Mercury release from dental amalgams into continuously replenished liquids

Estimated mercury vapor exposure from amalgams among American pregnant women

This study examined the impact of mercury (Hg) vapor exposure from amalgams among all American pregnant women. Amalgam-Hg vapor exposure among 1,665,890 weighted-pregnant women (n = 37) was examined in the 2015-2020 National Health and Nutrition Examination Survey (NHANES). Correlation coefficients between amalgam surfaces and daily micrograms (µg) of urinary Hg excretion and daily µg of Hg vapor exposure from amalgams per kilogram (Kg) bodyweight were calculated. Daily Hg vapor exposure from amalgams was compared to Hg vapor safety limits. About 600,000 pregnant women (∼36%) had at least one amalgam surface. Median daily urinary Hg excretion was ∼2.5-fold higher among pregnant women with amalgams as compared to pregnant women without amalgams. A significant correlation was observed between the number of amalgam surfaces and daily urinary Hg excretion. Among pregnant women with amalgams, it was estimated that the median daily Hg vapor dose from amalgams was 7.66 µg of Hg and 0.073 µg of Hg/Kg bodyweight. Among all pregnant women, ∼28% received daily Hg vapor doses from amalgams above the least restrictive United States (US) Environmental Protection Agency (EPA) safety limit and ∼36% received above the most restrictive California (CA) EPA safety limit. Given the potential for fetal toxicological effects from prenatal Hg vapor exposure, special emphasis needs to be placed on reducing/eliminating amalgams in pregnancy/women of reproductive age and future studies should evaluate adverse pregnancy outcomes.

Dental amalgam fillings and mercury vapor safety limits in American adults

Objective

For more than 150 years, dental amalgam fillings (50% metallic mercury (Hg0) by weight) have been used in American dentistry. The US Food and Drug Administration (FDA) acknowledged that amalgams release Hg vapor that may be harmful to certain patients. This study examined the impact of Hg vapor exposure from amalgams in American adults.

Methods

Amalgam-Hg vapor exposure among 158,274,824 weighted-adult Americans was examined in the 2015–2018 National Health and Nutrition Examination Survey (NHANES). Beta (β)-coefficients were calculated for the correlation between the number of amalgam surfaces and daily micrograms (μg) of urinary Hg and daily μg of Hg vapor exposure from amalgams per kilogram (Kg) bodyweight.

Results

About 91 million (57.8%) adults had ≥1 amalgam surface and about 67 million (42.2%) had no amalgams. A β-coefficient = 0.041 significantly correlated the number of amalgam surfaces to daily amounts of urinary Hg. Differences were observed for gender and racial groups. Daily Hg vapor doses from amalgams were in excess of the most restrictive California’s Environmental Protection Agency (EPA) safety limit for about 86 million (54.3%) adults and in excess of the least restrictive US EPA safety limit among about 16 million (10.4%) adults. The mean allowable number of amalgam surfaces ranged from 1.28 for adult females under the California’s EPA safety limit to 16.23 for adult males under the US EPA safety limit.

Conclusion

Given that American adults are receiving significant, ongoing exposure to Hg vapor from amalgams, careful evaluation of the need to reduce use of amalgams should be considered.

Association between Dental Amalgam Filling and Essential Tremor: A Nationwide Population-Based Case Control Study in Taiwan

Essential tremor (ET) is a common neurological disorder and the most common movement disorder. Low-level occupational exposure to mercury vapor is known to be a crucial factor that increases the risk of tremor. Dental amalgam is one of the main sources of mercury in those who possess amalgam restorations. However, the relationship between ET and amalgam filling (AMF) is not quite clear. The purpose of this study was to investigate the association between AMF and the risk of ET using a population-based administrative databank. The data for this study were sourced from the Taiwanese National Health Insurance Research Database (NHIRD). A retrospective case-control study was conducted using this databank from 2000 to 2013. Case and control groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index using the propensity score method with a 1:1 ratio. In this study, 3008 cases and 3008 controls were included. The results from this nationwide population-based case-control study did not indicate any association between ET and AMF in Taiwan. Although the results were not significantly statistical, the findings may be worthy to be valued.

