Effect of Polishing and Universal Bonding Application on Mercury Release from Aged Amalgam after Exposure to Bleaching Agents.

Objectives: Teeth bleaching is an accepted and modern treatment in cosmetic dentistry. Bleaching agents may affect amalgam restorations and increase mercury release; therefore, patients are at increased risk of mercury exposure in the body. The aim of this study was to investigate the effect of polishing and universal bonding application on mercury release from aged amalgams exposed to bleaching. Materials and Methods: In this in-vitro experimental study, 64 dental amalgam specimens with dimensions of 3×5×10 were prepared and divided into two experimental and control groups. Each group was further divided into 4 subgroups and received one of the following treatments: no intervention, surface bonding, polishing, or polishing and surface bonding. Subsequently, the samples were immersed in bleaching agent containing 7% hydrogen peroxide and the amount of mercury released after 96h was measured. The results were analyzed by two-way ANOVA and Tukey post hoc tests (α≤0.05). Results: The results showed that the type of solution (P<0.05) and surface treatment (P<0.001) significantly affected the level of mercury release. However, there was no significant interaction between surface treatment methods in the bleaching group and those in the phosphate buffer group (P=0.621). Conclusion: Bleaching agents were found to enhance mercury release from dental amalgam. The application of polishing and universal bonding on amalgam surfaces exhibited significant effects on the reduction of the mercury release.

Evaluating the accuracy of Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) responses to United States Food and Drug Administration (FDA) frequently asked questions about dental amalgam.

BACKGROUND: The use of artificial intelligence in the field of health sciences is becoming widespread. It is known that patients benefit from artificial intelligence applications on various health issues, especially after the pandemic period. One of the most important issues in this regard is the accuracy of the information provided by artificial intelligence applications. OBJECTIVE: The purpose of this study was to the frequently asked questions about dental amalgam, as determined by the United States Food and Drug Administration (FDA), which is one of these information resources, to Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) and to compare the content of the answers given by the application with the answers of the FDA. METHODS: The questions were directed to ChatGPT-4 on May 8th and May 16th, 2023, and the responses were recorded and compared at the word and meaning levels using ChatGPT. The answers from the FDA webpage were also recorded. The responses were compared for content similarity in "Main Idea", "Quality Analysis", "Common Ideas", and "Inconsistent Ideas" between ChatGPT-4's responses and FDA's responses. RESULTS: ChatGPT-4 provided similar responses at one-week intervals. In comparison with FDA guidance, it provided answers with similar information content to frequently asked questions. However, although there were some similarities in the general aspects of the recommendation regarding amalgam removal in the question, the two texts are not the same, and they offered different perspectives on the replacement of fillings. CONCLUSIONS: The findings of this study indicate that ChatGPT-4, an artificial intelligence based application, encompasses current and accurate information regarding dental amalgam and its removal, providing it to individuals seeking access to such information. Nevertheless, we believe that numerous studies are required to assess the validity and reliability of ChatGPT-4 across diverse subjects.

An Unusual Case of Sinusitis in a Flight Attendant.

Foreign body sinusitis is a rare but important condition that should be taken into account when considering differential diagnoses. In this case report, we present a unique case of sinusitis caused by a foreign body originating from a dental procedure. Additionally, the complexity of the case was compounded by the patient's occupation as a flight attendant. A 49-year-old female flight attendant presented with a two-month history of facial pressure exacerbated by flying. A computed tomography (CT) of her paranasal sinuses confirmed the presence of a radiopaque foreign body near the left maxillary infundibulum, with minimal left ethmoid sinus mucosal thickening. Initially, she elected for non-operative management due to schedule conflicts. Upon follow-up over the next year, she complains of recurring severe facial swelling and congestion. A repeat CT scan shows that she has a dental amalgam that migrated from her left maxilla to the ethmoid infundibulum, lodged between her uncinate process and ethmoid bulla. The patient subsequently underwent foreign body removal. The patient recovered well, and a follow-up CT confirmed the complete removal of the foreign body. This case provides excellent insight into the mechanism of foreign body migration and sinusitis complicated by the unique circumstances of barotrauma associated with regular air travel.

