[Residual dental caries under amalgam and silicate fillings].
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Dental Amalgam↗
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[Dental obturations using amalgams: problems and perspectives].
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Dental Amalgam↗
A study of the apical microleakage of a gallium alloy as a retrograde filling material.
The feasibility of utilizing mercury-free Gallium alloy GF for retrograde filling was investigated by comparing apical microleakage in 184 extracted human teeth. The teeth were divided into four experimental and two control groups. Three experimental groups were apical cavity retrofillings with the Gallium alloy GF, a mercury-containing amalgam, and a glass ionomer. The fourth experimental group was filled with gutta-percha and heat-burnished after apicoectomy. After 24 h, 1 wk, 4 wk, and 12 wk immersion in dye solution, the roots were vertically sectioned, and the deepest point of dye penetration was recorded. The glass ionomer showed the least leakage, followed by the amalgam group and the gallium group (no significant difference). The gutta-percha heat-burnished group displayed the greatest leakage. Gallium alloy GF was shown to have an equivalent sealing potential to dental amalgam for a retrograde filling material.
Analysis of Variance↗
Tunnel restorations: a long-term pilot study over a minimum of five years.
OBJECTIVES: The purpose of this study was to investigate the long-term performance of tunnel restorations. METHODS: Thirty-three glass polyalkenoate (ionomer) or cermet restorations were placed in the premolar or first molar teeth of 25 patients. Conservative amalgam control restorations were the means of treatment in 14 similar teeth of the same group. Review as to performance consisted of a regular clinical and radiographic examination and the criteria for failure were recurrent caries, fracture of the marginal ridge or gross loss of restorative material. RESULTS: After 3 years all types of restoration were satisfactory. By approximately 5 years one-quarter of the glass ionomer and 10% of the cermet restorations had failed. All the failures after any period of service could be replaced by conservative amalgam fillings. None of the controls required replacement. CONCLUSION: While tunnel restorations employing glass ionomer material and the cermet variant do enjoy a degree of success, this preliminary work suggests that small restorations of dental amalgam are more successful in the long term.
Adult↗
Amalgam tattoo (amalgam pigmentation) of the oral mucosa: clinical manifestations, diagnosis and treatment.
Amalgam tattoo is an iatrogenic lesion caused by traumatic implantation of dental amalgam into soft tissue. Amalgam tattoo is the most common localized pigmented lesion in the mouth. In a study of a mass screening oral examination in the United States, it was found in about 0.4-0.9% of the adult population and in Sweden in about 8%. Clinically, amalgam tattoo presents as a dark gray or blue, flat macule located adjacent to a restored tooth. Most are located on the gingiva and alveolar mucosa followed by the buccal mucosa and the floor of the mouth. Microscopic examination reveals that amalgam is present in the tissues in two forms: as irregular dark, solid fragments of metal or as numerous, discrete fine, brown or black granules dispersed along collagen bundles and around small blood vessels and nerves. In most lesions, it is presented in both forms. The biologic response to the amalgam is related to particle size, quantity and elemental composition of the amalgam. Large fragments often become surrounded by dense fibrous connective tissue. Smaller particles are associated with mild to moderate chronic inflammatory response with individual macrophages engulfing small amalgam particles. Occasionally, the reaction takes the form of foreign body granuloma in which macrophages and multinucleated giant cells are present. Some of the multinucleated giant cells also contain amalgam particles. Diagnosis of amalgam tattoo is usually obvious from the location and clinical appearance. A radiograph is recommended to confirm the presence of metallic particles, but absence of radiographic evidence does not rule out the possibility, since particles are often too fine or widely dispersed to be visible on radiographs. When there is no radiographic evidence or an adjacent restored tooth, biopsy is recommended to rule out an early melanoma. Once the diagnosis of amalgam tattoo has been established, no additional treatment is necessary except for cosmetic reasons. If the pigmentation is cosmetically unacceptable, surgical excision and transplantation of oral mucosal tissue has been suggested. Q-switched ruby laser and Q-switched alexandrite laser have also been used with favorable results.
Adult↗
Amalgam tattoo (amalgam pigmentation) of the oral mucosa: clinical manifestations, diagnosis and treatment.
