Mercury Concentration in Saliva and the Impact of Chewing: An Inductively Coupled Plasma Mass Spectrometry Study

Mercury, which is found in dental amalgams, is considered to be the most toxic non-radioactive element. However, the health policies of different countries have not reached a consensus on the use and safety of amalgam. This study aims to investigate the effect of amalgam restorations on mercury concentration in saliva, as well as the effect of restoration number, surface number, and chewing on this concentration. A total of 86 participants were included in this study (an equal number for the study and control groups). The number of amalgam restorations and their surfaces were recorded. While both unstimulated and stimulated saliva were collected from the study group, only unstimulated saliva was collected from the control group. The effect of chewing on mercury concentration was examined in the study group with unstimulated and stimulated saliva specimens using inductively coupled plasma mass spectrometry device. Mercury concentration in the unstimulated saliva was found to be higher in the study group compared to the control group (p= 0.000). As the number of amalgam restorations and the number of amalgam restoration surfaces increased, the mercury concentration in the saliva increased (p= 0.015 and p= 0.021, respectively). There was no statistically significant difference between mercury levels in the unstimulated saliva and the stimulated saliva (p=0.316). Chewing presented an insignificant difference in mercury concentration. Given this surprising result, the effect of chewing on mercury concentrations should be explored more extensively in future research.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

OBJECTIVES

To measure mercury release from standardised hydroxyapatite/amalgam constructs during MRI scanning and investigate the impact of static field strength and radiofrequency (RF) power on mercury release.

METHODS

Amalgam was placed into 140 hydroxyapatite disks and matured for 14-days in artificial saliva. The solution was replaced, and samples split into five groups of 28 immediately prior to MRI. One group had no exposure, and the remainder were exposed to either a 3T or 7T MRI scanner, each at high and low RF power. Mercury concentration was measured by inductively coupled plasma mass spectrometry. Groups were compared using one-way ANOVA, and two-way ANOVA for main effects/ interaction of field strength/ RF power.

RESULTS

Mercury concentration was increased in the 7T groups (high/ low: 15.43/ 11.33 ng mL^-1) and 3T high group (3.59) compared to control (2.44). MRI field strength significantly increased mercury release (p < .001) as did RF power (p = .030). At 3T, mercury release was 20.3 times lower than during maturation of dental amalgam, and for the average person an estimated 1.50 ng kg^-1 of mercury might be released during one 3T investigation; this is substantially lower than the tolerable weekly intake of 4,000 ng kg^-1.

CONCLUSION

Mercury release from amalgam shows a measurable increase following MRI, and the magnitude changes with magnetic field strength and RF power. The amount of mercury released is small compared to release during amalgam maturation. Amalgam mercury release during MRI is unlikely to be clinically meaningful and highly likely to remain below safe levels.

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

BACKGROUND

Approximately 50% of dental amalgam is elemental mercury by weight. Accumulating body of evidence now shows that not only static magnetic fields (SMF) but both ionizing and non-ionizing electromagnetic radiations can increase the rate of mercury release from dental amalgam fillings. Iranian scientists firstly addressed this issue in 2008 but more than 10 years later, it became viral worldwide.

OBJECTIVE

This review was aimed at evaluating available data on the magnitude of the effects of different physical stressors (excluding chewing and brushing) on the release of toxic mercury from dental amalgam fillings and microleakage.

MATERIAL AND METHODS

The papers reviewed in this study were searched from PubMed, Google Scholar, and Scopus (up to 1 December 2019). The keywords were identified from our initial research matching them with those existing on the database of Medical Subject Headings (MeSH). The non-English papers and other types of articles were not included in this review.

RESULTS

Our review shows that exposure to static magnetic fields (SMF) such as those generated by MRI, electromagnetic fields (EMF) such as those produced by mobile phones; ionizing electromagnetic radiations such as X-rays and non- Ionizing electromagnetic radiation such as lasers and light cure devices can significantly increase the release of mercury from dental amalgam restorations and/or cause microleakage.

CONCLUSION

The results of this review show that a wide variety of physical stressors ranging from non-ionizing electromagnetic fields to ionizing radiations can significantly accelerate the release of mercury from amalgam and cause microleakage.

Methylmercury-induced cytotoxicity and oxidative biochemistry impairment in dental pulp stem cells: the first toxicological findings

BACKGROUND

Methylmercury (MeHg) is a potent toxicant able to harm human health, and its main route of contamination is associated with the consumption of contaminated fish and other seafood. Moreover, dental amalgams are also associated with mercury release on human saliva and may contribute to the accumulation of systemic mercury. In this way, the oral cavity seems to be the primary location of exposure during MeHg contaminated food ingestion and dental procedures but there is a lack of literature about its effects on dental tissues and the impact of this toxicity on human health. In this way, this study aimed to analyze the effects of different doses of MeHg on human dental pulp stem cells after short-term exposure.

METHODS

Dental pulp stem cells from human exfoliated deciduous teeth (SHED) were treated with 0.1, 2.5 and 5 µM of MeHg during 24 h. The MeHg effects were assessed by evaluating cell viability with Trypan blue exclusion assay. The metabolic viability was indirectly assessed by MTT reduction assay. In order to evaluate an indicative of antioxidant defense impairment, cells exposed to 0.1 and 5 µM MeHg were tested by measuring glutathione (GSH) level.

RESULTS

It was observed that cell viability decreased significantly after exposure to 2.5 and 5 µM of MeHg, but the metabolic viability only decreased significantly at 5 µM MeHg exposure, accompanied by a significant decrease in GSH levels. These results suggest that an acute exposure of MeHg in concentrations higher than 2.5 µM has cytotoxic effects and reduction of antioxidant capacity on dental pulp stem cells.

Mercury exposure and its effects on fertility and pregnancy outcome

Mercury (Hg), a highly toxic environmental pollutant, shows harmfulness which still represents a big concern for human health, including hazards to fertility and pregnancy outcome. Research has shown that Hg could induce impairments in the reproductive function, cellular deformation of the Leydig cells and the seminiferous tubules, and testicular degeneration as well as abnormal menstrual cycles. Some studies investigated spontaneous abortion and complicated fertility outcome due to occupational Hg exposure. Moreover, there is a relation between inhaled Hg vapour and reproductive outcome. This MiniReview evaluates the hypothesis that exposure to Hg may increase the risk of reduced fertility, spontaneous abortion and congenital deficits or abnormalities.

Safety Considerations of 7-T MRI in Clinical Practice

Although 7-T MRI has recently received approval for use in clinical patient care, there are distinct safety issues associated with this relatively high magnetic field. Forces on metallic implants and radiofrequency power deposition and heating are safety considerations at 7 T. Patient bioeffects such as vertigo, dizziness, false feelings of motion, nausea, nystagmus, magnetophosphenes, and electrogustatory effects are more common and potentially more pronounced at 7 T than at lower field strengths. Herein the authors review safety issues associated with 7-T MRI. The rationale for safety concerns at this field strength are discussed as well as potential approaches to mitigate risk to patients and health care professionals.