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1.
The current study was to answer the question: Is enough mercury absorbed from dental amalgam fillings to produce renal damage? One hundred healthy adults (18-44 years old) filled out health questionnaires and voided urine samples. Urine mercury concentration and N-acetyl-beta-glucosaminidase (NAG) were measured. Subjects were grouped into those having amalgam fillings (N = 66) and those without (N = 34). Median (95% Confidence Interval) urine mercury was 1 (1-2) and 0 (0-0.6) ng/ml (P < 0.01) and median urine NAG was 23 (18-27) and 16 (11-18) units (P < 0.05) in the two groups respectively. People with mercury amalgam fillings excreted slightly more mercury than people without them, and have a very small increase in urinary NAG excretion that is probably of no clinical significance. This dose of mercury absorbed from amalgam appears to be too little to be a public health hazard for renal injury.  相似文献   

2.
Next to nutrition, amalgam fillings represent the main source for exposure of the general population to mercury. Toxicological considerations focus on the dose of mercury resulting from such exposure. Various approaches to estimate this dose are reviewed. Introducing the dose into the known toxicokinetic model for mercury, tissue and blood and urine concentrations related to mercury release from the fillings can be predicted. These agree well with autopsy and in vivo observations. An assessment of the health hazard for individuals with amalgam fillings shows that the combined mercury intake from food and amalgam does not exceed the acceptable daily intake. In addition, blood and urine mercury concentrations of amalgam bearers are below one tenth of the critical values associated with the onset of early symptoms or of subclinical effects attributable to mercury.  相似文献   

3.
The influence of application of skin-lightening creams and dental amalgam fillings on the urinary mercury (Hg) level was evaluated in 225 females (ages 17 to 58 years) living in Riyadh, capital of Saudi Arabia. The arithmetic mean of the urinary Hg level was 6.96 +/- 20.43 micrograms 1(-1), in the range 0 to 204.8 micrograms 1(-1). The mean urinary Hg level adjusted by creatinine (Cr) was 11.22 +/- 37.23 micrograms g-1 Cr, in the range 0 to 459.37 micrograms g-1. No significant difference in urinary Hg was noted between the females regarding the use of skin-lightening creams. On the other hand, results showed that urinary Hg concentration was influenced by the use and number of dental amalgam fillings. No women were identified with symptoms or signs that could be attributed to Hg intoxication. Urine analyses for creatinine, urea, uric acid, phosphorus, magnesium, glucose and calcium showed significant correlation with urinary Hg. This suggests that chronic exposure to Hg may be associated with a deterioration of renal function.  相似文献   

4.
Six groups of genetically mercury-susceptible female SJL/N (H-2s) mice were exposed to mercury vapor at a concentration of 0.3-1.0 mg Hg/m3 air for 0.5-19 hr/day 5 days a week for 10 weeks. The absorbed doses were calculated to be between 75 and 2365 micrograms Hg/week/kg body wt (micrograms Hg/week/kg). The correlation between the dose and the concentration of Hg in kidney, spleen, and thymus was highly significant (p < 0.0001; Spearman's rank correlation test). The lowest observed adverse effect level (LOAEL) for serum IgG antinucleolar antibodies (ANoA) was 170 micrograms Hg/week/kg, corresponding to a renal mercury concentration of 4.0 +/- 0.76 micrograms Hg/g wet wt. The correlation between the absorbed dose and the ANoA titer was highly significant (p < 0.0001; Spearman's rank correlation test), and all mice were ANoA-positive at a dose of 480 micrograms Hg/week/kg. High-titer ANoA targeted the nucleolar 34-kDa protein fibrillarin. The LOAEL for B-cell stimulation, measured as an increase in serum IgG2a and IgG1 concentrations, was 360 micrograms Hg/week/kg, but the increase was fivefold higher and also included IgE at a dose of 690 and 2365 micrograms Hg/week/kg. The serum Ig concentrations peaked after 2-4 weeks and then slowly declined but, except for IgE, remained significantly increased during the entire exposure time. Glomerular, mesangial IgG immune complex (IC) deposits, accompanied by systemic vessel wall IC deposits, were first detected at a dose of 480 micrograms Hg/week/kg. The mesangium also showed increased titers of IgM IC deposits and complement factor C3c. The correlation between the absorbed dose, and the individual titer of IgG, IgM, and C3c, was highly significant (p < 0.0001; Spearman's rank correlation test). In conclusion, mercury vapor efficiently induced an autoimmune syndrome in genetically susceptible mice, and the LOAEL for the adverse effects varied in the order ANoA < B-cell stimulation < IC deposits. Comparing the body burden of mercury in mice at the LOAEL for autoantibodies with the body burden in populations of occupationally exposed humans suggests that the safety margin may be narrow for genetically susceptible individuals.  相似文献   

