Risk aspects of dental restoratives:From amalgam to toothcolored materials

• 作者: Albert J Feilzer Franklin Garcia-Godoy Norbert Kramer Peter E Murray Roland Frankenberger
• 来源期刊: 世界口腔医学杂志
• 学科: 医学
• 关键词: EXPOSURES Restoratives AMALGAM Resinbased COMPOSITES Adhesives
• 年，卷（期）: 2013,（1）
• 页码范围: 1-11
• 页数: 11页
• 分类号: R

摘要

Dental materials’choice of patients has considerably changed.Whereas cast gold and amalgam have been the predominant biomaterials for decades,today toothcolored materials like resin-based composites and ceramics are more and more successful.However,are we going to replace a good but biologically questionable material(amalgam)with an equal material(resin composite)being more esthetic but also biologically questionable?For amalgam,long-term clinical studies reported some significant hints that in single cases amalgam may be a health hazard for patients,finally Norway banned amalgam completely.The main advantage of a resin-based composite over amalgam is its tooth-like appearance and more or less absence of extensive preparation rules.For many years it was believed that resin-based composites may cause pulpal injury.However,pulpal injury associated with the use of resin-based composites is not correlated with their cytotoxic properties.Nevertheless,resin-based composites and other dental materials require rigorous safety evaluation and continuous monitoring to prevent adverse events similar like with amalgam.Because of nonbiocompatible pulp responses to resin-based composites and amalgam,they should not be placed in direct contact with the dental pulp.The less dentin remaining in the floor of preparations between resin-based composites or other dental materials is more likely to cause pulpitis.Percentage of patients and dental practitioners who display allergic reactions is between 0.7%and 2%.The release of cytotoxic monomers from resin-based materials is highest after polymerization and much lower after 1 wk.Substances released from resin-based composites have been shown to be toxic in cytotoxicity tests.Nevertheless,in vitro cytotoxicity assays have shown that amalgam has greater toxic effects than resin-based composites,sometime 100-700-fold higher.Altogether,the risk of side-effects is low,but not zero,especially for dental personnel.