One-pot Sonochemical Synthesis of Hg-Ag Alloy Microspheres from Liquid Mercury

Metallic mercury has always attracted much attention in various fields because of its unique characteristic of forming amalgams. Here, different phases of pure crystalline Hg-Ag amalgam microspheres are synthesized by ultrasonically reacting liquid mercury with an aqueous solution of silver nitrate. Sonicating different molar ratios of liquid metallic Hg with AgNO₃ results in the formation of pure crystalline phases of solid silver amalgams with uniform morphology. The resulting Hg-Ag amalgams from various compositions after sonication are physically characterized by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDS) and Differential Scanning Calorimetry (DSC). The XRD of the amalgams obtained from the molar ratios of Hg:Ag (1:1.5) and Hg:Ag (1.5:1 and 2:1) match the Schachnerite and Moschellandbergite phases, respectively, whereas the Hg-Ag amalgam prepared from a 1:1Hg:Ag molar ratio results in a mixture of the Schachnerite and Moschellandbergite phases. The obtained amalgam microspheres are between 6 and 10µm in size. The detailed thermal and chemical behaviour of the Ag-Hg systems is also investigated.

The risk of occupational exposure to mercury vapor in some public dental clinics of Baghdad city, Iraq

BACKGROUND

Dental workers are exposed to elevated levels of elemental mercury vapor substantially above the occupational exposure standards when placing or removing mercury/silver tooth restorations and disposing of mercury waste. This results in a significant increase in occupational exposure and risk of mercury intoxication.

METHODS

To evaluate the occupational exposure of dental workers to amalgam in four dental clinics in Baghdad city, the concentrations of mercury vapor were measured seasonally from February to November 2016. Samples of blood and urine were collected from 30 dental workers (exposed individuals) and five non-occupationally exposed individuals. Biochemical parameters such as cholesterol, liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase), renal enzymes (urea and creatinine), total protein and reduced glutathione (GSH) were observed.

RESULTS

The results indicated that mercury vapor levels varied from 84.7 ± 18.67 to 609.3 ± 238.90 µg/m³ and most concentrations were above the occupational exposure standards. The results of the biochemical parameters showed a significant increase in levels of cholesterol, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and no significant increase in blood urea and creatinine in dental workers in comparison with unexposed persons (control). Although the results showed a significant reduction in the levels of glutathione and total protein, there was no significant decrease in the levels of alkaline phosphatase (ALP) in exposed dental workers when compared with non-occupationally exposed individuals.

CONCLUSIONS

It is concluded that mercury vapor concentrations in the indoor air of some dental clinics in Baghdad city are high and exceed the OSHA STEL(Occupational Safety and Health Administration Short Term Exposure Limit). The present data showed that altered biochemical parameters can be used as efficient bioindicators for mercury toxicity.

Mercury release of amalgams with various silver contents after exposure to bleaching agent

Background. Since it is possible for carbamide peroxide (CP) bleaching agent to contact old amalgam restorations, the present in vitro study evaluated the amount of dissolved mercury released from amalgam restorations with various percent-ages of silver content subsequent to the use of 15% CP.

Methods. Thirty ANA 2000 amalgam disks with 43.1% silver content and thirty ANA 70 amalgam disks with 69.3% silver content were prepared. In each group, 15 samples were randomly placed in glass tubes containing 15% CP (as experimental groups) and the remaining 15 samples were placed in buffered phosphate solution (as control groups) with the same 3-mL volume for 48 hours. Subsequently, the amount of mercury dissolved in each test tube was measured using Mercury Analyzing System (Cold Vapor Atomic Absorption, MASLO, Shimadzu, Japan). Data was analyzed with two-way ANOVA and a post hoc Tukey test. (α = 0.05).

Results. The amount of mercury released after exposure to CP was significantly higher than that released after exposure to buffered phosphate (P < 0.001). In addition, the amount of mercury released from dental amalgam with a silver content of 43% was significantly higher than that released from dental amalgam with a silver content of 69% (P < 0.001).

Conclusion. The amount of mercury release is inversely proportional to the silver content of dental amalgam.

Effect of Nd:YAG laser pulse energy on mercury vapor release from the dental amalgam

OBJECTIVE

The aim of this study was to evaluate the effect of different pulse energies of Nd:YAG laser on the amalgam ablation, and its effect on the amount of mercury vapor release from amalgam.

BACKGROUND DATA

Toxic vapor release from amalgam restorations at the laser focus site is possible.

MATERIALS AND METHODS

Forty-five amalgam samples (4 mm in diameter and 5 mm in height) were placed in sealed containers and underwent Nd:YAG laser irradiation with pulse energies of 50, 150, and 250 mJ at a distance of 1 mm from the amalgam surface for 4 sec. Subsequently, 150 mL of air was collected from the inside of the container using an Apex Pump to analyze the amount of mercury vapor in the air samples using a mercury vapor analyzer. Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p<0.05).

RESULTS

The amount of mercury vapor release significantly increased with an increase in the pulse energy of Nd:YAG laser (p<0.001). In addition, the amount of mercury vapor release with 250 mJ pulse energy was significantly higher compared with the standard mercury vapor concentration (50 μg/m(3)) (p<0.001). Nd:YAG laser produced cavities on the amalgam surface, which increased in size with an increase in the energy of the laser beam.