5.
Biological monitoring of mercury (Hg) in blood, urine and hair was performed in volunteers with amalgam fillings, in subjects who consumed fish and in Hg-exposed workers. It was found that both amalgam fillings and the consumption of fish burden the organism with Hg in the same order of magnitude. The Hg concentrations in urine in the occupationally exposed group were higher by a factor of about 100 compared to the group with amalgam fillings. No pathological changes were found in the exposed workers. It seems safe to conclude that no health-related problems from Hg are to be expected from amalgam fillings.  相似文献   

6.
Dental amalgam is the most widely used filling material in dentistry. In our country there are an estimated 40 million amalgam fillings in place. The mercury present in these fillings has caused health concerns over the last 160 years that amalgam has been used in decayed teeth. The fears have always proven to be unjustified and no harmful effects have ever been demonstrated in dental patients. Mercury can be found in several forms. In dentistry, only the metallic form is used, while inorganic and organic compounds are also present in the environment. The metallic form is absorbed in the human body mostly through the lungs. Once mercury reaches toxic levels inside the body, it will interfere with cell metabolism. Most important among the target organs are the brain, the liver and the kidneys. Elimination occur through urine and feces. Mercury is universally found in blood and urine. The concentration depends on absorption by air, water, nutrition, medication (including dental fillings) and occupational hazards. There are four kinds of objectives to dental amalgam: oral galvanism, toxicity, allergenicity and ecological grievances. Disorders from oral galvanism are difficult and delicate to evaluate as the actual currents are very small. Furthermore, no significant difference can be found in current intensity between patients with and without complaints. Finally patients with complaints often present other oral disorders, the treatment of which most often eliminates all complaints that could be attributed to oral galvanism. Toxicity is dose dependent. Industrial safety rules indicate that the amount of mercury absorbed from dental amalgam fillings is far below the safety level. HgB and HgU levels in patients with amalgam fillings are situated well below the acceptable levels. Allergic disorders are observed in patients with amalgam fillings but far less than expected in view of the wide spread use of dental amalgam. The problem of mercury spilling from dental amalgam fillings into the environment will be resolved by strict legislation in the near future. In this context, it can be stated that the use of dental amalgam is safe and justified. Furthermore, it is also advisable as no other material can meet the actual dental needs as efficiently as can dental amalgam.  相似文献   

7.
This is the second article in a series of seven on the future of dental amalgam. It describes the means of exposure to mercury which can occur in dental surgeries from the storage of mercury, preparation and placement of dental amalgam restorations, polishing dental amalgam restorations, the removal of amalgam fillings and the storage of waste amalgam. It also reports on the monitoring of dental practices and studies on the mercury air levels in dental surgeries and blood and urine levels in dentists and their staff. Also, studies which compare these levels with the health and neurobehaviour of dentists and their staff are included. In addition, it discusses post-mortem studies of the mercury levels in body organs in dentists and controls. It then recommends methods for the safe handling of mercury and dental amalgam. Finally, it discusses the issues surrounding the release of mercury into the environment from dental practices and industry.  相似文献   

