The release of mercury from dental amalgam: the mechanism and in vitro testing

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.

Exposure to Dental Filling Materials and the Risk of Dementia: A Population-Based Nested Case Control Study in Taiwan

When studying the range of toxic substances triggering dementia, special attention should be paid to the materials used in dental practice, particularly to dental fillings containing amalgam. This necessitated conducting large-scale epidemiologic studies. The aim of our research was to determine the risk factors for developing dementia when filling materials containing amalgam are used in dental practice. In order to achieve the set goals, the following tasks were undertaken: (1) The social and demographic characteristics of the examined patients were studied; (2) the spectrum of concomitant somatic diseases was determined in patients of different gender and age; and (3) the relationship between dementia incidence and the volume of dental filling material containing amalgam was identified in patients with different somatic diseases. In general, the research conducted did not reveal any direct relationship between the development of dementia and the volume of filling material containing amalgam. However, among the people with dementia, there were persons for whom its progression was accelerated in cases where a large volume of dental filling material containing amalgam was present.

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.

Correlation between long-term in vivo amalgam restorations and the presence of heavy elements in the dental pulp

PROJECT

To measure the levels of heavy metals (Hg, Sn) in the dental pulp and blood samples of patients with long-term amalgam restorations.

PROCEDURE

12 amalgam restored and 12 non-restored, sound teeth were chosen and access cavity preparation to the pulp chamber was made. The contents were transferred and dissolved in 5mL of concentrated nitric acid followed by placement in an oven at 180°C for tissue digestion. After cooling the tubes each digested sample was transferred to an atomic absorption system to measure the levels of heavy metals. The blood samples of five patients in each group were randomly analyzed to determine the levels of these heavy metals in the blood and if there were a correlation between these levels in blood and pulp. Data were analyzed by t-test at a P<0.05 level of significance.

RESULTS

No significant difference was seen between the levels of Hg and Sn in pulp tissues (P>0.05); however, the blood analysis showed higher level of Hg amalgam group (P=0.009). The analysis between the pulp and blood samples showed positive correlations for both Hg and Sn elements in dental pulp and the blood (P=1.000) (P=0.900).

CONCLUSIONS

The long-term presence of dental amalgam (at least 5 years) did not result in any remarkable changes in the levels of mercury and tin in the pulp tissue; however, there were increases in the level of mercury in the blood circulation even five years following the placement of the restoration.

Corrosion behavior of cast Ti-6Al-4V alloyed with Cu

It has recently been found that alloying with copper improved the inherently poor grindability and wear resistance of titanium. This study characterized the corrosion behavior of cast Ti-6Al-4V alloyed with copper. Alloys (0.9 or 3.5 mass % Cu) were cast with the use of a magnesia-based investment in a centrifugal casting machine. Three specimen surfaces were tested: ground, sandblasted, and as cast. Commercially pure titanium and Ti-6Al-4V served as controls. Open-circuit potential measurement, linear polarization, and potentiodynamic cathodic polarization were performed in aerated (air + 10% CO(2)) modified Tani-Zucchi synthetic saliva at 37 degrees C. Potentiodynamic anodic polarization was conducted in the same medium deaerated by N(2) + 10% CO(2). Polarization resistance (R(p)), Tafel slopes, and corrosion current density (I(corr)) were determined. A passive region occurred for the alloy specimens with ground and sandblasted surfaces, as for CP Ti. However, no passivation was observed on the as-cast alloys or on CP Ti. There were significant differences among all metals tested for R(p) and I(corr) and significantly higher R(p) and lower I(corr) values for CP Ti compared to Ti-6Al-4V or the alloys with Cu. Alloying up to 3.5 mass % Cu to Ti-6Al-4V did not change the corrosion behavior. Specimens with ground or sandblasted surfaces were superior to specimens with as-cast surfaces.

Surface analysis of dental amalgams by X-ray photoelectron spectroscopy and X-ray diffraction

OBJECTIVES

It is important to characterize the surface of dental amalgam in order to understand the process of mercury release from amalgam restorations in the oral cavity. The mercury evaporation occurs not only from the newly made restoration but also from the set material.

METHODS

The surfaces of four different types of amalgams, which had been well set, were analyzed with X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) and the relationship between surface compositions and mercury release was studied. Fresh amalgam surfaces as well as aged surfaces, which were stored for 30 days in air, were investigated using XPS and the chemical states of amalgam components and oxygen were studied. The aged surfaces were also characterized with XRD and grazing angle XRD.

