目的以Prime & Bond NT作黏结剂研究银汞合金黏结修复(bonded amalgam restorations,BAR)在充填治疗中的意义,探讨减少银汞合金充填体边缘微渗漏及增加充填体固位的有效方法。方法选择无龋的离体牙80颗,随机分为实验组(F组)和对照...目的以Prime & Bond NT作黏结剂研究银汞合金黏结修复(bonded amalgam restorations,BAR)在充填治疗中的意义,探讨减少银汞合金充填体边缘微渗漏及增加充填体固位的有效方法。方法选择无龋的离体牙80颗,随机分为实验组(F组)和对照组(C组),实验组在牙洞各壁先涂上Prime & Bond NT黏结剂,对照组常规用银汞合金充填。实验组和对照组各取其中一组(F2组、C2组)行负载温差循环试验和压力试验;再将标本置于压力机下施以垂直向和侧向压力,用扫描电镜测量各组充填体边缘和洞各壁间缝隙的宽度。结果经负载温差循环实验和加压后(F2组)银汞合金充填体边缘和洞壁间的缝隙宽度与未加压组(F1组)间无明显变化,且颊舌壁与髓壁差异均无统计学意义(P>0.05)。常规银汞合金充填组(C2组)经负载温差循环实验和加压后,充填体边缘和洞壁间的缝隙宽度比未加压组(C1组)增宽,且颊舌壁缝隙比髓壁增宽明显,差异有统计学意义(P<0.01)。特别是BAR加压组(F2组)与常规银汞合金充填加压组(C2组)相比较,充填体边缘和洞壁间的缝隙宽度明显增宽,差异有统计学意义(P<0.01)。结论银汞合金黏结修复,在口腔环境下承受最大咀嚼压力后,充填体边缘与窝洞各壁仍然保持紧密接触。使用Prime & Bond NT黏结剂行银汞合金黏结修复是减少充填体边缘微渗漏和增加充填体固位的有效方法。展开更多
Objectives: To determine contact allergies in patients with oral lichen planus and to monitor the effect of partial or complete replacement of amalgam fillings following a positive patch test reaction to ammoniated me...Objectives: To determine contact allergies in patients with oral lichen planus and to monitor the effect of partial or complete replacement of amalgam fillings following a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam. Design: In group A (20 patients), the oral lesions were confined to areas in close contact with amalgam fillings. In group B (20 patients), the lesions extended 1 cm beyond the area of contact with amalgam fillings. In group C (20 patients), the oral lesions had no topographic relationship with amalgam fillings. Partial or complete replacement of amalgam fillings was recommended if there was a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam. Control group D (20 patients) had signs of allergic contact dermatitis. Results: Amalgam fillings were replaced in 13 patients of group A, with significant improvement. Dental amalgam was replaced in 8 patients of group B, with significant improvement. In group C, amalgam replacement in 2 patients resulted in improvement in 1 patient. These results were evaluated after 3 months. No positive patch test reactions to mercury compounds were found in patients with concomitant cutaneous lichen planus and in group D. Conclusions: Contact allergy to mercury compounds is important in the pathogenesis of oral lichen planus, especially if there is close contact with amalgam fillings and if no concomitant cutaneous lichen planus is present. In cases of positive patch test reactions to mercury compounds, partial or complete replacement of amalgam fillings will lead to a significant improvement in nearly all patients.展开更多
Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychol...Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychological and renal function of children whose dental caries were restored using amalgam or mercury- free materials. Design and Setting The New England Children’ s Amalgam Trial was a 2- group randomized safety trial involving 5 community health dental clinics in Boston, Mass, and 1 in Farmington, Me, between September 1997 and March 2005. Participants and Intervention: A total of 534 children aged 6 to 10 years at baseline with no prior amalgam restorations and 2 or more posterior teeth with caries were randomly assigned to receive dental restoration of baseline and incident caries during a 5- year follow- up period using either amalgam (n=267) or resin composite (n =267) materials. Main Outcome Measures: The primary neuropsychological outcome was 5- year change in fullscale IQ scores. Secondary outcomes included tests of memory and visuomotor ability. Renal glomerular function was measured by creatinine- adjusted albumin in urine. Results: Children had a mean of 15 tooth surfaces (median, 14) restored during the 5- year period (range, 0- 55). Assignment to the amalgam group was associated with a significantly higher mean urinary mercury level (0.9 vs 0.6 μ g/g of creatinine at year 5, P < 0.001). After adjusting for randomization stratum and other covariates, no statistically significant differences were found between children in the amalgam and composite groups in 5- year change in full- scale IQ score (3.1 vs 2.1, P=0.21). The difference in treatment group change scores was 1.0 (95% confidence interval, - 0.6 to 2.5) full- scale IQ score point. No statistically significant differences were found for 4- year change in the general memory index (8.1 vs 7.2, P=0.34), 4- year change in visuomotor composite (3.8 vs 3.7, P=0.93), or year 5 urinary albumin (median, 7.5 vs 7.4 mg/g of creatinine, P=0.61).展开更多
Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychol...Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychological and renal function of children whose dental caries were restored using amalgam or mercury-free materials. Design and Setting The New England Children’s Amalgam Trial was a 2-group randomized safety trial involving 5 community health dental clinics in oston, Mass, and 1 in Farmington, Me, between September 1997 and March 2005. Participants and Intervention: A total of 534 children aged 6 to 10 years at baseline with no prior amalgam restorations and 2 or more posterior teeth with caries were randomly assigned to receive dental restoration of baseline and incident caries during a 5-year follow-up period using either amalgam (n=267) or resin composite (n =267) materials. Main Outcome Measures: The primary neuropsychological outcome was 5-year change in full-scale IQ scores. Secondary outcomes included tests of memory and visuomotor ability. Renal glomerular function was measured by creatinine-adjusted albumin in urine. Results: Children had a mean of 15 tooth surfaces (median, 14) restored during the 5-year period (range, 0-55). Assignment to the amalgam group was associated with a significantly higher mean urinary mercury level (0.9 vs 0.6 μg/g of creatinine at year 5, P < .001). After adjusting for randomization stratum and other covariates, no statistically significant differences were found between children in the amalgam and composite groups in 5-year change in full-scale IQ score (3.1 vs 2.1, P=.21). The difference in treatment group change scores was 1.0 (95%confidence interval, -0.6 to 2.5) full-scale IQ score point. No statistically significant differences were found for 4-year change in the general memory index (8.1 vs 7.2, P=.34), 4-year change in visuomotor composite (3.8 vs 3.7, P=.93), or year 5 urinary albumin (median, 7.5 vs 7.4 mg/g of creatinine, P=.61). Conclusions: In this 展开更多
Context: Dental (silver) amalgam is a widely used restorative material containing 50%elemental mercury that emits small amounts of mercury vapor. No randomized clinical trials have determined whether there are signifi...Context: Dental (silver) amalgam is a widely used restorative material containing 50%elemental mercury that emits small amounts of mercury vapor. No randomized clinical trials have determined whether there are significant health risks associated with this low-level mercury exposure. Objective: To assess the safety of dental amalgam restorations in children. Design: A randomized clinical trial in which children requiring dental restorative treatment were randomized to either amalgam for posterior restorations or resin composite instead of amalgam. Enrollment commenced February 1997, with annual follow-up for 7 years concluding in July 2005. Setting and Participants: A total of 507 children in Lisbon, Portugal, aged 8 to 10 years with at least 1 carious lesion on a permanent tooth, no previous exposure to amalgam, urinary mercury level < 10 μg/L, blood lead level < 15 μg/dL, Comprehensive Test of Nonverbal Intelligence IQ ≥67, and with no interfering health conditions. Intervention: Routine, standard-of-care dental treatment, with one group receiving amalgam restorations for posterior lesions (n=253) and the other group receiving resin composite restorations instead of amalgam (n=254). Main Outcome Measures: Neurobehavioral assessments of memory, attention/concentration, and motor/visuomotor domains, as well as nerve conduction velocities. Results: During the 7-year trial period, children had a mean of 18.7 tooth surfaces (median, 16) restored in the amalgam group and 21.3 (median, 18) restored in the composite group. Baseline mean creatinine-adjusted urinary mercury levels were 1.8 μg/g in the amalgam group and 1.9 μg/g in the composite group, but during follow-up were 1.0 to 1.5 μg/g higher in the amalgam group than in the composite group (P< .001). There were no statistically significant differences in measures of memory, attention, visuomotor function, or nerve conduction velocities (average z scores were very similar, near zero) for the amalgam and composite groups over all 7 years of follow-up, with no展开更多