Mercury Concentration in Saliva and the Impact of Chewing: An Inductively Coupled Plasma Mass Spectrometry Study.

Mercury, which is found in dental amalgams, is considered to be the most toxic non-radioactive element. However, the health policies of different countries have not reached a consensus on the use and safety of amalgam. This study aims to investigate the effect of amalgam restorations on mercury concentration in saliva, as well as the effect of restoration number, surface number, and chewing on this concentration. A total of 86 participants were included in this study (an equal number for the study and control groups). The number of amalgam restorations and their surfaces were recorded. While both unstimulated and stimulated saliva were collected from the study group, only unstimulated saliva was collected from the control group. The effect of chewing on mercury concentration was examined in the study group with unstimulated and stimulated saliva specimens using inductively coupled plasma mass spectrometry device. Mercury concentration in the unstimulated saliva was found to be higher in the study group compared to the control group (p= 0.000). As the number of amalgam restorations and the number of amalgam restoration surfaces increased, the mercury concentration in the saliva increased (p= 0.015 and p= 0.021, respectively). There was no statistically significant difference between mercury levels in the unstimulated saliva and the stimulated saliva (p=0.316). Chewing presented an insignificant difference in mercury concentration. Given this surprising result, the effect of chewing on mercury concentrations should be explored more extensively in future research.

The "Phase Down" of Dental Amalgam Restorations - What are the Criteria for Replacement and Indication?

ABSTRACT Objective: To guide professionals about the criteria for replacing amalgam restorations and inform them about the new guidelines regarding the use/indication of this (amalgam) material after the Minamata Convention - COP-4. Material and Methods: The articles were selected from the databases (PubMed, Scielo, Bireme), and relevant articles on the subject between the years 2003-2021 were selected. Recently, social media have been flooded with dental treatments that aim to perform restorations only with composite resins or other types of esthetic material and completely replace all dental amalgam restorations, irrespective of their time in place, size, and functionality. Results: Although improperly, it has been noted that this information reaches patients, and they are led to believe in the inaccurate data that is passed on, such as, for example, (that amalgam leads to) permanent contamination by mercury, causing systemic problems and the loss of the tooth. Conclusion: The "phase down" of amalgam in research and teaching has previously been observed in several countries worldwide; however, its use is still necessary given particular circumstances, which, theoretically, make it a material with exact indication.

Alternative Direct Restorative Materials for Dental Amalgam: A Concise Review Based on an FDI Policy Statement.

Dental restorative procedures remain a cornerstone of dental practice, and for many decades, dental amalgam was the most frequently employed material. However, its use is declining, mainly driven by its poor aesthetics and by the development of tooth-coloured adhesive materials. Furthermore, the Minamata Convention agreed on a phase-down on the use of dental amalgam. This concise review is based on a FDI Policy Statement which provides guidance on the selection of direct restorative materials as alternatives to amalgam. The Policy Statement was informed by current literature, identified mainly from PubMed and the internet. Ultimately, dental, oral, and patient factors should be considered when choosing the best material for each individual case. Dental factors include the dentition, tooth type, and cavity class and extension; oral aspects comprise caries risk profiles and related risk factors; and patient-related aspects include systemic risks/medical conditions such as allergies towards certain materials as well as compliance. Special protective measures (eg, a no-touch technique, blue light protection) are required when handling resin-based materials, and copious water spray is recommended when adjusting or removing restorative materials. Cost and reimbursement policies may need to be considered when amalgam alternatives are used, and the material recommendation requires the informed consent of the patient. There is no single material which can replace amalgam in all applications; different materials are needed for different situations. The policy statement recommends using a patient-centred rather than purely a material-centred approach. Further research is needed to improve overall material properties, the clinical performance, the impact on the environment, and cost-effectiveness of all alternative materials.