RESULTS

With increased oxidation, the surface contents of tin and oxygen were increased in all amalgams. In contrast, the surface contents of copper and mercury were decreased. An increase of zinc or indium content were observed in zinc or indium containing amalgams, respectively. A surface layer enriched with indium and oxygen was clearly detected by XPS but not with grazing angle XRD.

SIGNIFICANCE

The thickness of the enriched surface layer is estimated to be in the order of few nanometer, which is approximately equal to the analysis depth of XPS. In addition, the presence of metallic elements, like tin and zinc, that readily form a stable oxide layer at the surface suppress the release of mercury.

Corrosion behavior of cast titanium with reduced surface reaction layer made by a face-coating method

This study characterized the corrosion behavior of cast CP titanium made with a face-coating method. Wax patterns were coated with oxide slurry of Y(2)O(3) or ZrO(2) before investing with a MgO-based investment. Three surface preparations were tested: ground, sandblasted, and as-cast. Uncoated castings served as controls. Sixteen-hour open circuit potential (OCP) measurement, linear polarization and potentiodynamic cathodic polarization were performed in an aerated modified Tani-Zucchi synthetic saliva at 37 degrees C. Anodic polarization was conducted in the same deaerated medium. Polarization resistance (R(p)) and Tafel slopes were determined. Corrosion current density was calculated for each specimen. Results (n=4) were subjected to nonparametric statistical analysis (alpha=0.05). Cross sections of cast specimens were examined by optical microscopy. Energy dispersive spectroscopy (EDS) spot analysis was performed at various depths below the surface. The OCP stabilized within several hours for all the specimens. Apparent differences in anodic polarization behavior were observed among the different surfaces. A distinctive wide passive region followed by breakdown was seen on specimens with ground and sandblasted surfaces. There were no significant differences in the corrosion resistance among the control and the two face-coating groups for each group. The Mann-Whitney test showed significantly lower OCP and higher R(p) values for ground surfaces. The surface condition significantly affected the corrosion behavior more than the face coating methods. In most cases, specimens with as-cast surfaces exhibited the least corrosion resistance during the potentiodynamic anodic polarization.

Hg2+ and Ni2+ alter induction of heat shock protein-72 in THP-1 human monocytes

The biological liabilities that result from the release of metal ions from biomedical alloys, particularly Ni(2+) and Hg(2+), continue to be a concern. Heat-shock proteins (HSP) are a class of molecular chaperones that may be induced under conditions of cellular stress, including oxidative stress. Our hypothesis was that because Hg(2+) and Ni(2+) alter other cellular stress responses such as glutathione levels and cytokine secretion, these metal ions may alter HSP induction in monocytes, which are key cells in the response of tissues to biomedical alloys. THP-1 monocytes were exposed to sublethal concentrations of Hg(2+) or Ni(2+) for 1 h with or without heat stress (43 degrees C), then allowed to recover at 37 degrees C for 2-6 h. HSP72 was measured using immunoblotting with phosphorimage quantification. Hg(2+) exposures of 2-10 micromol/L induced HSP72 without heat stress. With heat stress, HSP72 levels were altered by Hg(2+) versus heat stress alone. The response depended on the concentration of Hg(2+) and the recovery time. Hg(2+) at 10 micromol/L caused uniformly lower HSP72 levels. Ni(2+) exposures of 20-100 micromol/L did not induce HSP72 without heat stress, but significantly altered heat-induced HSP72 expression, with a significant increase in expression over heat alone at 40 and 100 micromol/L. Results from the current study support the hypothesis that these metal ions can, at concentrations relevant to those released from biomedical alloys, modulate HSP expression in human monocytes. The modulation of HSP expression indicates an early sign of cellular stress that may be important to the overall biological response to biomedical alloys containing and releasing these metal ions.

Particle size effect on structure and properties of dispersed Pd-containing dental amalgam

Focus of the study is to evaluate the effect of dispersant particle size on the structure and various properties of spherical matrix, irregular dispersant admixed type Pd amalgams. The results indicate that amalgams prepared from smaller dispersant particles have a shorter setting time (faster amalgamation reaction), smaller setting expansion, higher eta' content and lower early stage gamma2 content. Smaller dispersant particles also lead to a slightly higher compressive strength, lower creep value, more cathodic corrosion potential and less early stage mercury vapor release. The particle size effect on corrosion current density and chemical composition of gamma1 phase in aged amalgam is less significant.

