Amalgam studies: disregarding basic principles of mercury toxicity

Ionic Organic Network-based C3-symmetric@Triazine core as a selective Hg+2 sensor

The C3-symmetry ionic polymer PPyTri has been designed with multi-walled carbon nanotubes (MWCNTs) or graphene nanoplatelets (GNPs) and studied as an ultrasensitive electrochemical sensor for trace Hg(II) detection. The synthesis approach incorporated attaching three pyridinium cationic components with chloride anions to the triazine core. The precursors, BPy, were synthesized using a condensation process involving 4-pyridine carboxaldehyde and focused nicotinic hydrazide. The polymer PPyTri was further modified with either MWCNTs or GNPs. The resulting ionic polymer PPyTri and its fabricated nanocomposites were characterized using infrared (IR), nuclear magnetic resonance (NMR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and powder X-ray diffraction (XRD). The analysis revealed that both the polymer and its nanocomposites have semi-crystalline structures. The electroactivity of the designed nanocomposites toward Hg + 2 ions revealed that among the nanocomposites and bare copolymer, the glassy carbon electrode (GCE) adapted with the PPyTri GNPs-5% exhibited the greatest current response over a wide range of Hg + 2 concentrations. The nanocomposite-modified electrode presented an excellent sensitivity of 83.33 µAµM - 1 cm - 2, a low detection limit of 0.033 nM, and a linear dynamic range of 0.1 nM to 0.01 mM (R2 = 0.9945).

Comparison of Marginal Fracture Between Conventional and Bonded Amalgam Restorations in Posterior Permanent Molar Teeth

Background/objectives Dental amalgam has been a successful restoration for over a century. However, restoration failures due to secondary caries, fractured teeth or restorations, marginal deficiencies, tooth wear, and secondary caries remain significant concerns. Amalgam-bond, known for its ability to bond amalgam to the tooth structure and prevent percolation, forms a strong bond with vital dentin. This study aimed to compare the outcome of marginal fractures in bonded amalgam and conventional amalgam posterior restorations among patients at a tertiary care dental hospital. Materials and methods Sixty consecutive patients aged 25-35 years, meeting the inclusion and exclusion criteria, participated in this study. A thorough history, clinical examination, and standardized periapical radiographs were conducted. Patients were divided randomly into two equal groups, group A and group B. Group A received bonded amalgam restorations, while group B received conventional amalgam restorations. Polishing was performed at a recall visit after seven days, and a follow-up evaluation was done after two months. The final assessment of marginal fractures was recorded after six months. Results After six months, 28 (46.7%) patients showed no marginal fractures, including 11 males and 17 females. On the other hand, 32 (53.3%) patients exhibited marginal fractures, comprising 17 males and 15 females. The clinical success rate of group A was better than group B (p = 0.001). Conclusion Bonded amalgam demonstrates a high success rate and should be a routine choice for treating carious permanent molars in dental practice.

A Comparative Study on the Microscale and Macroscale Mechanical Properties of Dental Resin Composites

Dental resin composites are universal restorative materials, and various kinds of fillers are used to reinforce their mechanical properties. However, a combined study on the microscale and macroscale mechanical properties of dental resin composites is missing, and the reinforcing mechanism of the composites is still not fully clarified. In this work, the effects of the nano-silica particle on the mechanical properties of dental resin composites were studied by combined dynamic nanoindentation tests and macroscale tensile tests. The reinforcing mechanism of the composites was explored by combining near-infrared spectroscopy, scanning electron microscope, and atomic force microscope characterizations. It was found that the tensile modulus increased from 2.47 GPa to 3.17 GPa, and the ultimate tensile strength increased from 36.22 MPa to 51.75 MPa, with the particle contents increasing from 0% to 10%. From the nanoindentation tests, the storage modulus and hardness of the composites increased by 36.27% and 40.90%, respectively. The storage modulus and hardness were also found to increase by 44.11% and 46.46% when the testing frequency increased from 1 Hz to 210 Hz. Moreover, based on a modulus mapping technique, we found a boundary layer in which the modulus gradually decreased from the edge of the nanoparticle to the resin matrix. Finite element modeling was adopted to illustrate the role of this gradient boundary layer in alleviating the shear stress concentration on the filler-matrix interface. The present study validates mechanical reinforcement and provides a potential new insight for understanding the reinforcing mechanism of dental resin composites.

Occupational and environmental mercury exposure and human reproductive health - a review

Mercury is a toxic heavy metal. Humans are exposed to mercury through several sources including environmental, occupational, contaminated food and water and from mercury-containing dental amalgam. Mercury exposure is known to harm the nervous system profoundly, and have a negative impact on digestive and immune systems, and other organs. To review and discuss the effect of mercury exposure through environmental or occupational routes on human reproduction, pregnancy, and its outcome. Published information about the potential toxic effects of mercury on human reproduction were collected and summarized. Literature was identified by systematic search using relevant keywords. Literature review revealed a number of negative impacts of mercury on human reproduction. These included effects on semen quality, including reduced sperm count, motility, and changes in morphology that may reduce fertility potential. There may also be an effect in changing reproductive hormone levels. Mercury exposure might also affect pregnancy but the data concerning mercury effects on female reproduction are limited except for some data about mercury exposure and poor pregnancy outcomes. Available data indicate that mercury exposure may have a toxicity effect on reproductive potential, especially in males. Prenatal mercury exposure may affect pregnancy or its outcome and this appears to be dependent upon dose, duration, and timing of exposure. Nutritional status of exposed individual might also influence the impact of mercury.

Low Prevalence of Amalgam-Associated Lichenoid Lesions in the Oral Cavity: A Prospective Study

Introduction: Amalgam has been the restoration of choice for years, but its popularity has declined due to concerns about aesthetics, mercury toxicity and lichenoid lesions associated with it. Lichenoid reaction is considered to be a delayed hypersensitivity type of reaction and it has been associated with dental materials in general and amalgam in particular.

Materials and Methodology: Two thousand patients having at least one amalgam restoration were examined for signs of lichenoid lesions when visiting the OPD of Conservative Dentistry and Endodontics at the Nair Hospital Dental College in Mumbai, India. Indirect spatial correlation to the amalgam restoration and the same were recorded. Descriptive analysis was used.

Results: Three (0.15%) out of 2000 patients with amalgam-associated lichenoid lesions showed complete resolution of lesions after the replacement of the restorations.