Comparison of Marginal Fracture Between Conventional and Bonded Amalgam Restorations in Posterior Permanent Molar Teeth.

Background/objectives Dental amalgam has been a successful restoration for over a century. However, restoration failures due to secondary caries, fractured teeth or restorations, marginal deficiencies, tooth wear, and secondary caries remain significant concerns. Amalgam-bond, known for its ability to bond amalgam to the tooth structure and prevent percolation, forms a strong bond with vital dentin. This study aimed to compare the outcome of marginal fractures in bonded amalgam and conventional amalgam posterior restorations among patients at a tertiary care dental hospital. Materials and methods Sixty consecutive patients aged 25-35 years, meeting the inclusion and exclusion criteria, participated in this study. A thorough history, clinical examination, and standardized periapical radiographs were conducted. Patients were divided randomly into two equal groups, group A and group B. Group A received bonded amalgam restorations, while group B received conventional amalgam restorations. Polishing was performed at a recall visit after seven days, and a follow-up evaluation was done after two months. The final assessment of marginal fractures was recorded after six months. Results After six months, 28 (46.7%) patients showed no marginal fractures, including 11 males and 17 females. On the other hand, 32 (53.3%) patients exhibited marginal fractures, comprising 17 males and 15 females. The clinical success rate of group A was better than group B (p = 0.001). Conclusion Bonded amalgam demonstrates a high success rate and should be a routine choice for treating carious permanent molars in dental practice.

Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report.

We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by the patient, the lesion had progressively increased in size. A history of previous dental manipulations was reported, namely, the extraction of teeth with amalgam obturations in the left half of the maxilla as per relevant indications. During the intraoral examination, a flat, black-colored lesion, 0.4 cm in diameter, with well-defined borders was observed in the buccal mucosa. Teeth 25, 26, and 27 were previously extracted five to seven years ago. An orthopantomography was performed as a routine procedure. It did not show any presence of X-ray contrast areas that could explain the symptoms of the patient. The symptomatic nature of the lesion as well as the negative radiological findings prompted surgical treatment and excisional biopsy with subsequent histological evaluation to rule out oral malignancy. An excision was performed. During the follow-up examination in the next eight days, all the symptoms of the patient were gone. The conclusion of the pathology report was "histological findings and clinical data consistent with amalgam tattoo". The amalgam tattoo is the most frequent iatrogenic pigmented lesion of the oral mucosa, which results from the implantation of amalgam particles in the soft tissues and it is usually asymptomatic. In this case, no surgical treatment is needed. However, in some rare cases, like the one we are presenting, some symptoms can occur and complicate the diagnostic process. In these cases, the complete excision of the lesion is to be performed with subsequent histological evaluation. The atraumatic intervention of teeth, obturated with definitive amalgam fillings, is a main factor for preventing this kind of pigmentation of the oral mucosa.

Assessment of Cytotoxic and Genotoxic Effect of Modern Dental Materials in vivo.

Objectives: The aim of the study was to assess the biocompatibility of modern composite and amalgam dental fillings. Material and Methods: The research was conducted on 150 healthy patients between the ages of 10 and 20 who had amalgam and composite fillings between 6 and 12 months. Under in vivo conditions, a swab of buccal cells near the fillings was taken, and the cytotoxic and genotoxic impact of composite and amalgam fillings on these cells was analyzed using the extended micronucleus test (cytomeassay). Results: The results showed statistically significant differences between the groups of subjects with amalgam and composite fillings and subjects without fillings for the following parameters: number of micronuclei (p=0.006), number of buds (p<0.001), number of binuclear cells (p<0.001), number of nucleoplasmic bridges (p<0.001).The number of micronuclei was statistically significantly higher in the group of subjects with amalgam and composite fillings compared to the group without fillings. The results for nuclear buds, for the number of binuclear cells and the number of nucleoplasmic bridges showed that the group with amalgam fillings had a statistically significantly higher number of these changes compared to other groups.The results of the analysis of the relationship between the parameters of the micronucleus test and the number of amalgam and composite surfaces did not show statistically significant values. Parameters indicating cell cytotoxicity were not statistically significantly elevated in subjects with fillings. The results of the analysis of the influence of the patients' lifestyle on the results of the micronucleus test showed statistically significant results for certain predictors (diagnostic X-ray radiation, coffee consumption, consumption of cooked, dried meat and baked food). Conclusion: Based on the results, it can be concluded that the buccal cells of subjects with amalgam fillings showed the highest degree of genotoxic changes, followed by those with composite fillings and the least buccal cells of patients without fillings.