Effect of particle configuration on structure and properties of dispersed Pd-containing dental amalgam

The present work investigates the effect of particle configuration on the structure and properties of four dispersed type Pd-containing amalgams with the same chemical composition. The results indicate that particle configuration plays an important role not only in the structure and chemistry, but also in such properties as compressive strength, creep and mercury release rate. Compromises among the various properties of the present Pd amalgams are needed, when a decision on particle configuration is to be made. As mechanical properties or corrosion resistance is concerned, the amalgam should comprise at least one spherical alloy (matrix or dispersant). As far as mercury release is concerned, the amalgam should comprise irregular dispersant alloy. The amalgam fabricated from irregular dispersant and spherical matrix particles seems to serve all well.

Surface chemistry of a high-copper dental amalgam

In amalgam, mercury is intended to take the form of stable intermetallic compounds. Any mercury leakage must therefore come from free mercury not involved in such compounds. Thus, a knowledge of the exact surface chemistry of dental amalgam is necessary if this phenomenon is to be understood. From XPS and EDS analyses, a model of the surface chemistry of amalgam is proposed which fully characterizes all the phases that are present. The data show the surface to have a composition different from that of the bulk, being comprised of a hydrocarbon deposit and adsorbed water covering the intermetallic phase gamma2 (Sn(6-8)Hg), tin (iv) oxide, and mercury in a free state. After amalgamation, the amount of mercury at the surface decreases with time and eventually attains a constant concentration, where it is all involved in the gamma2 phase, leaving no free mercury. A model is proposed for the surface of amalgam and the changes in this model with time.

Dissolution of mercury vapor in simulated oral environments

OBJECTIVE

The aim of this investigation was to determine the effects of variables on the dissolution of atomic mercury in simulated oral fluids. This study was based on a hypothesis that the rate of mercury vapor dissolution in synthetic saliva is affected by the oxidation power and stirring of the solution.

METHOD

The reference solution was synthetic saliva, and the oxidation power was increased by hydrogen peroxide or decreased by ascorbic acid. Test solutions were exposed to mercury vapor in a sealed container, and the dissolved mercury concentration was determined after exposures ranging from 2 to 48 h. The results were analyzed by ANOVA and Tukey's multiple comparison test (p < 0.05). The effect of stirring was examined for a 24 h exposure. Student t-tests were used to compare this data (p < 0.05). The analysis for mercury was performed by cold-vapor atomic absorption spectrophotometry.

RESULTS

Mercury dissolved much faster in the highly oxidizing solution with hydrogen peroxide than in the other two solutions, which dissolved mercury at the same rate. In the less oxidizing solutions, the dissolved mercury concentration reached a nearly constant value. Stirring the solution increased the rate of mercury dissolution for the highly oxidizing solution but had no effect on the less oxidizing solutions.

SIGNIFICANCE

The results show the importance of the transformation of mercury from the atomic to the ionic state. When dissolving atomic mercury is not oxidized, it may evaporate and be inhaled, but the dissolution rate becomes low. Under more oxidizing conditions, mercury dissolves faster, but does not generate mercury vapor. Diffusion in the liquid affects the mercury dissolution rate only under highly oxidizing conditions.

Effect of Ni ions on expression of intercellular adhesion molecule 1 by endothelial cells

Previous studies have shown that Ni-based alloys implanted into soft tissues cause an infiltration of inflammatory cells around the implant. This phenomenon is potentially important to dental alloys which are adjacent to oral tissues. To help define the mechanisms by which Ni causes an infiltration of inflammatory cells, we exposed endothelial cells in vitro to Ni ions and measured the expression of intercellular adhesion molecule 1 (ICAM-1). ICAM-1 is known to be involved in the recruitment of inflammatory cells from the bloodstream. We also exposed macrophages to Ni ions to test the hypothesis that Ni might alter cytokine secretion and subsequently cause expression of ICAM-1 on endothelial cells. The results showed that Ni ions could promote the expression of ICAM-1 on endothelial cells, but only at concentrations which were high enough (850 mumol/L for 24 h) to suppress cell metabolic activity. Although we had previous evidence that Ni could cause macrophages to secrete cytokines such as interleukin 1 beta, Ni-exposed macrophage supernatants did not induce expression of ICAM-1 on endothelial cells at concentrations subtoxic to the macrophages (85 mumol/L). At subtoxic concentrations, Ni ions were able to suppress ICAM-1 expression on endothelial cells which were stimulated with lipopolysaccharide. Thus, Ni ions either promoted or suppressed the expression of ICAM-1 depending on their concentration. This dual action of Ni ions may be important in vivo where a gradient of concentrations of released ions is likely to exist around the implanted biomaterial. Further studies are necessary to determine the effect of time of exposure and the molecular mechanisms of increased ICAM-1 expression.