Conclusion: Amalgam associated lichenoid lesions have a low prevalence and should not be a contraindication to its use in routine restorative dental practice. Patch tests and biopsies have questionable diagnostic and prognostic value. Identification of the lesions should be made after the elimination of all other causative factors for the presenting symptoms. A close spatial association of the lesion to amalgam and the regression of symptoms after its removal should be considered as confirming the diagnosis.

Uptake, efflux, and toxicity of inorganic and methyl mercury in the endothelial cells (EA.hy926)

Cardiovascular disease (CVD) is the major cause of morbidity, mortality, and health care costs in the United States, and possibly around the world. Among the various risk factors of CVD, environmental and dietary exposures to mercury (Hg), a highly toxic metal traditionally regarded as a neurotoxin, has been recently suggested as a potential contributor towards human atherosclerotic development. In this study, we investigated the toxicity, type of cell death, dose-dependent uptake, and efflux of inorganic HgII (as HgCl₂) and methylmercury or MeHg (as CH₃HgCl) in EA.hy926 endothelial cells, as these two forms of Hg are often reported to be present in human blood among the general populations (~20–30% as HgII and ~70–80% as MeHg). Our results showed that HgII is more toxic than MeHg to the endothelial cells, owing to the higher uptake into the cytoplasm and perhaps importantly lower efflux of HgII by the cells, thus the “net” accumulation by the endothelial cells is higher for HgII than MeHg when exposed to the same Hg levels in the media. Furthermore, both HgII and MeHg were found to induce apoptotic and necrotic cell death. This study has important implications for the contributions of these two common Hg species to the development of atherosclerosis, an important process leading to CVD.

Efficient removal of mercury from simulated groundwater using thiol-modified graphene oxide/Fe-Mn composite in fixed-bed columns: Experimental performance and mathematical modeling

Mercury contamination in groundwater has been considered as an environmental and public health issue all over the world. Yet, effective in situ remediation techniques have been lacking. A thiol-modified graphene oxide/Fe-Mn composite (SGO/Fe-Mn) was employed as a reactive sorbent of permeable reactive barrier (PRB) for in situ remediation of mercury contaminated groundwater using fixed-bed columns. Mercury existed as HgCl₂, Hg(OH)₂, and HgClOH, and was mainly removed through surface complexation. The Brunauer-Emmett-Teller sorption isotherm model provided adequate fitting of the sorption isotherm data with a maximum monolayer sorption capacity of 112.03 ± 16.59 mg g^-1. Breakthrough time, the time when 5% of initial Hg concentration is measured in the effluent, increased with the decrease of influent mercury concentration, pore velocity, dissolved oxygen (DO), and dissolved organic matter (DOM). The resultant column sorption capacity was enhanced at higher influent mercury concentration, lower groundwater pore velocity, lower DOM and DO. Moreover, when the SGO/Fe-Mn was thoroughly mixed with quartz sand in the column, the breakthrough time was increased and the resultant sorption capacity was improved compared to the case that SGO/Fe-Mn was packed between two layers of quartz sand. Mathematically, the Adams-Bohart model satisfactorily reproduced the initial behavior of mercury breakthrough curves (<40 pore volumes). Yan model adequately simulated the breakthrough curves. The results reveal the potential of SGO/Fe-Mn as an efficient PRB reactive material for in situ remediation of mercury in contaminated groundwater.

Bioaccumulations and potential human health risks assessment of heavy metals in ppk-expressing transgenic rice

In order to reduce the phosphorus (P) resource consume, the polyphosphatekinase (ppk)-expressing transgenic rice (ETR) with high utilization efficiency of P fertilizer had been constructed. However, synthesis polyphosphates (polyP) mediated byppkin the plants have the ability of chelating heavy metals, so the potential hazards of the new elite rice variety have raised concerns. In the study, we planted ETR and wild-type Nipponbare (WT) in paddy fields in southern China. After harvest, the concentrations of eight heavy metals in rice tissues were measured, and health risks assessments were performed. The field experiment showed that the ppkexpressions were detected in the roots and straws of ETR plants but did not increase the concentrations of As, Cd, Cr, Ni and Pb in rice tissues. The Hg concentration in the ETRD root was 1.70-fold higher than that in WT, but the abundant Hg bioaccumulation in ETRD only occurred in the root. The bioaccumulation factors (BAFs) of all the detected heavy metals in the ETRS were no different from WT except for Cu and Zn. The results of human health risks assessment of heavy metals in brown rice showed that the non-carcinogenic risks of Cu or Zn in ETRD were higher than that in WT, while there was no difference in the total noncarcinogenic risk of the eight heavy metals in ETR. The carcinogenic risks of heavy metals in ETR were also comparable to that in WT. The results of this study indicated that the ppk expression in rice did not increase human health risks of heavy metals by consuming brown rice, which would provide a safety guarantee for agricultural and environmental applications of ETR not only with single-copy line but also with double-copy line.

Medical management, prevention and mitigation of environmental risks factors in Neurology

The human environment and exposures arising therefrom are major contributors to neurological disorders ranging from stroke to neurodegenerative diseases. Reduction of exposure to environmental risk factors, with the goal of disease prevention or control, is addressed at the individual as well as the societal level and in recognition of differential subject vulnerability. We examine some practical solutions in high-income countries that may allow a better adaptation to environmental risks and reduce their adverse impact on the nervous system. We consider the citizen's role in reducing unhealthy exposures and explore new approaches to treatment.

In situ remediation of mercury-contaminated soil using thiol-functionalized graphene oxide/Fe-Mn composite

Mercury (Hg) contamination in soil is a paramount concern to the environment and public health. Yet, effective in situ remediation technologies have been lacking. In this study, a novel thiol-functionalized graphene oxide/Fe-Mn (SGO/Fe-Mn) composite was prepared and investigated for in situ immobilization of Hg in contaminated soil. Batch tests showed that application of SGO/Fe-Mn at doses of 0.4% and 0.8% effectively reduced H₂O, H₂SO₄ and HNO₃, CH₃COOH, and CaCl₂-extractable Hg by 90.3-98.9% and 96.5-98.9%, respectively, upon equilibrium after 72 d. An increasing of soil moisture content from 0 to 12.5% significantly enhanced the immobilization efficiency from 75.0% to 97.6%. XRD, FTIR, and XPS analyses suggested that the composite mainly immobilized Hg through surface complexation and chemical precipitation. Sequential extraction procedure demonstrated that the composite promoted the conversion of more accessible Hg (exchangeable and carbonate fractions) into the less accessible forms, i.e., oxides, organic matter, and residual fractions, resulting in substantially reduced environmental risk of Hg. The application of SGO/Fe-Mn enhanced soil cation exchange capacity, available N and K, and total organic carbon, and can be used to effectively improve soil properties. Moreover, immobilized Hg in soil by this composite remained stable over one year. The present study demonstrates the potential and viability of SGO/Fe-Mn for enhanced immobilization of Hg in soil and sediment.