Evaluation of the effect of amalgam fillings on the diagnosis of proximal caries using cone-beam computed tomography technique.

Background: Diagnosis of dental caries using cone-beam computed tomography (CBCT) may be hindered due to several introduced and inherent artifacts. The aim of this study was to evaluate the effect of amalgam fillings on the accuracy of diagnosis of proximal caries in CBCT. Materials and Methods: In this in vitro study, 102 extracted human teeth (mandibular and maxillary molars and premolars) were used. Six molars were chosen for mesio-occluso-distal amalgam restorations. Before obtaining the CBCT images, the 96 remaining teeth were stabilized in dental sockets of six dry human skulls in a way that the proximal contacts re-established. Thereafter, six of the molar teeth were replaced by the amalgam-restored teeth and the second group of images was then obtained. All images were evaluated by two independent observers in the panorama view and the presence or absence of caries was recorded. For histopathologic investigations, the teeth were cut and assessed by an oral pathologist using a stereomicroscope. The McNemar test was used for comparison between CBCT assessments and histopathologic evaluations (P < 0.05 was considered statistically significant). In addition, the receiver operating characteristics curve was utilized to evaluate the diagnostic accuracy in different sections of imaging. Results: The result sensitivity and specificity of CBCT imaging in the first group of images before placement of the restored teeth were 0.96 and 0.36, respectively. In the second group of images after placement of the restored teeth, these values were 0.78 and 0.18, respectively. Moreover, statistical analysis showed that there is a good agreement in interproximal caries diagnosis between histopathologic and CBCT imaging findings without placement of amalgam restorations (P < 0.001). However, this agreement does not exist after amalgam restorations (P = 0.84). Conclusion: Diagnosis of proximal caries using CBCT is not an efficient method where there are amalgam restorations adjacent to the suspected teeth.

Teaching and placement of dental amalgam restorations at South African dental schools.

Introduction: This paper set out to investigate the relationship between teaching and clinical practice of direct posterior restoration placement at tertiary dental institutions in South Africa. Methods: A cross-sectional study using a mixed methods approach was conducted, and all the South African dental schools were invited to participate. The quantitative phase of the study analyzed the Conservative Dentistry department's records of direct restorations at a single dental school. The number of amalgam and tooth-colored restorations placed by students in the fourth and fifth year of the program from 2004 to 2019 were compared. During the qualitative phase, semi-structured interviews were held with staff from the four dental schools involved with the teaching of direct posterior restorations. Results: The predominant direct posterior restoration placed in student clinics over a 15-year period at a South African dental school was tooth colored (75%). Teaching times do not correspond to a decrease in the placement of dental amalgam restorations for both one-surface and two-surface posterior restorations and a concomitant increase in the tooth-colored restorations. Discussion: Academic staff involved in teaching identified that South Africa's ratification of the Minamata Convention has consequences for dental education and training. However, all schools reported that dental amalgam would continue to be taught in the absence of an appropriate alternative.

Amalgam or composite in pediatric dentistry: Analysis of private insurance claims data.

BACKGROUND: Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States. METHODS: Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level. RESULTS: In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time. CONCLUSION: The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam. PRACTICAL IMPLICATIONS: The findings of this study can inform and support clinical decisions and the formation of public policies.