Effect of addition of palladium on properties of Ag2Hg3 (gamma 1) phase

The effect of palladium addition on the microstructure, compressive strength, creep rate and mercury release rate of Ag2Hg3 (gamma 1) phase was evaluated. Experimental results indicated that fairly pure gamma 1 phase could be fabricated using the present trituration method. The heat treatment of gamma 1 at 90 degrees C increased porosity level, increased dimensional shrinkage, increased mercury vapour release and enhanced the formation of beta1 phase. Addition of palladium in gamma 1 slowed down the amalgamation reaction, largely suppressed the phase transition to beta1 and caused a slight shift in open circuit potential toward the anodic direction. Although the overall anodic polarization profiles did not show a significant effect of palladium, scanning electron microscopy revealed morphological differences between pure and palladium-containing gamma 1. Addition of palladium in gamma 1 also increased compressive strength, increased creep resistance, and largely reduced both mercury vapour and ion release rates. Considering overall performance, the optimal palladium content in gamma 1 seems to be in the range between 0.50 and 0.75 wt%.

Dissolution of mercury from dental amalgam at different pH values

Dissolution of mercury from dental amalgam has been shown to be diminished by the formation of a tin oxide film on the surface of the mercury-rich gamma 1 phase (Marek, 1990b). Since tin oxides dissolve at low pH values (Deltombe et al., 1974), acidic conditions in the oral cavity may cause an increase in the mercury release. The purpose of this study was to determine the effect of acidity in the range of pH 1 to pH 8 on the rate of mercury dissolution in synthetic saliva from tin-free and tin-containing gamma 1 phase and two commercial dental amalgams. The tested hypothesis was that pH affects mercury dissolution only when a protective oxide film dissolves in an acidic environment. After exposures of the specimens for 2 hr or 24 hr in sealed glass bottles, the solutions were analyzed by flameless atomic absorption spectrophotometry for mercury and silver. The results have shown pH-independent mercury dissolution in the range of pH 3 to 8, and a much faster dissolution at pH 1. At all pH values, more mercury dissolved from the tin-free phase than from the tin-containing phase, and the rate of dissolution was lowest for the dental amalgams. The results were affected by the length of the test exposure. The pH independence in a wide range of pH values has been attributed to the atomic mechanism of mercury dissolution. The low rate of mercury dissolution from specimens containing tin has been explained by the formation of a barrier tin oxide film, which dissolved only at the lowest pH. Dissolution of silver at low pH values is believed to have accelerated dissolution of mercury from the tin-free gamma 1 phase. Variation of the dissolution rate with concentration of the dissolved species and kinetics of oxide film dissolution caused the effect of the exposure period.

Equilibrium vapor pressure of mercury from dental amalgam in vitro

OBJECTIVES

The purpose of this study was to acquire reliable quantitative data on mercury vapor pressure above the surface of dental amalgam samples in both the as-formed and the abraded state.

METHODS

The equilibrium vapor pressure of mercury from dental amalgam was obtained using residual gas analysis in conjunction with a quartz crystal microbalance. The measurements were performed under ultrahigh-vacuum conditions.

RESULTS

Using the residual gas analyzer, the average mercury vapor pressures measured from the as-formed and abraded dental amalgam surfaces were 8 x 10(-7) and 1.7 x 10(-4) Pa, respectively. The corresponding vapor densities are: 6 x 10(-2) micrograms/m3 and 14 micrograms/m3. The average mercury vapor pressures measured from the as-formed and abraded dental amalgam surfaces using the quartz crystal microbalance were: 2.4 x 10(-6) and 1.0 x 10(-4) Pa, respectively. The corresponding vapor densities are: 0.2 microgram/m3 and 8 micrograms/m3.

SIGNIFICANCE

This project provides a measurement of the equilibrium vapor pressure of mercury from as-formed and abraded amalgam surfaces. By definition, the equilibrium vapor pressure provides the maximum density of mercury which can be present in the environment above the amalgam. The vapor density of mercury within the oral cavity must be less than this value due to the dynamic nature of the system.