The cytotoxic and oxidative effects of restorative materials in cultured human gingival fibroblasts

The aim of this study was to evaluate the cytotoxic and oxidative effects of the most commonly used dental restorative materials on human gingival fibroblast cells (HGFCs). HGFCs were obtained from healthy individuals. The tested restorative materials were a microhybrid resin based composite, a compomer resin, a glass ionomer cement, and an amalgam alloy. One hundred eight cylindirical samples, 10 mm in diameter and 2 mm in height, were prepared according to ISO 10993-12:2002 specifications (n = 9 in the tested subgroups). Freshly prepared and aged samples in artificial saliva at 37 °C (7 and 21 d) were placed into well plates and incubated. Wells without dental materials were constituted as the control group. After 72 h incubation period, cytotoxicity was determined using the neutral red (NR) assay. Oxidative alterations were assessed using total antioxidant capacity (TAC) and total oxidant status (TOS) assay kits. Data were analyzed using the ANOVA and LSD post hoc tests. All tested materials led to significant decreases in the cell viability rates (33-73%) compared to the control group. Glass ionomer and resin composite were found to be more cytotoxic than amalgam alloy and compomer. The highest TAC level was observed in glass ionomer after seven-day aging and these changes prevented an increase in TOS levels. Increases in TAC levels after seven-day aging in all groups exhibited significant differences with freshly prepared samples (p < 0.05). In all material groups, TOS levels of freshly prepared samples differed statistically and significantly from samples aged for 7 and 21 d (p < 0.05). The data obtained suggested that all the tested materials exhibited cytotoxic and pro-oxidant features. Freshly prepared samples caused higher TOS levels. However, oxidant status induced by materials decreased over time.

A Turn-On Fluorescence-Based Fibre Optic Sensor for the Detection of Mercury

The design, development, and evaluation of an optical fibre sensor for the detection of Hg2+ in aqueous media are discussed in detail in this paper. A novel fluorescent polymeric material for Hg2+ detection, based on a coumarin derivative (acting as the fluorophore) and an azathia crown ether moiety (acting as the mercury ion receptor), has been synthesized. The fluorophore was covalently immobilized onto the fibre surface by polymerisation using the ion imprinting technique and exhibited a significant increase in fluorescence intensity in response to Hg2+ via a photoinduced electron transfer (PET) mechanism. The sensor provided a response over a concentration range of 0-28 µM with an acceptable response rate of around 11 min and a recovery rate of around 30 min in a Tris-EDTA buffer solution. A detection limit of 0.15 µM was obtained with a possibility of improvement by changing the thickness of the polymer layer and using a more sensitive detector. High-quality performance is seen through a high selectivity for Hg2+ over other metal ions, excellent photo-stability and reversibility which was also demonstrated, making this type of sensor potentially well suited for in-situ monitoring of mercury in the environment.

Iron Sulfide Minerals as Potential Active Capping Materials for Mercury-Contaminated Sediment Remediation: A Minireview

Several innovative approaches have been proposed in recent years to remediate contaminated sediment to reduce human health and environmental risk. One of the challenges of sediment remediation stems from its unfeasible high cost, especially when ex situ strategies are selected. Therefore, in situ methods such as active capping have been emerging as possible options for solving sediment problems. Active capping methods have been extensively tested in field-scale sediment remediation for organic pollutants (e.g., PCBs, PAHs, DDT) contamination with good sequestration efficiency; however, these methods have not been widely tested for control of heavy metal pollutants, such as mercury (Hg). In this review, the potentials of using iron sulfide minerals to sequestrate Hg were discussed. Iron sulfide minerals are common in the natural environment and have shown good effectiveness in sequestrating Hg by adsorption or precipitation. Iron sulfides can also be synthesized in a laboratory and modified to enhance their sequestration ability for Hg. Some of the potential advantages of iron sulfides are pointed out here. Additional tests to understand the possibility of applying iron sulfides as active caps to remediate complicated environment systems should be conducted.

Psychological symptoms and self-image of patients with complaints attributed to dental restorative materials

OBJECTIVES

The aim was to study self-image and the level of psychological symptoms in patients with symptoms attributed to their dental restorative materials.

MATERIALS AND METHODS

A questionnaire containing questions regarding dental and medical history was answered by 257 participants, one group with local oral symptoms only (LSO), and one group with multi-symptoms (M-S). A reference group was randomly selected from a research database at the Department of Psychology, Umeå University, Sweden. The self-image was assessed using the Structural Analysis of Social Behavior (SASB). Psychological symptoms such as somatization, depression, and anxiety were assessed using the Symptom Check List 90 (SCL-90) and the Global Severity Index (GSI) was used to determine the level of psychological symptoms.

RESULTS

SASB showed that the M-S group and the LSO-group scored significantly higher on the "spontaneous" and "positive self-image" than the reference group. In the SCL-90, the M-S group scored significantly higher than the LSO-group and the references on the somatization subscales. On depression, anxiety, and the GSI scale, the M-S group scored significantly higher than the reference group.

CONCLUSIONS

The two subgroups scored significantly higher on the SASB Spontaneous and Positive clusters which indicates that these patients have an excessively positive self-image, are very spontaneous and have an overconfidence in themselves compared to the reference group. In the M-S group there was a clear tendency to somatization, depression, and anxiety and they were more psychologically stressed than the reference group.

CLINICAL RELEVANCE

Among the patients with illness attributed to their dental materials, the M-S-patients had a significantly higher level of general psychological distress and somatization than the control group which may lead to mental stress.

UiO-66-(SH)2 as stable, selective and regenerable adsorbent for the removal of mercury from water under environmentally-relevant conditions

The dithiol functionalized UiO-66-(SH)₂ is developed as an efficient adsorbent for the removal of mercury in aqueous media. Important parameters for the application of MOFs in real-life circumstances include: stability and recyclability of the adsorbents, selectivity for the targeted Hg species in the presence of much higher concentrations of interfering species, and ability to purify wastewater below international environmental limits within a short time. We show that UiO-66-(SH)₂ meets all these criteria.