8.
Potential toxicity from exposure to mercury vapor (Hg(o)) from dental amalgam fillings is the subject of current public health debate in many countries. We evaluated potential central nervous system (CNS) toxicity associated with handling Hg-containing amalgam materials among dental personnel with very low levels of Hg(o) exposure (i.e., urinary Hg <4 microg/l), applying a neurobehavioral test battery to evaluate CNS functions in relation to both recent exposure and Hg body burden. New distinctions between subtle preclinical effects on symptoms, mood, motor function, and cognition were found associated with Hg body burden as compared with those associated with recent exposure. The pattern of results, comparable to findings previously reported among subjects with urinary Hg >50 microg/l, presents convincing new evidence of adverse behavioral effects associated with low Hg(o) exposures within the range of that received by the general population.  相似文献   

9.
In response to public concern, Health Canada recently conducted a review of amalgam safety and released a position statement entitled The Safety of Dental Amalgam. Essentially, the department has concluded that the levels of mercury absorbed by the body due to the release of mercury vapor from amalgam restorations, while detectable, do not approach those recognized to cause illness. It has therefore confirmed that amalgam restorations can be used safely in most patients, with some notable caveats. Despite Health Canada's position statement in support of amalgam, patient doubts about amalgam safety remain, including the tenuous hypothesized link between amalgam restorations and specific diseases. This article reviews the available studies of dentist mortality to identify possible links between mercury exposure and negative health effects. A lack of evidence to suggest a detrimental health outcome in dentists who are occupationally exposed to higher levels of mercury than their patients, and are known to have higher levels of mercury in their blood, provides an important reassurance concerning the safety of amalgam. The reviewed data indicates that the 10 leading causes of death in the United States and Canada are the same for both dentist and non dentist population groups, and that the percentage of deaths by the same cause are remarkably similar. By 1975, the year of the most recent U.S. study, the average age at death for white male dentists was about three years higher than for all adult white males. Although suicide standard mortality rates are known to be higher for dentists, suicide deaths have also been shown to be a factor in many other occupations, particularly those where there is easy access to drugs. Although updated actuarial data for dentist mortality are needed, the available data indicate no reduction in the life expectancy of practising dentists, nor any specific or disproportionate rates of disease associated with high mercury exposure. In fact, the available mortality studies are generally optimistic about the health of dentists, which should reassure patients about the safety of dental amalgam.  相似文献   

10.
For the past ten years, the amounts of mercury vapor released from dental amalgams and the possibility of side-effects caused by these amounts have been discussed. Although no adverse health effects have been substantiated from these minute amounts, besides rare cases of allergies, this release should be reduced. The aim of this study was to reduce the mercury evaporation from a high-copper amalgam during setting by triturating the alloy powder with binary Hg-In liquid alloys having various indium concentrations set at 0, 5, 10, 20, 30, 40, and 50 wt%. Specimens (n = 4) were made for each amalgam according to ANSI/ADA Specification #1 and placed into a measuring chamber kept at 36.5 +/- 0.5 degrees C, through which a continuous air flow of 0.75 L/min was pumped. The total mercury release was measured during the setting period, according to the method described by Ferracane et al. (1992). Four additional specimens were prepared from a modified 14% Indisperse amalgam powder for the purpose of comparison. The results showed that the release of mercury vapor decreased with increasing indium concentrations, and that the amalgams made with the Hg-In liquid alloy with 10% In or more released significantly less mercury than the modified 14% Indisperse. The method of mixing indium in mercury prior to trituration appeared to be another effective method for reducing mercury evaporation during setting. The reduced mercury release may be explained by a reduction of mercury concentration in the structure, a reduction of vapor pressure for the mercury in the matrix phases, or more efficient formation of a surface oxide layer.  相似文献   