Prenatal coexposure to metallic mercury vapour and methylmercury produce interactive behavioural changes in adult rats

Pregnant rats were 1) administered methyl mercury (MeHg) by gavage, 2 mg/kg/day during days 6-9 of gestation, 2) exposed by inhalation to metallic mercury (Hg degrees) vapour (1.8 mg/m3 air for 1.5 h per day) during gestation days 14-19, 3) exposed to both MeHg by gavage and Hg degrees vapour by inhalation (MeHg + Hg degrees), or 4) were given combined vehicle administration for each of the two treatments (control). The inhalation regimen corresponded to an approximate dose of 0.1 mg Hg degrees/kg/day. Clinical observations and developmental markers up to weaning showed no differences between any of the groups. Testing of behavioural function was performed between 4 and 5 months of age and included spontaneous motor activity, spatial learning in a circular bath, and instrumental maze learning for food reward. Offspring of dams exposed to Hg degrees showed hyperactivity in the motor activity test chambers over all three parameters: locomotion, rearing and total activity; this effect was potentiated in the animals of the MeHg + Hg degrees group. In the swim maze test, the MeHg + Hg degrees and Hg degrees groups evidenced longer latencies to reach a submerged platform, which they had learned to mount the day before, compared to either the control or MeHg groups. In the modified, enclosed radial arm maze, both the MeHg + Hg degrees and Hg degrees groups showed more ambulations and rearings in the activity test prior to the learning test. During the learning trial, the same groups (i.e., MeHg + Hg degrees and Hg degrees) showed longer latencies and made more errors in acquiring all eight pellets. Generally, the results indicate that prenatal exposure to Hg degrees causes alterations to both spontaneous and learned behaviours, suggesting some deficit in adaptive functions. Coexposure to MeHg, which by itself did not alter these functions at the dose given in this study, served to significantly aggravate the changes.

Estimation of mercury dose by a novel quantitation of elemental and inorganic species released from amalgam

Amalgam fillings constitute, after food, the main source of exposure to mercury for the general population. An evaluation of potential health risks has to be based on the dose of mercury released from the fillings. This dose is estimated by a new procedure of mercury speciation which elutes the released elemental and inorganic mercury with solvents of different polarity (paraffin and saline). In vitro tests with spherical amalgam pellets have shown that mercury release into the solvents is linearily correlated to time and amalgam surface area. Doses estimated in volunteers by this method average 4.5 micrograms/day (range 0.3-13.9), as compared to a dose of 3.4 micrograms/day (range 0.1-11.8) measured conventionally in the oral air. The aforementioned dose, combined with the nearly equal mercury uptake from food, is below the acceptable daily intake of 40 micrograms for all forms of mercury.

Mercury release from dental amalgams: an in vitro study under controlled chewing and brushing in an artificial mouth

The release of mercury vapor from class I amalgam restorations prepared in human molar teeth was studied during chewing simulations in an artificial mouth of a bi-axial servo-hydraulic mechanical test system. So that the total mercury released from the restoration over a fixed time could be determined, a closed chamber surrounded the envelope of chewing motion. In addition, the influence of sampling frequency on mercury release was corrected by the use of different sampling frequencies over a fixed time interval of mercury release measurement and extrapolation to zero sampling time. Thus, a combination of a closed environment and an extrapolation method to determine the mercury release under continuous sampling was used to determine the mercury released under normal breathing conditions. The measured mercury release rate data were used to calculate the potential daily mercury dose in a patient due to a single amalgam restoration, following the method previously outlined by Berglund. The mercury release from both a conventional and a high-copper amalgam was evaluated at different age intervals after the restoration was placed in the teeth. The results show that while the age of the amalgam and the amalgam type influence the extent of mercury release during the initial non-steady-state conditions, the steady-state value of mercury daily dose due to a single amalgam filling is 0.03 micrograms/day, which is well below the calculated threshold-limiting value (TLV) of 82.29 micrograms/day considered dangerous for occupational exposure in the United States.

Combined estimation of mercury species released from amalgam

Amalgam fillings constitute, after food, the main source of exposure to mercury for the general population. Banning amalgam would incur huge costs for additional dental treatment. An evaluation of potential health risks must be based on the mercury dose released from fillings. In this study, dose is estimated by a new procedure of mercury speciation which elutes the released elemental and inorganic mercury with solvents of differing polarity. We tested the procedure by incubating spherical amalgam pellets in a mixture of light paraffin oil and saline (0.9% NaCl). Release of mercury into paraffin and saline was linear in relation to both amalgam surface area and exposure time. Measurements with this method were then extended to a group of 21 amalgam-bearing volunteers. The absorbed dose averaged 4.8 micrograms/day compared with 3.7 measured conventionally in intra-oral air from the same persons. With both methods, the dose was significantly correlated to the number of amalgam-covered tooth surfaces. This dose, combined with the nearly equal mercury uptake from food, is far below the acceptable daily intake limit.