Mercurial risk from dental amalgam use in a population of Moroccan dentists: A latent class regression approach.

BACKGROUND: Dentists using dental amalgam are chronically exposed to low doses of elemental mercury. The complex toxico-kinetics of this systemic toxicant results in polymorphic and variable clinical phenotypes. In this context, adapted statistical methods are required to highlight potential adverse effects of occupational mercury exposure on dentists' health. OBJECTIVE: The present study aims to analyze the distribution of self-reported subjective symptoms, commonly associated with chronic mercury poisoning, according to occupational mercury exposure in a population of Moroccan liberal dentists. METHODS: In order to achieve the defined objectives, a three-step latent class regression was fitted. First a latent class analysis was performed to cluster the studied population according to their declared symptoms. Dentists were then classified in the defined latent classes based on their posterior probabilities. Finally, a logistic regression is fitted to identify predictors associated with the latent classes' membership. RESULTS: The final obtained model showed acceptable calibration and discrimination. Its interpretation revealed that the increase of the frequency of amalgam use was associated with significant higher odds of belonging to the high risk latent class. CONCLUSIONS: The present study represents an initial step towards the development of diagnosis model that predict clinical profiles according to occupational mercury exposure.

Posterior dental restoration material choices in privately insured people in the United States, 2017 through 2019.

BACKGROUND: In the context of evolving dental materials and techniques and a national agenda to phasedown use of dental amalgam, estimates of dental amalgam placement are necessary for monitoring purposes. METHODS: Numbers of amalgam and composite posterior restorations from 2017 through 2019 were calculated using retrospective dental claims analysis of privately insured patients. Kruskal-Wallis and multilevel, multivariable negative binomial regression models were used to test for differences in rates of amalgam and composite restoration placement by age group, sex, urban or rural area, and percentage race and ethnicity area distribution. Statistical significance was set at 0.05, with Benjamini-Hochberg correction for false discovery rate. RESULTS: The rate of amalgam restorations declined over time from a mean of 6.29 per 100 patients in 2017 to 4.78 per 100 patients in 2019, whereas the composite restoration rate increased from 27.6 per 100 patients in 2017 to 28.8 per 100 in 2019. The mean number of amalgam restorations placed per person were lowest in females compared with males, in urban areas compared with rural areas, and in areas with more than 75% non-Hispanic White residents. CONCLUSIONS: Amalgam restoration placements in privately insured people in the United States declined from 2017 through 2019. Amalgam restoration placements may be unevenly distributed by location. PRACTICAL IMPLICATIONS: Achieving further declines of dental amalgam use may require changes to insurance coverage, incentives, and provider training as well as augmented disease prevention and health promotion efforts. These efforts should focus particularly on groups with high caries risk or higher rates of amalgam placement.

Prevalence and mean number of teeth with amalgam and nonamalgam restorations, United States, 2015 through 2018.

BACKGROUND: Amalgam has been used for more than 150 years as a safe and reliable restorative material. The authors described the occurrence of amalgam and nonamalgam restorations in the United States in primary and permanent teeth across age groups and according to sociodemographic characteristics. METHODS: The authors used clinical examination data from the National Health and Nutrition Examination Survey 2015-2018 for participants 2 years and older (n = 17,040). The authors estimated the prevalence and mean number of amalgam and nonamalgam restorations in primary and permanent teeth according to age groups (2-5 years, 6-11 years, 12-15 years, 16-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥ 80 years), race and ethnicity, federal poverty guideline, education, and pregnancy status. RESULTS: The prevalence of amalgam restorations ranged from 4% through 69%. Overall, amalgam restorations were more prevalent in children and adolescents from racial and ethnic minority groups and families at lower poverty levels and with lower education. The mean number of teeth with nonamalgam restorations was higher than those with amalgam restorations in primary teeth of children aged 6 through 11 years, permanent teeth of those 12 through 15 years and 20 through 39 years, and women aged 20 through 49 years, regardless of pregnancy status. The mean number of amalgam restorations was higher than that for nonamalgam restorations in older age groups. CONCLUSIONS: Nonamalgam restorations were the most common in the primary teeth of children older than 5 years and in the permanent teeth of adults younger than 40 years. Amalgam restorations were more common in older adults. Amalgam and nonamalgam restorations were equally common in children younger than 5 years. PRACTICAL IMPLICATIONS: The study findings suggest a shift from amalgam to alternative restorative materials in the United States.