Increased Zn/Glutathione Levels and Higher Superoxide Dismutase-1 Activity as Biomarkers of Oxidative Stress in Women with Long-Term Dental Amalgam Fillings: Correlation between Mercury/Aluminium Levels (in Hair) and Antioxidant Systems in Plasma

BACKGROUND

The induction of oxidative stress by Hg can affect antioxidant enzymes. However, epidemiological studies have failed to establish clear association between dental fillings presence and health problems.

OBJECTIVES

To determine whether heavy metals (in hair), antioxidant enzymes (SOD-1) and glutathione levels could be affected by the chronic presence of heavy metals in women who had dental amalgam fillings.

MATERIALS AND METHODS

55 hair samples (42 females with amalgam fillings and 13 female control subjects) were obtained. All subjects (mean age 44 years) who had dental amalgam filling for more than 10 years (average 15 years). Certain metals were quantified by ICP-MS (Mass Spectrophotometry) in hair (μg/g: Al, Hg, Ba, Ag, Sb, As, Be, Bi, Cd, Pb, Pt, Tl, Th, U, Ni, Sn, Ti) and SOD-1 and Glutathione (reduced form) levels in plasma. Data were compared with controls without amalgams, and analyzed to identify any significant relation between metals and the total number of amalgam fillings, comparing those with four or less (n = 27) with those with more than four (n = 15). As no significant differences were detected, the two groups were pooled (Amlgam; n = 42).

FINDINGS

Hg, Ag, Al and Ba were higher in the amalgam group but without significant differences for most of the heavy metals analyzed. Increased SOD-1 activity and glutathione levels (reduced form) were observed in the amalgam group. Aluminum (Al) correlated with glutathione levels while Hg levels correlated with SOD-1. The observed Al/glutathione and Hg/SOD-1 correlation could be adaptive responses against the chronic presence of mercury.

CONCLUSIONS

Hg, Ag, Al and Ba levels increased in women who had dental amalgam fillings for long periods. Al correlated with glutathione, and Hg with SOD-1. SOD-1 may be a possible biomarker for assessing chronic Hg toxicity.

Paradigm shift redefining molecular, metabolic and structural events in Alzheimer's disease involves a proposed contribution by transition metals. Defined lengthy preclinical stage provides new hope to circumvent advancement of disease- and age-related neurodegeneration

It is estimated that 5.5 Million North Americans suffer from varying degrees of Alzheimer's disease (AD) and by the year 2050 it may be one in 85 people globally (100 Million). It will be shown that heavy metal toxicity plays a significant role in sporadic AD. Although current literature speaks to involvement of metal ions (via Fenton reaction), studies and reviewers have yet to link cellular events including known structural changes such as amyloid plaque development to this metal toxicity the way it is proposed here. Contrary to the current AD model which positions BACE1 (β-secretase) as an aberrant or AD-advancing enzyme, it is proposed herein that the neuron's protective counteraction to this metal toxicity is, in fact, a justified increase in BACE1 activity and amyloid precursor protein (APP) processing to yield more secreted APP (sAPP) and β-amyloid peptide in response to metal toxicity. This new perspective which justifies a functional role for APP, BACE1 enzyme activity and the peptide products from this activity may at first appear to be counterintuitive. Compelling evidence, however, is presented and a mechanism is shown herein that validate BACE1 recruitment and the resulting β-amyloid protein as strategic countermeasures serving the cell effectively against neuro-impeding disease. It is proposed that β-amyloid peptide chelates and sequesters free heavy metals in the extracellular medium to aggregate as amyloid plaque while unchelated β-amyloid migrates across the cell membrane to chelate intracellular free divalent metals. The sequestered intracellular metal is subsequently chaperoned as a metallo-peptide to cross the plasma membrane and aggregate as amyloid plaques extracellularly. The BACE1 countermeasure is not genetic or metabolic aberration; and this novel conclusion demonstrates that it must not be inhibited as currently targeted. APP, BACE1, β-amyloid peptide, and sAPP play positive roles against the preclinical oxidative load that predates AD symptoms for as long as 20 years. A healthy neuron may tolerate free metal toxicity, such as iron in the case of injury-induced amyloid, for as long as twenty years due to this very BACE1 activity. In later stages, the uncontrolled metals and ROS are compounded by other factors which together overcome this BACE1/β-amyloid protein countermeasure. This results in a sudden increase in IL-1 leading to Tau's hyperphosphorylation as cited and eventually to Tau dissociation from the microtubule cytoskeleton interrupting cell trafficking. At this later stage of AD the β-amyloid protein which once served as a vehicle to escort toxic metals to the extracellular medium and a trap to form a relatively benign extraneuronal disposal site is no longer translocated due to interruption of trafficking and now accumulates intracellularly facilitating hyper-oxidative ROS levels and contributes to irreversible neuron apoptosis.

A novel potentiometric self-plasticizing polypyrrole sensor based on a bidentate bis-NHC ligand for determination of Hg(ii) cation

In this approach, a new potentiometric self-plasticizing polypyrrole sensor was constructed based on a bidentate bis-NHC ligand for the purpose of Hg²⁺cation determination.

Effect of cropping systems on heavy metal distribution and mercury fractionation in the Wanshan mining district, China: implications for environmental management

The authors studied the concentration of heavy metals and mercury fractionation in contaminated soil in 2 agricultural land use systems (paddy rice and dry land) at the Wanshan mercury mine in China. The average concentrations of chromium, lead, copper, nickel, and zinc were generally lower in paddy rice soil relative to corn field soil. Soil under corn field production was slightly contaminated with lead (22-100 mg/kg), copper (31-64 mg/kg), and nickel (22-76 mg/kg) and moderately contaminated with zinc (112-635 mg/kg). In both soils, correlation of these metals with the titanium concentration in the soil indicates a geogenic origin for each metal (lead, r = 0.48; copper, r = 0.63; nickel, r = 0.47; zinc, r = 0.48). The mercury and antimony concentration in soil was high under both cropping systems, and future remediation efforts should consider the potential environmental risk presented by these metals. The concentration of bioavailable mercury in soil ranged from 0.3 ng/g to 11 ng/g across the 2 cropping systems. The majority of mercury (>80%) was associated with organic matter and the residual fraction. However, soil under paddy rice production exhibited a significantly lower concentration of Fe/Mn oxide-bound mercury than that under corn field production. This may be a function of the reduction of Fe/Mn oxides in the paddy rice soil, with the subsequent release of adsorbed metals to the soil solution. Sequential change from corn field to paddy rice production, as practiced in Wanshan, should therefore be avoided. Mercury adsorbed to Fe/Mn oxides in corn field soil potentially could be released into the soil solution and be made available for biomethylation under the flooded water management conditions of a rice paddy.