11.
During 1993-95 a total of 169 patients (112 women, 57 men) with a wide range of complaints associated with earlier or present amalgam fillings were seen by the "Dental Biomaterials Adverse Reaction Unit" in Norway. Most patients had amalgam fillings; 19 had removed all amalgam, and 14 were in the process of replacing the amalgam fillings with other materials. Predominant symptoms were of a subjective and general nature (96% of the patients). Muscle and joint pain, headache, dizziness and feeling exhausted comprised the most common symptoms. Intra-oral pathology was observed in 48%. There was a correlation between the amount of amalgam ("amalgam score") and urinary mercury. Those without amalgam fillings and significantly lower values (median = 1.6 micrograms mercury/g creatinine) than those with amalgam fillings (medians: with amalgam = 3.5 micrograms/g; with partial removal of amalgam = 2.7 micrograms/g). Overall, in the present group of patients, no statistically significant correlation seemed to exist between the type and number of subjective symptoms or objective findings and the urinary mercury. This would indicate therefore that there is no straightforward association between urinary mercury and symptoms in the present group of patients.  相似文献   

12.
Earlier studies have failed to establish a consensus on the amount of mercury vapour released from dental amalgam restorations. The purpose of this study was to accurately and quantitatively measure the equilibrium mercury vapour pressure from dental amalgam. The vapour pressure was measured using a quartz crystal microbalance as a function of the load from 0-5.4 MPa. Auger spectra were collected of the as-formed and argon ion sputter cleaned dental amalgam surface. For the as-formed surface the mercury vapour density is zero with no load and increases to 0.6 microg m(-3) at 5.4 M Pa. Following cleaning the mercury, vapour density increased to a maximum value of 15 microg m(-3). The Auger spectra of the as-formed surfaces were dominated by features associated with carbon and oxygen. These spectral results in concert with the mercury vapour density measurements indicate that the oxide film on the as-formed surfaces inhibited the release of mercury vapour. The results of this experiment provide an upper limit for the amount of mercury vapour released by dental amalgams. Under conditions simulating the oral cavity this value would be reduced by oxides that form on the surface of dental amalgam restorations.  相似文献   

13.
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.  相似文献   

14.
This article reports an experimental and theoretical investigation of mercury dissolution from dental amalgams immersed in neutral (noncorrosive) and acidic (corrosive) flows. Atomic absorption spectrophotometric measurements of Hg loss indicate that in neutral flow, surface oxide films formed in air prior to immersion persist and effectively suppress significant mercury release. In acidic (pH 1) flows, by contrast, oxide films are unstable and dissolve; depending on the amalgam’s material composition, particularly its copper content, two distinct mercury release mechanisms are initiated. In low copper amalgam, high initial mercury release rates are observed and appear to reflect preferential mercury dissolution from unstable Sn8Hg (γ 2) grains within the amalgam matrix. In high copper amalgam, mercury release rates are initially low, but increase with time. Microscopic examination suggests that this feature reflects corrosion of copper from grains of Cu6Sn5 (η′) and consequent exposure of Ag2Hg3 (γ 1) grains; the latter serve as internal mercury release sites and become more numerous as corrosion proceeds. Three theoretical models are proposed in order to explain observed dissolution characteristics. Model I, applicable to high and low copper amalgams in neutral flow, assumes that mercury dissolution is mediated by solid diffusion within the amalgam, and that a thin oxide film persists on the amalgam’s surface and lumps diffusive in-film transport into an effective convective boundary condition. Model II, applicable to low copper amalgam in acidic flow, assumes that the amalgam’s external oxide film dissolves on a short time scale relative to the experimental observation period; it neglects corrosive suppression of mercury transport. Model III, applicable to high copper amalgam in acidic flow, assumes that internal mercury release sites are created by corrosion of copper in η′ grains and that corrosion proceeds via an oxidation-reduction reaction involving bound copper and diffusing hydrogen ions. The models appear to capture the correct time dependence of each dissolution mechanism and to provide reasonable fits to the experimental data.  相似文献   