CONCLUSIONS

The amount of mercury vapor significantly increased with an increase in the pulse energy of the laser beam, and was significantly higher than the standard mercury vapor concentration with 250 mJ pulse energy.

Effect of filler size and morphology on viscoelastic stability of resin-composites under dynamic loading

Effect of variation in filler particle size, morphology and wet conditioning on the viscoelastic stability of resin-composites under dynamic loading was investigated. Eight experimental light cured resin-composites were selected. For each of the eight resin-composites, ten cylindrical specimens (4 × 6 mm), divided into two subgroups (n = 5) were prepared. Group 1 and 2 were loaded dynamically after 1 day of dry storage and 1 week of wet storage, respectively. A cyclic load between 1 and 50 MPa was applied for both groups at a frequency of 0.25 Hz for 30 min to obtain the 'dynamic' creep strain (%). Data was analysed by univariate ANOVA. Unimodal spherical and irregular resin-composites showed a significant influence of particle size and shape on dynamic creep under dry condition, but not for wet conditions. Irregular filler particles in both unimodal and multimodal resin-composites were more resistant to dynamic creep under wet conditions and showed higher stiffness.

Biocompatibility of dental amalgams

Objective. The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental amalgam. Materials and Methods. Two key-words “dental amalgam” and “toxicity” were used to search publications on dental amalgam biocompatibility published in peer-reviewed journals written in English. Manual search was also conducted. The most recent declarations and statements were evaluated using information available on the internet. Case reports were excluded from the study. Results. The literature show that mercury released from dental amalgam restorations does not contribute to systemic disease or systemic toxicological effects. No significant effects on the immune system have been demonstrated with the amounts of mercury released from dental amalgam restorations. Only very rarely have there been reported allergic reactions to mercury from amalgam restorations. No evidence supports a relationship between mercury released from dental amalgam and neurological diseases. Almost all of the declarations accessed by the internet stated by official organizations concluded that current data are not sufficient to relate various complaints and mercury release from dental amalgam. Conclusions. Available scientific data do not justify the discontinuation of amalgam use from dental practice or replacement with alternative restorative dental materials.

Dependence of kinetic variables in the short-term release of Hg2+, Cu2+ and Zn2+ ions into synthetic saliva from an high-copper dental amalgam

The short term (up to 14 days after restoration) release of selected ions (i.e., Hg(2+), Cu(2+) and Zn(2+)) from Dispersalloy into artificial saliva has been evaluated in regards to the nature of the saliva (Fusayama and McCarty and Shklar's solutions), the amount of amalgam, the time of contact and the periodical renewal (every 48 h interval) of artificial saliva. The evaluation of the ionic fraction of such metals has been accomplished by using anodic stripping methods (i.e., Differential Pulse Anodic Stripping Voltammetry, DPASV) with a 7 microm graphite disk microelectrode as a working electrode. Data obtained in this work are almost unprecedented in the literature due the fact that such analytical method exclude metals in non-ionic forms (e.g., metals or organometallic compounds). The high concentrations measured in every experimental condition confirm the concern for the short-term release of metals from amalgam into saliva.

Load bearing capacity of fibre-reinforced and particulate filler composite resin combination

OBJECTIVES

Longevity of particulate filler resin (PFR) is controversial for large restorations with high occlusal-stresses. The aim of this study was to reinforce PFR with fiber reinforced composite (FRC) and to evaluate the effect of thickness of FRC substructure and thickness of overlaying PFR, on the static load-bearing capacity of the material combination.

METHODS

A total of 336 test specimens having a FRC substructure (short random or continuous bidirectional fibre orientation) and layer of restorative PFR were prepared for this study. In Group A, the specimens contained short random oriented fibres (length: 2-3mm) and in Group B, there were continuous bidirectionally oriented fibres. The specimens (n = 12/group) were polymerized with a hand light-curing unit and were either dry-stored or thermocycled before they were statically loaded with a steel ball until fracture, using a universal testing machine.

RESULTS

Increase the volume fraction of the short random FRC versus the fraction of PFR, the load-bearing capacity of the specimen increased (p < 0.001). Short random FRC revealed significantly different behavior than the bidirectionally oriented FRC (p < 0.001). By combining the FRC layer of 0.5mm in thickness with a layer of 2.5mm of PFR gave load values of 1462N and 1196N, which were considerably higher than values for plain PFR of 3mm in thickness (782N and 729N).

CONCLUSION

The results suggest that by adding a FRC substructure under the PFR, the load-bearing capacity of the material combination was increased.