New science challenges old notion that mercury dental amalgam is safe

Mercury dental amalgam has a long history of ostensibly safe use despite its continuous release of mercury vapor. Two key studies known as the Children's Amalgam Trials are widely cited as evidence of safety. However, four recent reanalyses of one of these trials now suggest harm, particularly to boys with common genetic variants. These and other studies suggest that susceptibility to mercury toxicity differs among individuals based on multiple genes, not all of which have been identified. These studies further suggest that the levels of exposure to mercury vapor from dental amalgams may be unsafe for certain subpopulations. Moreover, a simple comparison of typical exposures versus regulatory safety standards suggests that many people receive unsafe exposures. Chronic mercury toxicity is especially insidious because symptoms are variable and nonspecific, diagnostic tests are often misunderstood, and treatments are speculative at best. Throughout the world, efforts are underway to phase down or eliminate the use of mercury dental amalgam.

Allergological and toxicological aspects in a multiple chemical sensitivity cohort

Background. Multiple chemical sensitivity (MCS) is a chronic condition characterized by an exaggerated response to toxicants. We ascertained the prevalence of allergy to metals and toxicological aspects in MCS patients. Methods. We conducted a retrospective review of medical records of 41 patients with MCS. We performed patch testing (n = 21) for dental series and did lymphocyte transformation test (n = 18) for metals. We measured mercury in samples of blood (n = 19), urine (n = 19), saliva (n = 20), and scalp hair (n = 17) to investigate the association between mercury levels and cases of MCS. Results. The prevalence of metal immune hypersensitivity in a subset of 26 patients was 92.3 percent. Elevations of mercury occurred in 81.2 percent (26 of 32). The mean (±SD) in blood concentrations of mercury was 7.6 ± 13.6 μg/L; mean in urine was 1.9 ± 2.5 μg/L; mean in scalp hair was 2.2 ± 2.5 μg/g; mean in saliva was 38.1 ± 52.1 μg/L. Subgroup analyses showed that elevation of mercury levels in biological matrices were associated with mercury amalgams in patients with MCS (22 patients), compared with controls (8 patients) (odds ratio 11 : 95 percent confidence interval 1.5 to 81.6; P = 0.023). Conclusions. Our data show an increased prevalence of metal allergy and elevation of mercury levels in bioindicators among patients with MCS.

Human brain mercury levels related to exposure to amalgam fillings

The safety of dental amalgam as the primary material in dental restoration treatments has been debated since its introduction. It is widely accepted that amalgam restorations continuously release elemental mercury (Hg) vapor, which is inhaled and absorbed by the body and distributed to tissues, including the brain. The aim of the present study was to investigate whether the presence of amalgam fillings is correlated with brain Hg level. The Hg levels in the parietal lobes of the brains of 32 cadavers were analyzed with an atomic absorption spectrometer with the mercury hydride system. A total of 32 brain samples were tested; of these, 10 were from cadavers with amalgam fillings, while 22 of them were amalgam free. Hg was detected in 60.0% (6 of 10) of the samples in the amalgam group and in 36.3% (8 of 22) in the amalgam-free group. The average Hg level of the amalgam group was 0.97 ± 0.83 µg/g (minimum: 0.3 µg/g and maximum: 2.34 µg/g), and in the amalgam-free group, it was 1.06 ± 0.57 µg/g (minimum: 0.17 µg/g and maximum: 1.76 µg/g). The results of the present study showed no correlation between the presence of amalgam fillings and brain Hg level.

Risk aspects of dental restoratives: From amalgam to tooth-colored materials

Dental materials’ choice of patients has considerably changed. Whereas cast gold and amalgam have been the predominant biomaterials for decades, today tooth-colored materials like resin-based composites and ceramics are more and more successful. However, are we going to replace a good but biologically questionable material (amalgam) with an equal material (resin composite) being more esthetic but also biologically questionable For amalgam, long-term clinical studies reported some significant hints that in single cases amalgam may be a health hazard for patients, finally Norway banned amalgam completely. The main advantage of a resin-based composite over amalgam is its tooth-like appearance and more or less absence of extensive preparation rules. For many years it was believed that resin-based composites may cause pulpal injury. However, pulpal injury associated with the use of resin-based composites is not correlated with their cytotoxic properties. Nevertheless, resin-based composites and other dental materials require rigorous safety evaluation and continuous monitoring to prevent adverse events similar like with amalgam. Because of non-biocompatible pulp responses to resin-based composites and amalgam, they should not be placed in direct contact with the dental pulp. The less dentin remaining in the floor of preparations between resin-based composites or other dental materials is more likely to cause pulpitis. Percentage of patients and dental practitioners who display allergic reactions is between 0.7% and 2%. The release of cytotoxic monomers from resin-based materials is highest after polymerization and much lower after 1 wk. Substances released from resin-based composites have been shown to be toxic in cytotoxicity tests. Nevertheless, in vitro cytotoxicity assays have shown that amalgam has greater toxic effects than resin-based composites, sometime 100-700-fold higher. Altogether, the risk of side-effects is low, but not zero, especially for dental personnel.

Mercury activates phospholipase a(2) and induces formation of arachidonic Acid metabolites in vascular endothelial cells

ABSTRACT Currently, mercury has been identified as a risk factor in cardiovascular diseases among humans. Here, we tested our hypothesis that mercury modulates the activity of the vascular endothelial cell (EC) lipid signaling enzyme phospholipase A(2) (PLA(2)), which is an important player in the EC barrier functions. Monolayers of bovine pulmonary artery ECs (BPAECs) in culture, following labeling of membrane phospholipids with [(3)H]arachidonic acid (AA), were exposed to the inorganic form of mercury, mercury chloride, and the release of free AA (index of PLA(2) activity) and formation of AA metabolites were determined by liquid scintillation counting and enzyme immunoassay, respectively. Mercury chloride significantly activated PLA(2) in BPAECs in a dose-dependent (0 to 50 muM) and time-dependent (0 to 120 min) fashion. Metal chelators significantly attenuated mercury-induced PLA(2) activation, suggesting that cellular mercury-ligand interaction is required for the enzyme activation and that chelators are suitable blockers for mercury-induced PLA(2) activation in ECs. Sulfhydryl (thiol-protective) agents, calcium chelating agents, and cPLA(2)-specific inhibitor also significantly attenuated the mercury-induced PLA(2), suggesting the role of thiol and calcium in the activation of cPLA(2) in BPAECs. Significant formation of AA metabolites, including the release of total prostaglandins, thromboxane B(2), and 8-isoprostane, were observed in BPAECs following their exposure to mercury chloride. Mercury chloride induced cytotoxicity as observed by the altered cell morphology and enhanced trypan blue uptake, which was attenuated by the cPLA(2) inhibitor AACOCF(3). The results of this study revealed that inorganic mercury-induced PLA(2) activation through the thiol and calcium signaling and the formation of bioactive AA metabolites further demonstrated the association of PLA(2) with the cytotoxicity of mercury in ECs. Overall, the results of the current study underscore the importance of PLA(2) signaling in mercury-induced endothelial dysfunctions.