Amalgam tattoo is an iatrogenic lesion caused by traumatic implantation of dental amalgam into soft tissue. Amalgam tattoo is the most common localized pigmented lesion in the mouth. In a study of a mass screening oral examination in the United States, it was found in about 0.4-0.9% of the adult population and in Sweden in about 8%. Clinically, amalgam tattoo presents as a dark gray or blue, flat macule located adjacent to a restored tooth. Most are located on the gingiva and alveolar mucosa followed by the buccal mucosa and the floor of the mouth. Microscopic examination reveals that amalgam is present in the tissues in two forms: as irregular dark, solid fragments of metal or as numerous, discrete fine, brown or black granules dispersed along collagen bundles and around small blood vessels and nerves. In most lesions, it is presented in both forms. The biologic response to the amalgam is related to particle size, quantity and elemental composition of the amalgam. Large fragments often become surrounded by dense fibrous connective tissue. Smaller particles are associated with mild to moderate chronic inflammatory response with individual macrophages engulfing small amalgam particles. Occasionally, the reaction takes the form of foreign body granuloma in which macrophages and multinucleated giant cells are present. Some of the multinucleated giant cells also contain amalgam particles. Diagnosis of amalgam tattoo is usually obvious from the location and clinical appearance. A radiograph is recommended to confirm the presence of metallic particles, but absence of radiographic evidence does not rule out the possibility, since particles are often too fine or widely dispersed to be visible on radiographs. When there is no radiographic evidence or an adjacent restored tooth, biopsy is recommended to rule out an early melanoma. Once the diagnosis of amalgam tattoo has been established, no additional treatment is necessary except for cosmetic reasons. If the pigmentation is cosmetically unacceptable, surgical excision and transplantation of oral mucosal tissue has been suggested. Q-switched ruby laser and Q-switched alexandrite laser have also been used with favorable results.
Adult↗
[No connection between the number of amalgam fillings and health. Epidemiological observations from a population study of women in Gothenburg].
Number of dental amalgam fillings and baseline serum mercury concentration were assessed with respect to a number of health related variables as part of a population study of women. There was no increased incidence of symptoms, no derangement of laboratory variables of clinical significance, nor any increased mortality or increased risk of myocardial infarction, stroke, diabetes or cancer in women with many amalgam fillings compared with those with few fillings, nor in women with higher serum mercury concentration compared with those with lower serum mercury concentration.
Dental Amalgam↗
Combined amalgam and composite restorations.
All indirect restorative techniques involving cast metals, ceramics or resin-based materials are expensive compared to directly placed restorations. A restorative technique is presented that combines the esthetic properties of directly bonded resin-based composite material and the wide range of indications for dental amalgam in stress-bearing areas.
Bisphenol A-Glycidyl Methacrylate↗
Acute exposure to mercury from amalgam: no short-time effect on the peripheral blood lymphocytes in healthy individuals.
Mercury, released from dental amalgam, has been considered to adversely affect the human immune system. This study has been performed in order to evaluate if an acute low-dose mercury exposure, achieved by total amalgam removal in 10 healthy individuals, would affect the immunocompetent cells in human blood when the mercury level in blood and plasma was increasing. Induction of lymphocyte proliferation, measured as spontaneous de novo DNA synthesis, and total T cells, CD4+ T cells, CD8+ T cells, and B cells, was studied prior to and 7, 31, and 48 h after amalgam removal. In addition, the levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in serum/plasma were measured. Despite a significant increase of the plasma mercury levels within 24 h after intervention, no significant influence on the peripheral blood lymphocytes could be detected during the first 48 h. The serum IL-6 levels increased significantly within 48 h after intervention, but were still low and within normal range. No influence on the CRP levels up to 7 d after amalgam removal was detected.
Adult↗
Dynamic mechanical properties of amalgams.