15.
AIM OF THE STUDY: The aim of this study was to investigate the concentration of metals of environmental-medical relevance in biological materials in persons seeking asylum with regard to their country of origin. COLLECTIVE AND METHOD: During medical examination after entry into Germany of persons seeking asylum, samples were taken for determination of the following biological monitoring parameters: lead in blood, and arsenic, cadmium and mercury in urine. A total of 103 males were investigated (13 from former Yugoslavia, 29 from the former USSR, 33 Africans and 28 Asians) ranging from 16 to 53 years of age (median 27 years). 34 male Germans without occupational exposure to these substances and a similar age structure (age 25-36 years; median 26 years) served as a control group. RESULTS: The countries of origin had a significant influence on all the biological monitoring parameters investigated. The mean blood lead concentration in the Asians of 75.4 micrograms/L was the highest level found, while the lowest concentration of 38.0 micrograms/L was measured in the German controls. Also the level of arsenic excreted in the urine was on average much higher in the persons seeking asylum than in the German controls. In the Africans a mean level of 9.7 micrograms/g creatinine was reached. The Germans had the lowest arsenic concentrations in urine of 5.3 micrograms/g creatinine. There were, however, considerable interindividual fluctuations, which are probably due to oral uptake of arsenic compounds as a result of eating seafoods. The highest mean concentration of mercury excreted in urine was found in the German controls. Values of 0.9 microgram/g creatinine were determined. The men seeking asylum from former Yugoslavia had significantly higher values than other groups for cadmium excreted in urine. The median of 0.6 microgram/g creatinine was nearly three times as high as found in the Germans. CONCLUSIONS: For all parameters investigated, with the exception of mercury, higher internal exposure was found in the persons seeking asylum than in the German controls. This may be due to individual life style, dietary habits or environmental conditions in the country of origin. For clinical environmental medicine, the 95th percentile, as the upper limit of the reference range, can only be regarded as an orientation aid for classifying the exposure to hazardous substances of an individual compared to other persons from the same environment.  相似文献   

16.
OBJECTIVE: The aim of the present study was to determine whether removal of all amalgam restorations might significantly affect mercury levels in plasma and urine and whether the use of rubber dams might reduce patient exposure to mercury during amalgam removal. METHODS: All amalgam restorations were removed from 18 subjects during a single treatment session in which a rubber dam was used and from 10 subjects when a rubber dam was not used. All amalgam restorations were removed by the same dentist using high-speed cutting, water coolant, and high-volume evacuation. The levels of mercury in plasma and urine were analyzed both before and during the subsequent twelve months after amalgam removal. In order to determine whether removal of all amalgam restorations might cause an exposure large enough to significantly increase the mercury levels in two indicator media for mercury exposure, i.e., plasma and urine, and to determine if the removal might cause a significant decrease in the mercury levels found over time, the one-tailed, paired Students' t-test was used. For each individual, the pre-removal levels were compared with both the levels found in plasma on d 1 and in urine on d 10, and also with the levels found 1 y after removal. Furthermore, in order to examine whether the use of rubber dams had any effect on the mercury levels found after removal, the changes in the mercury levels found were compared between the groups using the Wilcoxon-Mann-Whitney rank sum test. RESULTS: After removal of all amalgam restorations, only the non-rubber dam group showed significant increases in the mercury levels found in plasma (p = 0.012) and urine (p = 0.037). However, one year later, the mercury levels in plasma and urine had sunk significantly below the pre-removal levels for both groups. When the changes in the mercury levels found were compared between the groups, the non-rubber dam group showed a significantly higher increase of mercury in plasma than the rubber dam group the day after removal (p = 0.0010). Compared to the pre-removal mercury levels in plasma and urine, the levels found 1 y after removal of all amalgam restorations were on average 52 +/- 23% (range 4-89%) lower in plasma and 76 +/- 21% (range 20-94%) lower in urine. SIGNIFICANCE: The study showed that dental amalgam had a statistically significant impact on the mercury levels found in plasma and urine in the patients tested, and that the use of a rubber dam during removal of all amalgam restorations significantly reduced the peak of mercury in plasma following removal.  相似文献   