Hg emission from dental amalgam as related to the amount of Sn in the Ag-Hg (gamma 1) phase

Previous studies have shown that: (1) different dental amalgams emit different amounts of Hg vapor after surface films have been removed by abrasion (Boyer, 1988); (2) Sn oxide may be the predominant factor in these surface films that inhibit Hg vapor loss (Okabe et al., 1989); and (3) Sn in the Ag-Hg (gamma 1) phase may influence the vapor pressure of gamma 1 (Reynolds, 1974). The purpose of this study was to explore the relationship between Hg vapor emission and the Sn content of the Ag-Hg (gamma 1) phase in dental amalgam. Eleven commercial amalgams were selected whose gamma 1 phases contain different amounts of Sn. Amalgam specimens were ground on 600-grit carborundum paper and immediately placed into an apparatus designed around a gold film Hg vapor detector. Hg vapor loss in air over a 30-minute period was determined, and the log10 Hg loss/volume fraction gamma 1 was plotted vs. the Sn content of the gamma 1 phase for the 11 test amalgams. A linear regression of these data, showing that of the higher the Sn content in gamma 1, the lower the Hg vapor loss, produced a highly significant R2 = 0.94 (p < 0.001). To examine for differences in vapor pressure among alloys, we eliminated the oxidation effect by conducting these same tests in an argon atmosphere. Although the Hg loss was significantly greater in argon than in air, the same differences among alloys were observed. Thus, from the standpoint of both vapor pressure and oxidation, the amount of Sn in the gamma 1 phase of dental amalgam has a significant and specific influence on the potential for Hg vapor emission.

In vitro effects of metal ions on cellular metabolism and the correlation between these effects and the uptake of the ions

The effects of Ag+1, Au+3, Cd+2, Cu+2, Ga+3, In+3, Ni+2, Pd+2, and Zn+2 on DNA synthesis, protein synthesis, succinic dehydrogenase activity, and total cellular protein of mammalian fibroblasts were measured for exposures less than 12 h. The rates at which these cellular functions responded to metal ion exposure were compared and related to the uptake rate of the ions into the cells. These rates of response were significantly different: DNA synthesis decreased the fastest, followed by protein synthesis, succinic dehydrogenase activity, and total protein. This order of response was similar for most metal ions. At 4 h, the rate of uptake of the metal ions correlated most closely with depression of succinic dehydrogenase activity, whereas at 8 h, the uptake correlated most closely with depression of protein synthesis. The similar response of cells to all metal ions may imply that these ions act on cells by similar mechanisms. The rates of uptake of Ag+1, Cu+2, and Zn+2 were sufficiently fast that in vivo exposures of tissues to these metals for periods less than 12 h would be capable of disrupting cellular metabolism.

Dental mercury--a public health hazard

The aim of this review is to point out the health hazards of the uncontrolled global use of implanted mercury-leaking dental amalgam fillings. In spite of the pandemic use of amalgam, most dentists and doctors are still ignorant about the levels of mercury exposure and its health implications. This review discusses the following chronically neglected aspects in clinical practice: The use of materials science in calculating the mercury exposure levels, which may exceed the TLVs by an order of magnitude; Microbial dissolution and methylation of mercury from amalgam by oral and intestinal bacteria; Diagnostic problems and effects of chronic mercury exposure with emphasis on intestinal, cardiovascular, mental and neurologic symptoms and disorders; Diagnostic value of faeces--instead of urine examination--as the main indicator of Hg exposure; Lack of control groups unexposed to Hg (amalgam free) for epidemiologic investigations of health problems; Contribution of dental mercury to environmental pollution. In conclusion, a lack of interdisciplinary research and of a critical approach to established clinical routine appears to be the reason for the failure of the dental profession to protect the patient from Hg exposure when saving the tooth.

The effect of the electrode potential on the release of mercury from dental amalgam