A recently developed dynamic mechanical analysis technique was utilized to determine the setting rates of dental amalgams. Via a compound parallel beam apparatus the dynamic mechanical properties of five amalgam materials were continuously measured at 37 degrees C within ca. 7 min after the start of trituration. Over a 15 hr period results showed that the modulus of elasticity (Ea) increased from 1.2 X 10(10) Pa to 6.5 X 10(10) Pa--the latter generally approaching those values reported via ultrasonic techniques. Moduli results via compression tests on microspecimens (3 X 2 X 1 mm) paralleled previous reliable literature data, nominally yielding values for Ea of 2-3 X 10(10) Pa. The extent of Ea scatter from both inter- and intrapreparer experiments appeared similar, although superior technique generally could be recognized by a systematic shift of the mean results to higher Ea's. In addition to modulus studies both compressive strengths (sigma max) and their corresponding strains (epsilon) were measured on microspecimens at a strain rate (epsilon) of 0.031 min-1, with a significant increase being noted in sigma max for the one material tested at over an order of magnitude increase in epsilon.
Dental Amalgam↗
[Amalgam--a question of belief? A review and assessment of the current literature].
Several hundred written sources have been researched regarding old and new findings. Forgotten and new facts are covered in four chapters. One of the authors is a retired industrial chemist, and the other a dental surgeon. In the first section the natural and synthetic sources of mercury are explained. In every scientific study the ubiquity of mercury for billions of years must be taken into consideration. The second chapter looks at the toxicology of mercury and its compounds. Well known catastrophies in Japan and Iraq are depicted. Individual intoxications are hardly mentioned in literature. The third chapter is devoted to the dental amalgam, a silver alloy with both physical-chemical properties, and corrosive and thermal behaviour. An attempt is made to define the mercury balance. The forth paragraph deals with the disposal and recycling of mercury. Many dental associations are currently discussing the possibility of recycling amalgam, which is rather a stable silver alloy than a volatile mercury compound. A controlled landfill disposal of dental amalgam will absorb a certain quantity of mercury during its life cycle, and is positive. Recycling is expensive, energy consuming and causes additional exposure. Unless silver and mercury become rare metals, recycling should not be considered. As yet no worldwide regulatory procedures exist.
Chemical Phenomena↗
Mercury vaporization from amalgams with varied alloy compositions.
The fact that mercury is released from dental amalgam restorations after abrasion provides a source of continued controversy over the safe use of this material. Studies have shown that the amount and rate of mercury release vary for different amalgam products. The objective of this study was to determine how alloy composition affects mercury vaporization from experimental amalgams with similar alloy particle size and shape and percent residual mercury. An hypothesis to be tested was that mercury release is dependent upon the concentration of tin in the silver-mercury matrix phase of the amalgam. Seven spherical amalgam alloys (two low-copper and five high-copper) were made by a dental manufacturer (Tokuriki Honten, Japan). Trituration conditions were adjusted so that all set amalgams had the same residual Hg (47.3%). ADA-type amalgam cylinders were aged for 14 days at 37 degrees C, then lightly wet-abraded on #600 silicon carbide, dried, and placed into a tube through which air was blown at a rate of 750 mL/min. Mercury vaporization was monitored with a gold film analyzer (Jerome 411) for 30 min. Total Hg release was determined by integration. We analyzed polished specimens via electron microprobe to determine composition, volume fraction of silver-mercury matrix (gamma 1), and amount of tin in the gamma 1. The results showed a strong negative correlation (r2 = 0.941) between the log of total mercury released and the amount of tin in the gamma 1. The effect of alloy composition, specifically the presence or absence of zinc in the amalgam, could not be definitively determined.(ABSTRACT TRUNCATED AT 250 WORDS)
Analysis of Variance↗
Strength and microstructure of gallium alloys.
This study investigated the physical and mechanical properties and the microstructure of four different gallium alloys. For all gallium alloys, the compressive strengths measured at one hour (86-223 MPa) and 24 hours (265-286 MPa) after specimen preparation were found to be well within the range exhibited by many high-copper amalgams. The creep values and dimensional change of the gallium alloys were comparable to those of leading amalgams, except for the dimensional change value of one alloy. The set gallium alloys consisted of a multi-phase structure including beta-Sn, CuGa2, In4Ag9, Ag72Ga28, and Ga5Pd (except for one product that did not contain Pd) that was more complicated than the structure of dental amalgams. Although the gallium alloys had physical and mechanical properties comparable to those of high-copper amalgams, the microstructure, coupled with the instability of the element gallium itself, could make these materials more prone to corrosive attack compared to amalgams.