O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas / ¿Sigue siendo necesaria la enseñanza de la amalgama en la carrera odontológica? Percepción de los dentistas / Is the teaching of amalgam in dental training still necessary? Perceptions of dentists

A Odontologia tem vivenciado, nos últimos tempos, um declínio acentuado do uso do amálgama, em consequência da evolução dos materiais e técnicas adesivas e das discussões acerca dos riscos de contaminação pelo mercúrio. Assim, buscou-se identificar a percepção dos cirurgiões-dentistas sobre a necessidade da continuidade do ensino do amálgama nos cursos de Odontologia. Trata-se de um estudo transversal, usando um questionário semiestruturado com aspectos relativos às condições sociodemográficas, capacitação para executar os procedimentos, conhecimento acerca do manejo do material e gerenciamento dos resíduos. As respostas objetivas foram analisadas pela estatística descritiva e as subjetivas processadas no software IRaMuTeQ. Dos 257 respondentes, 60,7%afirmam utilizar esse material, 91,8% usam amálgama encapsulado e 95,7% descartam os resíduos em lixo hospitalar. Sobre a permanência do material, 63,4% acreditam ser necessária e 88% concordam que o ensino deva continuar sobretudo considerando o perfil do egresso sugerido pelas Diretrizes Curriculares Nacionais. Dos dados subjetivos emergiram cinco classes/categorias que retratam a percepção dos profissionais sobre relação custo-benefício, acesso ao serviço, condições de trabalho e longevidade das restaurações. Conclui-se que, mesmo com a evolução dos materiais adesivos, o amálgama ainda é necessário, principalmente no serviço público, onde a demanda por restaurações de baixo custo e grande longevidade é alta. Assim, para essa amostra, enquanto não houver um material restaurador livre de mercúrio, barato, de fácil manuseio e durável, o ensino desse conteúdo deve permanecer nos cursos de graduação em Odontologia (AU).

La odontología ha experimentado recientemente una fuerte disminución en el uso de amalgamas como resultado de las discusiones sobre los riesgos de contaminación por mercurio, así como la evolución de los materiales y las técnicas adhesivas. Así, buscamos identificar la percepción de los odontólogos sobre la necesidad de continuar enseñando amalgama en los cursos de odontología. Se trata de un estudio transversal utilizando un cuestionario semiestructurado con aspectos relacionados con las condiciones sociodemográficas, capacitación para realizar los procedimientos, conocimientos sobre manejo de materiales y gestión de residuos. Las respuestas objetivas se analizaron mediante estadística descriptiva y las respuestas subjetivas se procesaron mediante el software IRaMuTeQ. De los 257 encuestados, el 60,7% afirma utilizar este material, el 91,8% utiliza amalgama encapsulada y el 95,7% desecha los residuos en la basura de hospital. En cuanto a la permanencia del material, el 63,4% cree que es necesario y el 88% está de acuerdo en que la enseñanza debe continuar, sobre todo para la graduación de profesionales que van al servicio público. A partir de los datos subjetivos, surgieron cinco clases/categorías que retratan la percepción de los profesionales sobre la rentabilidad, el acceso al servicio, las condiciones de trabajo y la longevidad de las restauraciones. Se concluye que, aún con la evolución de los materiales adhesivos, la amalgama sigue siendo necesaria, especialmente en el servicio público, donde la demanda de restauraciones de bajo costo y gran longevidad es alta. Así, mientras no exista un material restaurador libre de mercurio, económico, fácil de manejar y duradero, la enseñanza de este contenido O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas debe permanecer en los cursos de graduación en odontología (AU).