The effect of the electrode potential on the rate of mercury dissolution from the matrix phase (gamma 1) of dental amalgam was investigated. Specimens of the Ag-Hg phase, with and without dissolved tin, were exposed to synthetic saliva and maintained at various potentials by means of a potentiostat. The amount of dissolved mercury was determined after 24 h by cold-vapor Atomic Absorption Spectrophotometry. Anodic polarization curves for the gamma 1 specimens and pure silver and mercury were also recorded. The results for the Ag-Hg phase showed a potential-independent dissolution rate between -0.6 and -0.1 V (SCE), followed by a sharp increase. Mercury dissolution from the Ag-Hg-Sn phase was much slower than from the tin-free gamma 1 phase, and potential-independent to +0.05 V (SCE); a sharp increase in mercury dissolution was observed at +0.1 V (SCE). The anodic polarization curves for the Ag-Hg-Sn phase indicated passivity between -0.67 V and +0.1 V (SCE), but no clear passivation for the Ag-Hg specimen, silver, or mercury. The results show that in the potential-independent region, mercury dissolved in the atomic form from both the tin-free and tin-containing gamma 1 phase. The increase in dissolution in the upper range of potentials was tentatively attributed to selective anodic dissolution of silver and an onset of electrochemical dissolution. The results indicate that the rate of mercury release from the gamma 1 phase of dental amalgam was not affected by potential changes due to alloying or galvanic contacts unless the potential exceeded some critical value.

An in vitro and in vivo study of the release of mercury vapor from different types of amalgam alloys

The aim of the in vitro part of the study was to measure the rate of release of mercury vapor from different types of dental amalgam in air, and in air during cyclic dipping into isotonic saline solution or Fusayama solution. The measurements were carried out by means of the Mercollector/Mercometer system, based on atomic absorption spectrophotometry. Both new (age approximately 2 months) and old (age approximately 1.5 years) amalgam specimens were studied. The variations in the rate of release of mercury vapor in air during cyclic dipping into aqueous media were most pronounced during the first day of the 10-day period studied. In air during cyclic dipping into the aqueous media, the conventional amalgam specimens released mercury vapor at lower rates over the whole period than did the dispersed and single-composition types studied. The aim of the in vivo part of the study was to determine the daily release of mercury vapor from amalgam restorations made of alloys of the same types and batches as those used in the in vitro part of the study. A series of measurements was carried out on each of eight subjects before and after amalgam therapy. None of the subjects was occupationally exposed to mercury. The subjects had to follow a standardized schedule for 24 h, where they ate, drank, and brushed their teeth at predetermined times (Berglund, 1990). The amount of mercury vapor released per time unit was measured at intervals of 30-45 min. Samples of urine and saliva were analyzed formercury.(ABSTRACT TRUNCATED AT 250 WORDS)

Release of mercury vapor from corroding amalgam in vitro

The release of mercury vapor was determined from eleven different amalgams exposed to externally induced corrosion by galvanic contact with a dental casting gold alloy. The electrolyte was an artificial saliva solution at 37 degrees C. The corrosion rates of the amalgams could be divided into two groups corresponding to the grouping into conventional and high-copper materials. The mercury release rate decreased during the 24 h test period for all the amalgams except one containing indium. There was no significant difference in the total mercury release between the conventional and high-copper amalgams as groups. The same applied for the individual products, except the one containing indium, which released significantly more mercury vapor than the two products with the lowest release.

Interactions between dental amalgams and the oral environment

Dental amalgam fillings interact in a complex way with the environment in the oral cavity as they are subjected to chemical, biological, mechanical, and thermal forces. These forces change the restoration's appearance and properties, while metal ions, amalgam debris, non-metallic corrosion products, and mercury vapor are released into the oral cavity. The phenomena and conditions that affect the amalgam/environment interaction include the chemistry and biochemistry of the environment, formation of biofilms on the amalgam surfaces, existence of localized corrosion cells, galvanic contacts with other metallic restorations, abrasion during mastication, and synergistic effects of the different forces. Corrosion processes result in a degradation of the functional amalgam properties, while tarnishing reactions cause discoloration. Corrosion degradation of amalgam fillings is due mainly to localized corrosion cells in pores and crevices. Corrosion on occlusal surfaces is accelerated by abrasion during mastication, which removes the protective surface films. The average total amounts of metal species, including mercury, released per day in vivo from a restoration have not been determined. Much of the reported indirect evidence for high mercury release rates is either unreliable or controversial. A more detailed investigation is needed and will require the development of more sophisticated techniques of sampling in vivo, as well as both experimental and theoretical modeling in vitro.