Does a specific dental amalgam syndrome exist? A comparative study

OBJECTIVE

The aim of this article was to investigate whether there is evidence for a specific syndrome of health problems attributed to dental amalgam.

MATERIAL AND METHODS

A secondary and retrospective analysis of two different databases was performed: (a) 90 patients (47% female, mean (SD) age 34 (6) years) of a clinical trial to remove amalgam fillings who attribute their health complaints to dental amalgam, and (b) 116 patients (62% female, mean (SD) age 37 (8) years) from an outpatient unit for environmental medicine who attribute their symptoms to environmental sources other than amalgam.

RESULTS

The samples differed in age, sex, and educational level. No statistically significant differences between either of the groups were found in overall psychological distress, intensity of the symptoms, or in numbers of self-reported symptoms in the Symptom Check List after controlling for age, sex, and education (Mean Global Severity Index 0.62 versus 0.63). Patients from the amalgam group showed mean values for private and public self-consciousness similar to the population norm, while patients from the comparison group had statistically significantly decreased mean values. While the amalgam group more frequently reported mental symptoms, patients from the comparison group had a higher prevalence of somatic symptoms.

CONCLUSIONS

The results showed some differences in symptomatology, while general psychological distress was similar in both groups, indicating no strong evidence for an amalgam-specific syndrome.

Remediation of mercury contaminated sites - A review

Environmental contamination caused by mercury is a serious problem worldwide. Coal combustion, mercury and gold mining activities and industrial activities have led to an increase in the mercury concentration in soil. The objective of this paper is to present an up-to-date understanding of the available techniques for the remediation of soil contaminated with mercury through considering: mercury contamination in soil, mercury speciation in soil; mercury toxicity to humans, plants and microorganisms, and remediation options. This paper describes the commonly employed and emerging techniques for mercury remediation, namely: stabilization/solidification (S/S), immobilization, vitrification, thermal desorption, nanotechnology, soil washing, electro-remediation, phytostabilization, phytoextraction and phytovolatilization.

Neurobehavioral effects of combined prenatal exposure to low-level mercury vapor and methylmercury

We evaluated the effects of prenatal exposure to low-level mercury (Hg(0)) or methylmercury (MeHg) as well as combined exposure (Hg(0) + MeHg exposure) on the neurobehavioral function of mice. The Hg(0) exposure group was exposed to Hg(0) at a mean concentration of 0.030 mg/m(3) for 6 hr/day during gestation period. The MeHg exposure was supplied with food containing 5 ppm of MeHg from gestational day 1 to postnatal day 10. The combined exposure group was exposed to both Hg(0) vapor and MeHg according to above described procedure. After delivery, when their offspring reached the age of 8 weeks, behavioral analysis was performed. Open field (OPF) tests of the offspring showed an increase and decrease in voluntary activity in male and female mice, respectively, in the MeHg exposure group. In addition, the rate of central entries was significantly higher in this group than in the control group. The results of OPF tests in the Hg(0) + MeHg exposure group were similar to those in the MeHg exposure group in both males and females. The results in the Hg(0) exposure group did not significantly differ from those in the control group in males or females. Passive avoidance response (PA) tests revealed no significant differences in avoidance latency in the retention trial between the Hg(0), MeHg, or Hg(0) + MeHg exposure group and the control group in males or females. Morris water maze tests showed a delay in the latency to reach the platform in the MeHg and Hg(0) + MeHg exposure groups compared with the control group in males but no significant differences between the Hg(0), MeHg, or Hg(0) + MeHg exposure group and the control group in females. The results of OPF tests revealed only slight effects of prenatal low-level Hg(0) exposure (0.03 mg/m(3)), close to the no-observable-effect level (NOEL) stated by the WHO (0.025 mg/m(3)), on the subsequent neurobehavioral function. However, prenatal exposure to 5 ppm of MeHg affected exploratory activity in the OPF test, and, in particular, male mice were highly sensitive to MeHg. The MeHg and Hg(0) + MeHg exposure groups showed similar neurobehavioral effects. Concerning the effects of prenatal mercury exposure under the conditions of this study, the effects of MeHg exposure may be more marked than those of Hg(0) exposure.

The mercury burden of the Czech population: An integrated approach

In this paper an integrated approach in assessment of the population exposure from various sources of total mercury (THg) oral intake in the Czech Republic is presented. The information on total mercury levels in diet, drinking water, surface urban soil and body fluids and tissues stem from the Czech national Environmental Health Monitoring System (EHMS) operated since 1994. The THg concentration was determined by the special atomic absorption spectrophotometer AMA 254. The data on THg content in food from the sales network were collected in 12 cities. The estimated average dietary intake representing more than 95% of weight of usual diet composition ranged 1-2% of the JECFA/FAO WHO provisional tolerable weekly intake (PTWI) value for total mercury (5 microg/kg b.w./week). Data on drinking water quality stem from the nationwide monitoring database. The content of THg in drinking water is generally low; only 0.2% of the Czech population supplied with drinking water from the distribution networks (total of 92% of the population) has a mercury intake from drinking water higher than 1% PTWI and not exceeding 5% PTWI. The estimation of potential mercury intake by unintentional consumption of soil in small children was based on THg content in surface soil of a total of 324 nursery schools in 24 cities and towns. Median value was 0.16 mg/kg. Human biomonitoring was performed in 9 Czech cities. In 2007, the mercury median values in blood of adults (N=412) were 0.85 and 0.89 microg/l in males and in females, respectively; urine median value in adults was 1.10 microg/g creatinine. In 2008, the blood median value in children (N=324) amounted to 0.35 microg/l; urine median value is 0.16 microg/g creatinine. In children's hair the median THg value was 0.18 microg/g. The correlation between fish consumption and blood THg levels was observed in both adults and children. Also the biomonitoring outputs did not reveal a substantial burden of the population.