Dentistry has recently experienced a sharp decline in the use of amalgam, as a result of the evolution of adhesive materials and techniques and discussions about the risks of mercury contamination. Thus, we sought to identify the perception of dentists about the need to continue teaching amalgam in dentistry courses. This is a cross-sectional study, using a semi-structured questionnaire with aspects related to sociodemographic conditions, training to perform the procedures, knowledge about material management and waste management. The objective responses were analyzed by descriptive statistics and the subjective ones processed in the IRaMuTeQ software. Of the 257 respondents, 60.7% claim to use this material, 91.8% use encapsulated amalgam and 95.7% dispose of waste in hospital waste. Regarding the permanence of the material, 63.4% believe it is necessary and 88% agree that teaching should continue, especially considering the profile of the graduate suggested by the National Curriculum Guidelines. From the subjective data emerged five classes/categories that portray the perception of professionals about cost-benefit ratio, access to service, working conditions and longevity of restorations. It is concluded that, even with the evolution of adhesive materials, amalgam is still necessary, especially in the public service, where the demand for low cost and high longevity restorations is high. Thus, for this sample, as long as there is no mercury-free, inexpensive, easy to handle and durable restorative material, the teaching of this content should remain in undergraduate courses in Dentistry (AU).

COVID-19 Reflections on Restorative Treatments of Permanent First Molars.

BACKGROUND AND AIM: It is important to provide appropriate dental care for newly erupted permanent first molars (PFMs) since they are susceptible to caries. As the coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in the way dental services are provided to patients, the purpose of this study is to examine the procedure records assigned to PFMs of 6-15 year-olds during the pandemic and analyze the restorative material preferences of the residents of public dental hospitals. MATERIALS AND METHODS: Procedure records of patients aged between 6-15 years were extracted from the Public Oral and Dental Health Center, Bursa, Türkiye. All teeth groups except PFMs were excluded, while extracted, survived (restorative/endodontic/prosthetic procedures), and prevented (fissure sealant application) PFMs were analyzed retrospectively. Furthermore, restorative material preferences were analyzed by arch location, cavity surfaces, and dentition types. RESULTS: Strong positive correlation was seen between age and PFM extraction (r=0.973; p<0.001) and age and PFM restorative treatments (r= 0.966; p<0.001); a negative correlation was detected between age and fissure sealants (r= -0.984; p<0,001) performed on PFMs of 8-15-year-olds. Amalgam was most often preferred as the restorative material (p<0.05). CONCLUSION: The distribution of treatments and dental restorations can vary based on many factors, and the pandemic conditions may have changed treatment preferences to favor preventive dentistry. The excess of multi-surface restorations may be related to the delay of treatment applications during COVID-19.

Association between dental amalgam restoration and urine mercury concentrations among young women: a cross-sectional study.

BACKGROUND: The association between dental amalgam fillings and urine mercury concentrations was investigated in this study to assess the health risks associated with dental amalgams. METHODS: This cross-sectional study included 99 women in their 20s who visited the dental clinic in Daegu, Korea. The 99 participants were composed of 68 subjects who had dental amalgam fillings (exposure group) and 31 subjects who did not have dental amalgam fillings (nonexposure group). Oral examinations were conducted by a single dental hygienist, sociodemographic features were investigated as confounding variables, and urine mercury concentrations were measured using an automatic mercury analyzer. RESULTS: The mean±standard deviation of the urine mercury concentrations of the exposure and nonexposure groups were 1.50±1.78 µg/g creatinine and 0.53±0.63 µg/g creatinine, respectively. The exposure group showed significantly higher levels than the nonexposure group (p<0.01). The urine mercury concentration significantly increased with an increase in the number of teeth filled with amalgam, cavity surfaces involved, and number of defective amalgam fillings, and according to the latest exposure time (p<0.001). In the multiple regression analysis of amalgam-related factors and urine mercury concentrations after correction for confounding factors, the urine mercury concentration in the group with six or more amalgam-filled teeth, 11 or more cavity surfaces, and two or more defective amalgams was significantly higher than that in the nonexposure group (p<0.001). CONCLUSION: According to this study, exposure to dental amalgams was confirmed to significantly affect urine mercury concentrations.