文摘目的以Prime & Bond NT作黏结剂研究银汞合金黏结修复(bonded amalgam restorations,BAR)在充填治疗中的意义,探讨减少银汞合金充填体边缘微渗漏及增加充填体固位的有效方法。方法选择无龋的离体牙80颗,随机分为实验组(F组)和对照组(C组),实验组在牙洞各壁先涂上Prime & Bond NT黏结剂,对照组常规用银汞合金充填。实验组和对照组各取其中一组(F2组、C2组)行负载温差循环试验和压力试验;再将标本置于压力机下施以垂直向和侧向压力,用扫描电镜测量各组充填体边缘和洞各壁间缝隙的宽度。结果经负载温差循环实验和加压后(F2组)银汞合金充填体边缘和洞壁间的缝隙宽度与未加压组(F1组)间无明显变化,且颊舌壁与髓壁差异均无统计学意义(P>0.05)。常规银汞合金充填组(C2组)经负载温差循环实验和加压后,充填体边缘和洞壁间的缝隙宽度比未加压组(C1组)增宽,且颊舌壁缝隙比髓壁增宽明显,差异有统计学意义(P<0.01)。特别是BAR加压组(F2组)与常规银汞合金充填加压组(C2组)相比较,充填体边缘和洞壁间的缝隙宽度明显增宽,差异有统计学意义(P<0.01)。结论银汞合金黏结修复,在口腔环境下承受最大咀嚼压力后,充填体边缘与窝洞各壁仍然保持紧密接触。使用Prime & Bond NT黏结剂行银汞合金黏结修复是减少充填体边缘微渗漏和增加充填体固位的有效方法。
文摘Objectives: To determine contact allergies in patients with oral lichen planus and to monitor the effect of partial or complete replacement of amalgam fillings following a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam. Design: In group A (20 patients), the oral lesions were confined to areas in close contact with amalgam fillings. In group B (20 patients), the lesions extended 1 cm beyond the area of contact with amalgam fillings. In group C (20 patients), the oral lesions had no topographic relationship with amalgam fillings. Partial or complete replacement of amalgam fillings was recommended if there was a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam. Control group D (20 patients) had signs of allergic contact dermatitis. Results: Amalgam fillings were replaced in 13 patients of group A, with significant improvement. Dental amalgam was replaced in 8 patients of group B, with significant improvement. In group C, amalgam replacement in 2 patients resulted in improvement in 1 patient. These results were evaluated after 3 months. No positive patch test reactions to mercury compounds were found in patients with concomitant cutaneous lichen planus and in group D. Conclusions: Contact allergy to mercury compounds is important in the pathogenesis of oral lichen planus, especially if there is close contact with amalgam fillings and if no concomitant cutaneous lichen planus is present. In cases of positive patch test reactions to mercury compounds, partial or complete replacement of amalgam fillings will lead to a significant improvement in nearly all patients.
文摘Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychological and renal function of children whose dental caries were restored using amalgam or mercury- free materials. Design and Setting The New England Children’ s Amalgam Trial was a 2- group randomized safety trial involving 5 community health dental clinics in Boston, Mass, and 1 in Farmington, Me, between September 1997 and March 2005. Participants and Intervention: A total of 534 children aged 6 to 10 years at baseline with no prior amalgam restorations and 2 or more posterior teeth with caries were randomly assigned to receive dental restoration of baseline and incident caries during a 5- year follow- up period using either amalgam (n=267) or resin composite (n =267) materials. Main Outcome Measures: The primary neuropsychological outcome was 5- year change in fullscale IQ scores. Secondary outcomes included tests of memory and visuomotor ability. Renal glomerular function was measured by creatinine- adjusted albumin in urine. Results: Children had a mean of 15 tooth surfaces (median, 14) restored during the 5- year period (range, 0- 55). Assignment to the amalgam group was associated with a significantly higher mean urinary mercury level (0.9 vs 0.6 μ g/g of creatinine at year 5, P < 0.001). After adjusting for randomization stratum and other covariates, no statistically significant differences were found between children in the amalgam and composite groups in 5- year change in full- scale IQ score (3.1 vs 2.1, P=0.21). The difference in treatment group change scores was 1.0 (95% confidence interval, - 0.6 to 2.5) full- scale IQ score point. No statistically significant differences were found for 4- year change in the general memory index (8.1 vs 7.2, P=0.34), 4- year change in visuomotor composite (3.8 vs 3.7, P=0.93), or year 5 urinary albumin (median, 7.5 vs 7.4 mg/g of creatinine, P=0.61).
