroxyethoxy)phenyl]fluorene. Dent Mater 2018; 34:1003-1013. [DOI: 10.1016/j.dental.2018.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/16/2018] [Accepted: 03/23/2018] [Indexed: 01/22/2023]
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24
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Becher R, Wellendorf H, Sakhi AK, Samuelsen JT, Thomsen C, Bølling AK, Kopperud HM. Presence and leaching of bisphenol a (BPA) from dental materials. ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 2018; 4:56-62. [PMID: 29868625 PMCID: PMC5974758 DOI: 10.1080/23337931.2018.1476869] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/09/2018] [Indexed: 12/16/2022]
Abstract
BPA has been reported to leach from some resin based dental restorative materials and materials used for orthodontic treatment. To confirm and update previous findings, especially in light of the new temporary lower threshold value for tolerable daily BPA intake, we have investigated the leaching of BPA from 4 composite filling materials, 3 sealants and 2 orthodontic bonding materials. The materials were either uncured and dissolved in methanol or cured. The cured materials were kept in deionized water for 24 hours or 2 weeks. Samples were subsequently analyzed by ultra-performance liquid chromatography coupled to mass spectrometry (UPLC-MS-MS). The composite filling material Tetric EvoFlow® and the fissure sealant DELTON® showed significantly higher levels of BPA leaching compared to control samples for all test conditions (uncured, 24 h leaching and 2 weeks leaching). There were no significant differences in amount of leached BPA for any of the tested materials after 24 hours compared to 2 weeks. These results show that BPA is still released from some dental materials despite the general concern about potential adverse effects of BPA. However, the amounts of BPA were relatively low and most likely represent a very small contribution to the total BPA exposure.
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Affiliation(s)
- Rune Becher
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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25
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Deierlein AL, Wolff MS, Pajak A, Pinney SM, Windham GC, Galvez MP, Rybak M, Calafat AM, Kushi LH, Biro FM, Teitelbaum SL. Phenol Concentrations During Childhood and Subsequent Measures of Adiposity Among Young Girls. Am J Epidemiol 2017; 186:581-592. [PMID: 28525533 DOI: 10.1093/aje/kwx136] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/21/2016] [Indexed: 12/17/2022] Open
Abstract
Phenolic compounds represent a class of environmental chemicals with potentially endocrine-disrupting capabilities. We investigated longitudinal associations between childhood exposure to phenols, from both manmade and natural sources, and subsequent measures of adiposity among girls enrolled in the Breast Cancer and the Environment Research Program between 2004 and 2007. Baseline (ages 6-8 years) urinary concentrations were obtained for creatinine and phenol metabolites: enterolactone, genistein, daidzein, benzophenone-3, bisphenol A, the sum of parabens (methyl, ethyl, and propyl parabens), 2,5-dichlorophenol, and triclosan. Body mass index (weight (kg)/height (m)2), waist circumference, and percent body fat were measured at annual or semiannual examinations through 2015 (n = 1,017). Linear mixed-effects regression was used to estimate how baseline concentrations of phenols (tertile groups) were related to changes in girls' adiposity measurements from ages 7 through 15 years. Enterolactone was inversely associated with body mass index, waist circumference, and percent body fat, while 2,5-dichlorophenol was positively associated with these measurements. A nonmonotonic association was observed for triclosan and girls' adiposity; however, it was due to effect modification by baseline overweight status. Triclosan was positively associated with adiposity only among overweight girls. These results suggest that exposure to specific phenols during childhood may influence adiposity through adolescence.
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26
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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27
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Four or More Amalgam Fillings Correlate With Higher Blood Mercury Levels in Pregnant Women but Not High Enough to be of Health Concern. J Evid Based Dent Pract 2017; 17:139-141. [PMID: 28501064 DOI: 10.1016/j.jebdp.2017.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Dental associations with blood mercury in pregnant women. Golding J, Steer CD, Gregory S, Lowery T, Hibbeln JR, Taylor CM. Community Dent Oral Epidemiol 2016; 44: 216-22. SOURCE OF FUNDING This study was funded by a combination of government (UK Medical Research Council), foundation/nonprofit (the Welcome Trust) and university (University of Bristol, UK) grants. TYPE OF STUDY/DESIGN Cross-sectional.