17.
Recent studies have shown that metal ions can be released from dental amalgam or other dental materials, and can cause toxic effects on various cells. In this study, the effects of amalgam-conditioned culture medium (ACCM), components of amalgam (Ag+, Cu2+, Sn2+, Hg2+) and dental composite-conditioned culture medium (CCCM) on histamine release from human blood basophils (healthy subjects, n = 3) and tissue mast cells (n = 3) were analyzed. ACCM and CCCM were prepared using either fresh or 6-weeks-aged specimens. Of the metal ions tested, Ag+, and Hg2+ were found to induce histamine release from basophils (Ag+, 0.33 mM: 83 +/- 11% vs Hg2+, 0.33 mM: 100% vs control medium: 5 +/- 5%) and mast cells (Ag+, 0.33 mM: 91 +/- 16% vs Hg2+, 0.33 mM: 99 +/- 1% vs control: 2 +/- 1%), whereas no effects were seen with Cu2+ and Sn2+. Neither ACCM from freshly prepared amalgam nor ACCM from 6-weeks aged amalgam, produced histamine release in basophils or mast cells. Inductively coupled plasma atomic emission spectrometry (ICP) revealed that the Ag(+)- and Hg(2+)-concentrations in ACCM were below the range in which histamine release occurred. Similar to ACCM, no effects on basophils or mast cells were observed with CCCM. In summary, our data show that distinct metal ions present in dental amalgam, can induce (toxic) histamine liberation from basophils and mast cells. However, the amounts of metal ions released from amalgam apparently were too low, to cause histamine release.  相似文献   

18.
This is the fifth article in a series of seven on the future of dental amalgam. This covers the studies of mercury distribution to the blood, body organs and the fetus and its excretion in the urine and faeces of humans and experimental animals. It firstly describes the clinical studies comparing the blood and urine mercury levels in patients with and without amalgam fillings and goes on to consider attempts which have been made to calculate tolerable mercury thresholds for the urine. It secondly describes the studies on the body distribution of mercury from amalgam restorations in experimental animals and human cadavers. It finally describes the studies of mercury distribution to the fetus during pregnancy and includes both studies of experimental animals and human clinical studies. The factors affecting the accuracy of these calculations and the relevance of these results is also extensively discussed.  相似文献   

19.
Eleven patients with amalgam illness aged 33-50 years were investigated by psychodynamic methods. Six of them, all women, were dental nurses and hygienists exposed to amalgam/mercury both from their own dental fillings and occupationally. Four men and one woman were exposed only to amalgam/mercury from their own fillings. Assays of mercury in urine samples and in the ambient air during work routines involving the heaviest exposure indicated that the exposure was far below the levels at which even subclinical symptoms could be indicated by psychometric tests. The psychologic investigation indicated that the symptoms of amalgam illness were psychosomatic. All patients had experienced important psychic traumata in close connection with the first appearance of symptoms. It can be concluded from the psychodynamic dialogues that they had not been able to mourn for a loss in an adequate manner and that the body had been forced to symbolize the great pain in their souls.  相似文献   

20.
A model using semidomesticated mink was set up to study the effects of chronic oral methylmercury exposure in piscivorous mammals. Three groups of mink were fed daily with diets containing approximately 0.1, 0.5, and 0.9 micrograms/g of total mercury. Piscivorous and non-piscivorous fish, naturally contaminated with methylmercury, were used to prepare diets. Renal injury was evaluated using total urine protein/creatinine ratio and differentiation of urinary low-molecular-weight and high-molecular-weight proteins on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The significance of the total urine protein/creatinine ratio data was assessed by comparing the results to a 95% group-based reference interval. The values for total urine protein/creatinine ratio did not reveal any significant increased excretion, and no dose-related trends were observed within the reference interval. Overall the total urine protein data did not suggest renal damage. Analysis of the SDS-PAGE electrophoretograms did not suggest the presence of any persistent glomerular damage in any group. High-molecular-weight proteins were not detected more frequently for any of the dose groups. During the adaptation phase, the B2M-like protein band was not remarked during the visual analysis of the gels. The B2M-like protein band was remarked during the gel analysis only several weeks into the exposure phase. This B2M-like protein band was more prevalent in urine samples taken from minks in the 0.5 and 0.9 micrograms/g groups than in the 0.1 microgram/group. These latter data, however, did not allow an evaluation of a quantitative dose-response excretion with time. The B2M-like data are suggestive of very minor renal injury.  相似文献   

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