Amalgam x Composite Resin: supplies and restorative procedures more performed among Oral Health Teams in Brazil

Abstract This study aimed to compare the availability of supplies and amalgam and composite resin restorations among Oral Health Teams (OHT) in Brazilian regions. Secondary data were extracted from Modules I and II of the 1st (2012) and V and VI of the 2nd (2014) and 3rd cycle (2017) of the external evaluation of the National Program for Access and Quality in Primary Care2. The proportions between regions and cycles were compared using the Chi-square test with the z-test adjusted by the Bonferroni method (p<0.05). Among 2012, 2014, and 2017 there was a significant reduction in the proportion of OHT that performed amalgam restorations (87.5%, 89.2%, and 80.2%; p<0.001) and an increase in resin composite (92.5 %, 97.7%, and 99.0%; p<0.001), with the same trend in Brazilian regions (p<0.001). Amalgamator availability decreased among 2012 (99.0%), 2014 (98.4%) and 2017 (85.6%) (p<0.001). Amalgam availability was lower in 2017 (80.1%), compared to 2012 (87.5%) and 2014 (97.5%) (p<0.001). The availability of light curing decreased between 2012 (99.0%), 2014 (98.4%) and 2017 (85.6%) (p<0.001), being less available in the North (95.7%) (p<0.001). The light-curing resin increased between 2012 (94.1%), 2014 (96.6%) and 2017 (97.0%) (p<0.001), with no increase only in the North (p=0.134). While there was a reduction in supplies and amalgam restoration, there was an increase in supplies and resin composite restorations in the period evaluated in all Brazilian regions. However, regional disparities are still evident, with fewer supplies of restorative services in the North region.

Resumo Este estudo objetivou comparar a disponibilidade de fornecimentos e restaurações de amálgama e resina composta entre as Equipas de Saúde Oral (OHT) por regiões brasileiras. Os dados secundários foram extraídos dos módulos I e II do 1º (2012) e V e VI do 2º (2014) e 3º ciclo (2017) da avaliação externa do Programa Nacional de Acesso e Qualidade em Cuidados Primários. As proporções entre regiões e ciclos foram comparadas utilizando o teste Qui-quadrado com o teste z ajustado pelo método de Bonferroni (p<0,05). Entre 2012, 2014, e 2017 houve uma redução significativa na proporção de OHT que realizou restaurações de amálgama (87,5%, 89,2%, e 80,2%; p<0,001) e um aumento na resina composta (92,5%, 97,7%, e 99,0%; p<0,001), com a mesma tendência nas regiões brasileiras (p<0,001). A disponibilidade de amalgamadores diminuiu entre 2012 (99,0%), 2014 (98,4%) e 2017 (85,6%) (p<0,001). A disponibilidade de amálgama foi menor em 2017 (80,1%), em comparação com 2012 (87,5%) e 2014 (97,5%) (p<0,001). A disponibilidade de polimerização por luz diminuiu entre 2012 (99,0%), 2014 (98,4%) e 2017 (85,6%) (p<0,001), estando menos disponível no Norte (95,7%) (p<0,001). A resina fotopolimerizadora aumentou entre 2012 (94,1%), 2014 (96,6%) e 2017 (97,0%) (p<0,001), sem aumento apenas no Norte (p=0,134). Embora tenha havido uma redução nos fornecimentos e restauração de amálgamas, houve um aumento nos fornecimentos e restaurações de resina composta no período avaliado em todas as regiões brasileiras. Contudo, as disparidades regionais são ainda evidentes, com menos oferta de serviços de restauração na região Norte.