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28
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Dursun E, Fron-Chabouis H, Attal JP, Raskin A. Bisphenol A Release: Survey of the Composition of Dental Composite Resins. Open Dent J 2016; 10:446-453. [PMID: 27708726 PMCID: PMC5039892 DOI: 10.2174/1874210601610010446] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/15/2016] [Accepted: 07/27/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Bisphenol A (BPA) is an endocrine disruptor with potential toxicity. Composite resins may not contain pure BPA, but its derivatives are widely used. Several studies found doses of BPA or its derivatives in saliva or urine of patients after composite resin placement. OBJECTIVE The aims of this study were to establish an exhaustive list of composite resins marketed in Europe and their composition, and to assess the extent of BPA derivatives used. METHODS A research on manufacturers' websites was performed to reference all composite resins marketed in Europe, then their composition was determined from both material safety data sheets and a standardized questionnaire sent to manufacturers. Manufacturers had to indicate whether their product contained the monomers listed, add other monomers if necessary, or indicate "not disclosed". RESULTS 160 composite resins were identified from 31 manufacturers and 23 manufacturers (74.2%) responded to the survey. From the survey and websites, the composition of 130 composite resins (81.2%) was: 112 (86.2%) based on BPA derivatives, 97 (74.7%) on bis-GMA, 17 (13.1%) without monomer derived from BPA (UDMA, sometimes with TEGDMA) and 6 (4.6%) with UDMA (only); 1 (0.8%) did not contain a BPA derivative or UDMA or TEGDMA. Pure BPA was never reported. CONCLUSION This work has established a list of 18 composite resins that contain no BPA derivative. Manufacturers should be required to report the exact composition of their products as it often remains unclear or incomplete.
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Affiliation(s)
- Elisabeth Dursun
- Unité de Recherche en Biomatériaux, Innovations et Interfaces - EA 4462, Faculté de Chirurgie Dentaire, Université Paris Descartes, Paris, Groupe Hospitalier Mondor-Chenevier, Créteil, France
| | - Hélène Fron-Chabouis
- Unité de Recherche en Biomatériaux, Innovations et Interfaces - EA 4462, Faculté de Chirurgie Dentaire, Université Paris Descartes, Paris, Hôpital Charles Foix, Ivry-sur-Seine, France
| | - Jean-Pierre Attal
- Unité de Recherche en Biomatériaux, Innovations et Interfaces - EA 4462, Faculté de Chirurgie Dentaire, Université Paris Descartes, Paris, Hôpital Charles Foix, Ivry-sur-Seine, France
| | - Anne Raskin
- UMR 7268 ADES, EFS, CNRS Faculté d'Odontologie, Université d'Aix-Marseille, Marseille, Pôle d'Odontologie, UF des soins spécifiques, APHM, Hôpital de la Timone, Marseille, France
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29
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Stacy SL, Eliot M, Calafat AM, Chen A, Lanphear BP, Hauser R, Papandonatos GD, Sathyanarayana S, Ye X, Yolton K, Braun JM. Patterns, Variability, and Predictors of Urinary Bisphenol A Concentrations during Childhood. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:5981-90. [PMID: 27152530 PMCID: PMC5547574 DOI: 10.1021/acs.est.6b00794] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We examined the patterns, variability, and predictors of urinary bisphenol A (BPA) concentrations in 337 children from the Cincinnati, Ohio HOME Study. From 2003 to 2014, we collected two urine samples from women at 16 and 26 weeks of pregnancy and six urine samples from children at 1-5 and 8 years of age. We used linear mixed models to calculate intraclass correlation coefficients (ICCs) as a measure of within-person BPA variability and to identify sociodemographic and environmental predictors. For the 8-year visit, we used multivariable linear regression to explore associations between urinary BPA concentrations and exposure-related factors. We calculated daily intakes using equations estimating creatinine excretion rates and creatinine-standardized BPA concentrations. Urinary BPA concentrations, which decreased over childhood, had a low degree of reproducibility (ICC < 0.2). Estimated daily intakes decreased with age and were below the reference dose of 50 μg/kg body weight/day. BPA concentrations were positively associated with consuming food stored or heated in plastic, consuming canned food and beverages, and handling cash register receipts. Our results suggest that there are multiple sources of BPA exposure in young children. Etiological studies should collect serial urine samples to accurately classify BPA exposure and consider sociodemographic and environmental factors as possible confounders.
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Affiliation(s)
- Shaina L. Stacy
- Department of Epidemiology, Brown University, Providence, Rhode Island 02912, United States
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, Rhode Island 02912, United States
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Bruce P. Lanphear
- Child and Family Research Institute, BC Children’s Hospital and the Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia V5A 1S6, Canada
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | - George D. Papandonatos
- Department of Biostatistics, Brown University, Providence, Rhode Island 02912, United States
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle Children’s Research Institute, Seattle, Washington 98105, United States
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98195, United States
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 45229, United States
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island 02912, United States
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