Behavioural effects of neonatal metallic mercury exposure in rats

The effect of neonatal exposure of rats to mercury vapour (Hg0), at the concentration 0.05 mg/m3, 1 h (low dose) or 4 h (high dose), on the behaviour in adulthood were studied. Exposure occurred on days 11-17 (the period of rapid brain growth). Tests for spontaneous motor activity were performed at the ages of 2 and 4 months. Rats exposed to the high dose Hg0 showed a marked increase in variables locomotion and total activity but a decrease for rearing when tested at 2 months of age. At 4 months of age these rats showed a marked hypoactivity with respect to all three variables. Rats exposed to the low dose showed no significant differences at 2 months compared to controls. However, at the age of 4 months the same pattern (increase in variables locomotion and total activity but a decrease for rearing) already noticed in the high dose group at 2 months was observed. In the spatial learning tasks applied, the radial arm maze and circular swim maze, neonatally exposed pups showed a retarded acquisition to the former, while there was no difference compared to controls in the latter. These data indicate that neonatal exposure to mercury vapour results in similar behaviour changes as reported from offspring prenatally exposed to mercury vapour or methylmercury. Furthermore, exposure for 1 week to concentrations around Swedish threshold values (TLV) for 1 or 4 h resulted in dose and age-related behavioural changes.

Dental amalgam: the materials

The goal of this presentation is to describe the material as it is used clinically, explain why small quantities of Hg can be released, and suggest ideas for amalgams that do not release mercury. A set amalgam is a dynamic material that undergoes many microstructural changes during clinical use, related to both the elevated temperature and corrosion-prone environment in the mouth and mechanical forces applied to the restoration. Amalgams can be divided roughly into two groups by their copper content: low Cu (traditional) and high Cu. High-Cu amalgams generally perform better clinically, but all amalgams corrode to some extent in the mouth. Some corrosion is deemed to be a positive factor, because corrosion product deposition reduces leakage at the margins of restorations; that is, the restorations are partly self-sealing. One of the reasons cited for the improved clinical performance of high-Cu amalgams over low-Cu amalgams is that the corrosion-prone phase, gamma 2, is nearly eliminated in high-Cu amalgams. Future research should involve improvements in the clinical performance of dental amalgams, studies of the mercury release from various types of amalgams and the toxic potential of this exposure, and the development of new amalgam systems that reduce the mercury exposure. Although the longevity of modern amalgams is impressive, it is important for their stability to be increased both clinically and microstructurally. An amalgam should be developed with a stable microstructure that, once set, would not change during clinical use. Microstructural changes lead to clinical deterioration. A stable system would not corrode, and the matrix transformation gamma 1 to beta 1 would be prohibited.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of cleaning on the kinetics of in vitro metal release from dental casting alloys

The kinetics of the release of elements from six dental casting alloys into cell-culture medium was assessed by means of atomic absorption spectroscopy. Alloys were evaluated in the polished and polished-cleaned conditions so that the effects of cleaning could be determined. Auger scanning microscopy was used for analysis of the surfaces of selected alloys before and after exposure to the cell-culture medium. Release patterns for each element were characterized by the shape of the dissolution vs. time curve, concentration of the element at 12 h as a percentage of the 72-hour concentration, and the relative slope of the curve from 48 to 72 h. Three patterns of release were observed for elements in these alloys. Type I patterns had logarithmic shapes with relatively large 12-hour concentrations and low 48-72-hour slopes. Type II patterns had logarithmic shapes but with moderate 12-hour concentrations and 48-72-hour slopes. Type III patterns were polynomial in shape, had relatively low 12-hour concentrations, and had large 48-72-hour slopes. Cleaning did not change the pattern of release but did generally significantly decrease the quantities of elements released (p = 0.05). The type of dissolution vs. time curve appeared to be dependent upon the element and the composition of the alloy. When cleaning reduced dissolution, surface analyses showed that the cleaning process increased the abundance of elements such as Au and Pd and reduced the abundance of Ag and Cu. Elements which were released from the alloys were more abundant on the surface than in the bulk in both polished and polished-cleaned conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental amalgam and mercury

The mercury concentrations in blood (HgB) and urine (HgU) samples, and in exhaled air (HgAir) were measured in 147 individuals from an urban Norwegian population, using cold vapour atomic absorption spectrometry. The study aimed to estimate the mercury exposure from the dental restorations, by correlating the data to the presence of amalgam restorations. Mean values were HgB = 24.8 nmol/l, HgU = 17.5 nmol/l and HgAir = 0.8 micrograms/m3. HgU correlated with HgAir, and both HgU and HgAir with the number of amalgam restorations, amalgam restored surfaces and amalgam restored occlusal surfaces. HgB showed poor correlation to HgU and HgAir and the presence of amalgam restorations. A differentiation of the mercury absorption due to exposure from dental amalgams and from the dietary intake, necessitates measurements of both organic and inorganic mercury in the plasma, and in the erythrocytes. The results suggest that individuals with many amalgam restorations, i.e., more than 36 restored surfaces, absorb 10-12 micrograms Hg/day.