Amalgám

Erythematous lesion on the adjacent oral soft tissues

• Tongue and buccal mucosa

Hypersensitivity reaction

Asociovaná onemocnění

• Chronic exposure, even to low concentration levels of mercury, can cause
• Cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity [2]

Expozice

• Workers
• Usually exposed to substantially higher Hg(0) levels than individuals with dental amalgam restorations
• Typically exposed 8 hours per day for 20-30 years [1]

• Persons with dental amalgam restorations
• Exposed 24 hours per day over some portion of a lifetime
• no convincing evidence pointing to any adverse health effects that are attributable to dental amalgam restorations
• Only hypersensitivity in some individuals [1]

Historie

• American Dental Association
• Said for the past 150 years that the mercury in amalgam is safe and does not leak
• no clinical studies were ever done [2]

• Food and Drug Administration
• Approved amalgam under a grandfather clause
• Subsequent studies have shown this claim of safety not to be true [2]

• Federation of American Societies for Experimental Biology Journal
• Published a comprehensive article calling mercury restorative material a major source of mercury exposure to the U.S. population [2]

Informovaný souhlas

• In Europe, the federal governments of Norway, Finland, Denmark, and Sweden
• Legislation requiring that dental patients receive informed consent information about the dental restorative material that will be used.
• United States, a few state governments have enacted informed consent legislation for dental patients receiving dental restorations.
• Maine, California, Connecticut, and Vermont [2]

Kardiovaskulární nemoci

• Hypertension
• Coronary heart disease
• Myocardial infarction
• Neurotoxic effects of mercury might also impact cardiac autonomic function
• Mercury exposure
• Could have a long-lasting effect on
• Cardiac parasympathetic activity
• Might affect heart rate variability
• Particularly early exposures in children [2]

Oxidační stres

• Exposure to mercury increases
• Production of free radicals
• Role of mercury in the Fenton reaction
• Reduction in the activity of antioxidant enzymes
• Glutathione peroxidase [2]

Popis

• Widely used restorative dental material
• Introduced over 150 years ago
• Most standard dental amalgam formulations contain approximately 50% elemental mercury [1,2]
• 50% mercury (Hg) in a complex mixture of copper, tin, silver, and zinc [2]
• Hg(0) is released from dental amalgam restorations and is absorbed by the human body

• Numerous studies report positive correlations between:
• The number of dental amalgam restorations or surfaces and urine mercury concentrations in nonoccupationally exposed individuals [1]

Uvolňování vyšší

• Well documented that this mixture continually emits mercury vapor
• Dramatically increased by chewing, eating, brushing, and drinking hot liquids [2]

NÚ

• Historically, studies of occupationally exposed individuals provided consistent information
• Relationship between exposure to Hg(0) and adverse effects
• Nervous system
• Renal dysfunction :1::