Peracetic Acid: A Practical Alternative to Formalin for Disinfection of Extracted Human Teeth

Extracted human teeth provide the closest approximation to teeth in situ and play important roles in dental education and materials research. Since extracted teeth are potentially infectious, the Centers for Disease Control recommend their sterilization by autoclaving or disinfection by formalin immersion to ensure safe handling. However, autoclaving is not recommended for teeth with amalgam fillings and formalin is hazardous. The goal of the present study was to investigate the potential of peracetic acid (PA) as an alternative method to achieve reliable disinfection of freshly extracted teeth. A total of 80 extracted teeth were collected for this study. Whole teeth were incubated in one of four solutions for defined periods of time: sterile water (2 weeks), formalin (2 weeks), PA 1000 ppm (2 weeks), and PA 2000 ppm (1 week). After sectioning, the crown and root fragments were transferred into separate tubes containing brain–heart infusion broth and incubated at 37 °C under anaerobic conditions for 72 h. Absence of broth turbidity was used to assess effectiveness of disinfection. No turbidity was observed in any of the formalin-treated or peracetic acid-treated samples, signifying complete disinfection. Our results indicate that PA can effectively disinfect extracted human teeth, providing a reliable alternative to formalin and autoclaving.

The Hazardous Effects of Dental Amalgam Fillings in Human Body: A Systematic Review

The Dental amalgam used in the dental fillings is basically an alloy of mercury (Hg). The amalgam is one of the most commonly used and versatile restorative material. Since more than 150 years this alloy of mercury, that is amalgam is used for it been economical, easy to use, durable, high strength and bacterio-static characteristics. Due to environmental pollution, detrimental health its use is decreasing in recent times. Also its not so appealing like the other materials used that resemble the tooth color. The tooth coloured restorative materials are recommended by both the doctor and the patient. Many researchers suggested that over the period of time the mercury from the filling might leach into the mouth. Thus in this study a detailed review of all the literature available online is done to understand the hazardous effects of dental amalgam fillings in the human body. The systematic literature search using Scopus, PubMed, EMBASE and Web of Science electronic databases was done using PRISMA. The experiments conducted in Sheep and monkey suggested the penetration of amalgam into the jaw bone of the patient with dental restorations. Constant exposure of mercury at lower levels can also lead to multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus. Most commonly reported renal dysfunction due to the dental amalgams are Tubular and Glomerular damage of the kidneys.

Validity and responsiveness of EQ-5D-5L and SF-6D in patients with health complaints attributed to their amalgam fillings: a prospective cohort study of patients undergoing amalgam removal

Background Evidence of health utility changes in patients who suffer from longstanding health complaints attributed to dental amalgam fillings are limited. The change in health utility outcomes enables calculating quality-adjusted life-year (QALY) and facilitates the comparison with other health conditions. The purpose of this study was to estimate the validity and responsiveness of the EQ-5D-5L and SF-6D utilities following removal of dental amalgam fillings in patients with health complaints attributed to their amalgam fillings, and examine the ability of these instruments to detect minimally important changes over time. Methods Patients with medically unexplained physical symptoms, which they attributed to dental amalgam restorations, were recruited to a prospective cohort study in Norway. Two health state utility instruments, EQ-5D-5L and SF-6D, as well as self-reported general health complaints (GHC-index) and visual analogue scale (EQ-VAS) were administered to all patients (n = 32) at baseline and at follow-up. The last two were used as criteria measures. Concurrent and predictive validities were examined using correlation coefficients. Responsiveness was assessed by the effect size (ES), standardized response mean (SRM), and relative efficiency. Minimally important change (MIC) was examined by distribution and anchor-based approaches. Results Concurrent validity of the EQ-5D-5L was similar to that of SF-6D utility. EQ-5D-5L was more responsive than SF-6D: the ES were 0.73 and 0.58 for EQ-5D-5L and SF-6D, respectively; SRM were 0.76 and 0.67, respectively. EQ-5D-5L was more efficient than SF-6D in detecting changes, but both were less efficient compared to criteria-based measures. The estimated MIC of EQ-5D-5L value set was 0.108 and 0.118 based on distribution and anchor-based approaches, respectively. The corresponding values for SF-6D were 0.048 and 0.064, respectively. Conclusions In patients with health complaints attributed to dental amalgam undergoing amalgam removal, both EQ-5D-5L and SF-6D showed reasonable concurrent and predictive validity and acceptable responsiveness. The EQ-5D-5L utility appears to be more responsive compared to SF-6D. Trial registration The research was registered at ClinicalTrials.gov., NCT01682278. Registered 10 September 2012, https://clinicaltrials.gov/ct2/show/NCT01682278.