Analysis of Variance↗
An in vitro study of the effect endodontic access preparation and amalgam restoration have upon incisor crown retention.
Endodontic access preparation leads to a significant reduction in crown retention. This study sought to determine whether this retention can be regained after access. Eighteen extracted human maxillary incisors had PFM crowns fabricated. Crowns were cemented, retention measured, recemented, access preparations cut, and retention once again measured. Then, crowns were recemented and accesses restored with dental amalgam and new retention measured. This format allowed each crown to be used as a control of itself. For crowns cemented with zinc phosphate cement and restored with amalgam, a 126% increase over original retention was measured. For crowns cemented with polycarboxylate cement and restored with amalgam, a 237% increase over original retention was measured. For crowns cemented with polycarboxylate cement and restored with amalgam, a 237% increase over original retention was measured. These results suggest that recementing crowns secondary to endodontic access and restoring the access with amalgam regains and even surpasses the original retention.
Cementation↗
Dissolution of amalgam in saline solution.
This experiment was designed to investigate the in vitro corrosion of several modern dental amalgams in saline solution over a six-month period by measuring changes in the soluble corrosion products. Based on the change of the electrical conductivity of the solution, the dissolution rate seemed to decrease gradually for the first three to four months. Then a rapid increase was observed, indicating a reactivated corrosion process. Larger dissolutions of copper and mercury were observed, especially for the high copper alloys, in these later stages. Zinc and indium, if present, were preferentially released at the earlier stages. Silver and tin could not be detected. Evidence exists that the corrosion of tin results in insoluble deposits of corrosion products.
Copper↗
Influence of a standard laboratory diet containing nutritionally adequate levels of selenium on renal pathology from mercury released by experimental amalgam tattoos.
Twenty-four guinea pigs were subcutaneously implanted with 2 X 25 mg of powdered dental amalgam for between 1 and 24 months. Four animals served as controls. All animals were fed a standard diet containing 0.2 microgram/g selenium (Se). Mercury (Hg) was released from the implants at an average rate of 21.7 micrograms/d and 4.35-16.94 micrograms of Se were consumed daily in the diet. The renal Hg rose to a maximum of 263 micrograms/g at 11 months in implanted animals and 6.65 mg Hg was excreted over 2 yr. The renal proximal tubular cells of implanted animals contained visible Hg deposits in secondary lysosomes and within nuclei containing both Hg and Se. No other signs of obvious renal pathology were seen in implanted animals as compared with controls. It would seem likely that the low Se levels present within this standard laboratory diet were sufficient to protect against Hg toxicity.
Animals↗
Resistance to condensation of 'condensable' resin composites as evaluated by a mechanical test.
This study compared the resistance-to-condensation forces of recently introduced condensable resin composites to that of amalgams and conventional resin composites. Using the flat platens of a servohydraulic testing machine, cylindrical specimens of each material 2.8 mm in diameter and 5.5 mm in length were compressed diametrally over two seconds to a thickness of 0.75 mm. Peak forces generated during compression were recorded. This method ranked the various classes of restorative material for resistance to condensation in the same order as most clinicians subjectively reported, with the highest forces observed with admixed dental amalgams, followed in order by spherical amalgams, condensable resin composites and conventional resin composites. Although peak forces observed with the condensable resin composites were generally higher than those observed with conventional resin composites, these were significantly lower than the peak forces observed with amalgams.
Analysis of Variance↗
New selenium-containing silver amalgam.
An investigation was made to determine the effects of the addition of selenium to the silver-tin amalgam alloy. The addition of 0.2 wt% to 0.6 wt% selenium in the alloy completely eliminated the cytotoxicity, evaluated by the 51Cr release assay and morphology, of the silver amalgam on the L cells and JTC-12 cells. The physical properties of the amalgam containing 0.2 wt% selenium in the alloy were tested according to the American Dental Association Specification No. 1 for Alloy for Dental Amalgam and were found to meet the requirements.
Cell Survival↗