文摘Context: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects. Objective: To compare the neuropsychological and renal function of children whose dental caries were restored using amalgam or mercury-free materials. Design and Setting The New England Children’s Amalgam Trial was a 2-group randomized safety trial involving 5 community health dental clinics in oston, Mass, and 1 in Farmington, Me, between September 1997 and March 2005. Participants and Intervention: A total of 534 children aged 6 to 10 years at baseline with no prior amalgam restorations and 2 or more posterior teeth with caries were randomly assigned to receive dental restoration of baseline and incident caries during a 5-year follow-up period using either amalgam (n=267) or resin composite (n =267) materials. Main Outcome Measures: The primary neuropsychological outcome was 5-year change in full-scale IQ scores. Secondary outcomes included tests of memory and visuomotor ability. Renal glomerular function was measured by creatinine-adjusted albumin in urine. Results: Children had a mean of 15 tooth surfaces (median, 14) restored during the 5-year period (range, 0-55). Assignment to the amalgam group was associated with a significantly higher mean urinary mercury level (0.9 vs 0.6 μg/g of creatinine at year 5, P < .001). After adjusting for randomization stratum and other covariates, no statistically significant differences were found between children in the amalgam and composite groups in 5-year change in full-scale IQ score (3.1 vs 2.1, P=.21). The difference in treatment group change scores was 1.0 (95%confidence interval, -0.6 to 2.5) full-scale IQ score point. No statistically significant differences were found for 4-year change in the general memory index (8.1 vs 7.2, P=.34), 4-year change in visuomotor composite (3.8 vs 3.7, P=.93), or year 5 urinary albumin (median, 7.5 vs 7.4 mg/g of creatinine, P=.61). Conclusions: In this
文摘Context: Dental (silver) amalgam is a widely used restorative material containing 50%elemental mercury that emits small amounts of mercury vapor. No randomized clinical trials have determined whether there are significant health risks associated with this low-level mercury exposure. Objective: To assess the safety of dental amalgam restorations in children. Design: A randomized clinical trial in which children requiring dental restorative treatment were randomized to either amalgam for posterior restorations or resin composite instead of amalgam. Enrollment commenced February 1997, with annual follow-up for 7 years concluding in July 2005. Setting and Participants: A total of 507 children in Lisbon, Portugal, aged 8 to 10 years with at least 1 carious lesion on a permanent tooth, no previous exposure to amalgam, urinary mercury level < 10 μg/L, blood lead level < 15 μg/dL, Comprehensive Test of Nonverbal Intelligence IQ ≥67, and with no interfering health conditions. Intervention: Routine, standard-of-care dental treatment, with one group receiving amalgam restorations for posterior lesions (n=253) and the other group receiving resin composite restorations instead of amalgam (n=254). Main Outcome Measures: Neurobehavioral assessments of memory, attention/concentration, and motor/visuomotor domains, as well as nerve conduction velocities. Results: During the 7-year trial period, children had a mean of 18.7 tooth surfaces (median, 16) restored in the amalgam group and 21.3 (median, 18) restored in the composite group. Baseline mean creatinine-adjusted urinary mercury levels were 1.8 μg/g in the amalgam group and 1.9 μg/g in the composite group, but during follow-up were 1.0 to 1.5 μg/g higher in the amalgam group than in the composite group (P< .001). There were no statistically significant differences in measures of memory, attention, visuomotor function, or nerve conduction velocities (average z scores were very similar, near zero) for the amalgam and composite groups over all 7 years of follow-up, with no