Mercury Exposure Assessment in Mother–Infant Pairs from Continental and Coastal Croatia

The main source of mercury (Hg) exposure in the general population is fish. Another possible source is dental amalgam. Here, we compare the levels of Hg and selenium (Se) in samples of maternal and fetal origin collected shortly after childbirth of healthy postpartum women in the coastal (n = 96) and continental (n = 185) areas of Croatia related to maternal seafood/fish consumption. We also evaluated Hg concentrations and maternal serum metallothionein (MT2) concentrations in relation to the number of dental amalgam fillings, and MT2A-5A/G (rs28366003) polymorphism. The levels of Hg and Se in maternal hair and blood/serum, placenta and cord blood/serum increased in relation to increasing fish consumption with the highest values in subjects from the coast. The concentrations of each element and between elements correlated across the matrices. Increasing amalgam number correlated linearly with increased Hg levels in maternal and cord serum and was not associated with serum MT2. No association of MT2A-5A/G polymorphism and Hg or Se levels were found. The results confirmed higher fish consumption in coastal vs. continental Croatia and increases of both Hg and Se related to fish consumption in all analyzed samples. Increased blood Hg reflected the predominant MeHg share from seafood, while increased serum Hg matched exposure from dental amalgams.

The determination of mercury levels in the blood and hair of rabbits with amalgam fillings

Purpose: This study was conducted to investigate the level of blood and hair mercury transition in rabbits depending on the number of amalgam filled teeth in the mouth. Material and Methods: A total of 18 male rabbits from New Zealand were used in the study. The rabbits were separated into three groups in this study. The first group was named as control group, the second group was named as dichotomous filled group, and the third group was named as quadruple amalgam filled group. Blood samples were collected from filler animals before the filling, at 24 hour, at the first week and month and also hair samples were taken before the filling and at the first month. The transfer of mercury, taken by the blood and feather samples of rabbits in the study, was made with the hydride system in the absorption spectrophometer. Results: The data’s, obtained from the study, were evaluated by using the SPSS 21 package program. Compared by the control group at the 24th hour, any statically difference wasn’t seen between dichotomous and quadruple amalgam filling groups in terms of blood mercury level. (P>0.05). However, the level of blood mercury, one week and one month later was significantly higher than the control group.(P<0.05) In the all periods, the level of blood mercury was found similar between dichotomous and quadruple amalgam filling groups (P>0.05). Conclusions: Mercury couldn’t be detected in hair samples. As a result, it was revealed that amalgam filling affects the blood mercury level. How to cite this article: Yerebasan Ü, Servi K, Ataş O, Doğan MS. The determination of mercury levels in the blood and hair of rabbits with amalgam fillings. Int Dent Res 2020;10(1):12-16. https://doi.org/10.5577/intdentres.2020.vol10.no1.3 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Dental Amalgam Fillings and Multiple Sclerosis: A Nationwide Population-Based Case–Control Study in Taiwan

Multiple sclerosis (MS) is an inflammatory neurological disease characterized by autoimmune-mediated demyelination of the central nervous system. Genetic and environmental factors may contribute to the development of MS. This has not been confirmed yet. Dental amalgam has long been controversial in MS due to its mercury content but the toxicological implications of mercury-containing amalgam fillings (AMF) for MS remain to be elucidated. We conducted a case–control study to investigate the association between AMF and the risk of MS from the Taiwanese National Health Insurance Research Database (NHIRD). Case (n = 612) and control (n = 612) groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index by propensity score matched with a 1:1 ratio from 2000 to 2013. Differences between cases and controls was not statistically significant (OR: 0.82, 95% CI = 0.65–1.05). In subjects stratified by gender, MS was also not associated with AMF for women (OR: 0.743, 95% CI = 0.552–1.000) and men (OR: 1.006, 95% CI = 0.670–1.509), respectively. In summary, this Taiwanese nationwide population-based case–control study did not find an association between MS and AMF.