Effect of liquid rubber additions on physical properties of Bis-GMA based dental resins

OBJECTIVE

The aim of this investigation was to determine the effect of an experimental liquid rubber (LR) toughening agent on fracture toughness, crosslink density and Barcol hardness of polymerized mixtures of 50/50 wt% Bis-GMA and TEGDMA.

METHODS

An experimental LR, was added to a solution of Bis-GMA and TEGDMA containing 1wt% dimethylamino ethyl methacrylate and 0.5 wt% camphoroquinone at concentrations 0-10%. The composites were polymerized by exposure to a visible light curing unit for 60s. Fracture toughness was determined according to ASTM. 399. Crosslink density was evaluated using a swell test in ethanol.

RESULTS

Mean fracture toughness values ranged from 0.39 MPa m(1/2) for samples containing 6% to 1.24 MPa m(1/2) for samples containing 8% LR. Fracture toughness of samples containing 2%, 4%, and 8% LR were significantly higher than controls. The highest degree of cross-linkage was obtained in controls and lowest for samples containing 2% LR. Barcol Hardness values ranged from 36.7 for the control and 4% LR composition to 31.2 for samples containing 10% LR.

SIGNIFICANCE

Addition of 2, 4 and 8% LR increases the fracture toughness of Bis-GMA/TEGDMA composites. Addition of LR shows promise as a method of improving the fracture toughness of Bis-GMA based dental composites.

The role of intracellular glutathione in inorganic mercury-induced toxicity in neuroblastoma cells

It is well known that antioxidants containing sulfhydryl (-SH) groups are protective against the toxic effects of mercury. The current study was designed to elucidate the mechanism(s) of the cytoprotective effects of glutathione (GSH) and N-acetylcysteine (NAC) against the toxicity of inorganic mercury (HgCl(2)) in neuroblastoma cells (N-2A). The obtained results demonstrated the protective effects of these compounds in a dose dependant manner up to 95 and 74% cell viability, respectively as compared to the control of HgCl(2) of 10%. The administration of buthionine sulfoximine (BSO), an inhibitor of GSH synthesis, increased the toxicity of HgCl(2) in a dose dependent manner. Moreover, BSO treatment attenuated the levels of the cellular free -SH concentrations at low concentrations (1-100 microM) of HgCl(2). The data also show that cellular thiol concentrations were augmented in the presence of GSH and NAC and these compounds were cytoprotective against HgCl(2) and this is due to up regulating of GSH synthesis. A reduction in intracellular levels of GSH was observed with treatment of HgCl(2). In addition, the ratio of GSH/GSSG increased from 16:1 to 50:1 from 1 to 10 microM concentration of HgCl(2.) The ratio of GSH/GSSG then decreased from 4:1 to 0.5:1 with the increase of concentration of HgCl(2) between 100 microM and 1 mM due to the collapse of the N-2A cells. It was of interest to note that the synthesis of GSH was stimulated in cells exposed to low concentration of HgCl(2) when extra GSH is available. These data support the idea that the loss of GSH plays a contributing role to the toxic effects of HgCl(2) and that inorganic mercury adversely affects viability, through altering intracellular -SH concentrations. The data further indicate that the availability of GSH to the cells may not be sufficient to provide protection against mercury toxicity and the de novo synthesis of intracellular GSH is required to prevent the damaging effects of mercury.

New dental composites containing multimethacrylate derivatives of bile acids: a comparative study with commercial monomers

We have prepared multifunctional methacrylate derivatives of bile acids as cross-linkable monomers for use in dental composites. By modifying the chemical structure of the monomers, we were able to vary the viscosity, hydrophobicity, and reactivity and have studied the effect of these parameters on the conversion of the monomers, the shrinkage during polymerization, and the mechanical properties of the resulting polymers and composites. Materials containing these new monomers generally had physical, thermal, and mechanical properties comparable to those containing the commonly used dental monomers BisGMA or UDMA and had lower polymerization shrinkage. The multimethacrylate derivatives of cholic acid, which are known to be less cytotoxic than BisGMA and UDMA, are shown to be promising materials for dental applications.

Posterior amalgam restorations--usage, regulation, and longevity

The use of dental amalgam has declined, but in most of the world, amalgam is the most widely used and widely taught direct restorative material for load-bearing posterior restorations. There are few national regulations on the use of amalgam; however, there are several nations where few amalgam restorations are placed. Long-term studies have shown that under optimum conditions, posterior restorations of amalgam and resin composite last longer than reported previously and that amalgam restorations outlast composite restorations. In general practice settings, posterior amalgam and composite restorations both have lower longevities.

Phospholipase A2 activation regulates cytotoxicity of methylmercury in vascular endothelial cells

Mercury has been identified as a risk factor for cardiovascular disease among humans. Through diet, mainly fish consumption, humans are exposed to methylmercury, the biomethylated organic form of environmental mercury. As the endothelium is an important player in homeostasis of the cardiovascular system, here, the authors tested their hypothesis that methylmercury activates the lipid signaling enzyme phospholipase A(2) (PLA(2)) in vascular endothelial cells (ECs), causing upstream regulation of cytotoxicity. To test this hypothesis, the authors used bovine pulmonary artery ECs (BPAECs) cultured in monolayers, following labeling of their membrane phospholipids with [(3)H]arachidonic acid (AA). The cells were exposed to methylmercury chloride (MMC) and then the release of free AA (index of PLA(2) activity) and lactate dehydrogenase (LDH; index of cytotoxicity) were determined by liquid scintillation counting and spectrophotometry, respectively. MMC significantly activated PLA(2) in a dose-dependent (5 to 15 microM) and time-dependent (0 to 60 min) fashion. Sulfhydryl (thiol-protective) agents, calcium chelators, antioxidants, and PLA(2)-specific inhibitors attenuated the MMC-induced PLA(2) activation, suggesting the role of thiols, reactive oxygen species (ROS), and calcium in the activation of PLA(2) in BPAECs. MMC also induced the loss of thiols and increase of lipid peroxidation in BPAECs. MMC induced cytotoxicity in BPAECs as observed by the altered cell morphology and LDH leak, which was significantly attenuated by PLA(2) inhibitors. This study established that PLA(2) activation through thiols, calcium, and oxidative stress was associated with the cytotoxicity of MMC in BPAECs, drawing attention to the involvement of PLA(2) signaling in the methylmercury-induced vascular endothelial dysfunctions.

Electrochemical behaviors of sulfhydryl compounds in the presence of elemental mercury

In the expression of bioaccumulated elemental mercury (Hg 0) toxicity, the first Hg 0 oxidation step is crucial. Therefore, to clarify the mechanism underlying the interactions of sulfhydryl (SH) compounds and Hg 0 in the present study, we analyzed the oxidation of reduced glutathione (GSH) and L-cysteine (Cys) in the presence of Hg 0 in aqueous solution by cyclic voltammetry (CV). Production of Hg2+ in the reaction mixture was found to increase along with a decrease in free SH residues. CV showed that the oxidation of Cys increased after a 4-h incubation in the presence of Hg(0), but the oxidation of Cys after a 24-h incubation was suppressed. Conversely, GSH oxidation increased with incubation time in the absence of Hg(0). In the presence of Hg(0), the oxidation of GSH was suppressed. The different reactivities of Cys and GSH with Hg(0) may arise from differences in their oxidation/reduction potentials and pH. The important SH compound interactions with Hg(0) oxidation were as follows: (i) oxidation of Hg(0) to form either mercurous ion (Hg+) or mercuric ion (Hg2+) which both form stable complexes in aqueous solution as Hg I (RS) or Hg II(RS)2; (ii) catalyzed oxidation of SH compounds in the presence of Hg 0; and (iii) suppression of the oxidation of SH compounds due to the reduced concentration of free SH compounds through the binding of SH compounds with Hg+ or Hg2+ The present results demonstrate the chemical reaction processes by which Hg 0 dissolves in aqueous solution in the presence of SH compounds, and contribute to our understanding of SH compounds in non-enzymatic Hg 0 oxidation in vivo.

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.

Mercury activates vascular endothelial cell phospholipase D through thiols and oxidative stress

Currently, mercury has been identified as a risk factor of cardiovascular diseases among humans. Here, the authors tested the hypothesis that mercury modulates the activity of the endothelial lipid signaling enzyme, phospholipase D (PLD), which is an important player in the endothelial cell (EC) barrier functions. Monolayers of bovine pulmonary artery ECs (BPAECs) in culture, following labeling of membrane phospholipids with [32P]orthophosphate, were exposed to mercuric chloride (inorganic form), methylmercury chloride (environmental form), and thimerosal (pharmaceutical form), and the formation of phosphatidylbutanol as an index of PLD activity was determined by thin-layer chromatography and liquid scintillation counting. All three forms of mercury significantly activated PLD in BPAECs in a dose-dependent (0 to 50 microM) and time-dependent (0 to 60 min) fashion. Metal chelators significantly attenuated mercury-induced PLD activation, suggesting that cellular mercury-ligand interaction(s) is required for the enzyme activation and that chelators are suitable blockers for mercury-induced PLD activation. Sulfhydryl (thiol-protective) agents and antioxidants also significantly attenuated the mercury-induced PLD activation in BPAECs. Enhanced reactive oxygen species generation, as an index of oxidative stress, was observed in BPAECs treated with methylmercury that was attenuated by antioxidants. All the three different forms of mercury significantly induced the decrease of levels of total cellular thiols. For the first time, this study revealed that mercury induced the activation of PLD in the vascular ECs wherein cellular thiols and oxidative stress acted as signal mediators for the enzyme activation. The results underscore the importance of PLD signaling in mercury-induced endothelial dysfunctions ultimately leading to cardiovascular diseases.

An overview of treatment considerations for esthetic restorations: a review of the literature

Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.

The role of thiols, dithiols, nutritional factors and interacting ligands in the toxicology of mercury

Mercury has been a known as a toxic substance for centuries. Whilst the clinical features of acute mercury poisoning have been well described, chronic low dose exposure to mercury remains poorly characterised and its potential role in various chronic disease states remains controversial. Low molecular weight thiols, i.e. sulfhydryl containing molecules such as cysteine, are emerging as important factors in the transport and distribution of mercury throughout the body due to the phenomenon of "Molecular Mimicry" and its role in the molecular transport of mercury. Chelation agents such as the dithiols sodium 2,3-dimercaptopropanesulfate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) are the treatments of choice for mercury toxicity. Alpha-lipoic acid (ALA), a disulfide, and its metabolite dihydrolipoic acid (DHLA), a dithiol, have also been shown to have chelation properties when used in an appropriate manner. Whilst N-acetyl-cysteine (NAC) and glutathione (GSH) have been recommended in the treatment of mercury toxicity in the past, an examination of available evidence suggests these agents may in fact be counterproductive. Zinc and selenium have also been shown to exert protective effects against mercury toxicity, most likely mediated by induction of the metal binding proteins metallothionein and selenoprotein-P. Evidence suggests however that the co-administration of selenium and dithiol chelation agents during treatment may also be counter-productive. Finally, the issue of diagnostic testing for chronic, historical or low dose mercury poisoning is considered including an analysis of the influence of ligand interactions and nutritional factors upon the accuracy of "chelation challenge" tests.

Changed clinical chemistry pattern in blood after removal of dental amalgam and other metal alloys supported by antioxidant therapy

This study aimed to investigate a possible connection between removal of dental amalgam restorations supported by antioxidant therapy and indicative changes of clinical chemistry parameters. A group of 24 patients, referred for complaints related to amalgam restorations, underwent a removal of their amalgams. All patients were treated with antioxidants (vitamin B-complex, vitamin C, vitamin E, and sodium selenite). An age- and sex-matched control group of 22 individuals was also included. The mercury (Hg) and selenium (Se) concentration in plasma, Hg concentration in erythrocytes, and 17 clinical chemistry variables were examined in three groups: patients before amalgam removal (Before), patients after amalgam removal (After), and control individuals (Control). The Hg and Se values decreased (p < 0.05) in plasma, and the Hg concentration decreased (p < 0.05) in erythrocytes after amalgam removal. The variables serum lactate dehydrogenase (serum LDH) and serum sodium differed significantly both when comparing Control with Before (p < 0.01) and Before with After (p < 0.01). The variables white blood cell count (WBC), blood neutrophil count, blood eosinophil count, blood basophil count, blood lymphocyte count, blood monocyte count, serum potassium, and serum creatinine differed in the Before/After test (p < 0.05). Multivariate statistics (discriminant function analysis) could separate the groups Before and After with only one misclassification.