Neurobehavioral Effects of Dental Amalgam in Children

摘要: ContextDental (silver) amalgam is a widely used restorative material containing 50% elemental mercury that emits small amounts of vapor. No randomized clinical trials have determined whether there are significant health risks associated with this low-level exposure.ObjectiveTo assess the safety dental restorations in children.DesignA trial which children requiring treatment were to either for posterior or resin composite instead amalgam. Enrollment commenced February 1997, annual follow-up 7 years concluding July 2005.Setting and ParticipantsA total 507 Lisbon, Portugal, aged 8 10 at least 1 carious lesion on permanent tooth, no previous exposure amalgam, urinary level <10 μg/L, blood lead <15 μg/dL, Comprehensive Test Nonverbal Intelligence IQ ≥67, interfering conditions.InterventionRoutine, standard-of-care treatment, one group receiving lesions (n = 253) other (n = 254).Main Outcome MeasuresNeurobehavioral assessments memory, attention/concentration, motor/visuomotor domains, as well nerve conduction velocities.ResultsDuring 7-year period, had mean 18.7 tooth surfaces (median, 16) restored 21.3 18) group. Baseline creatinine-adjusted levels 1.8 μg/g 1.9 group, but during 1.0 1.5 higher than (P<.001). There statistically differences measures attention, visuomotor function, velocities (average z scores very similar, near zero) groups over all follow-up, observed any time point (P values from .29 .91). Starting 5 after initial need additional was approximately group.ConclusionsIn study, who received did not, average, neurobehavioral velocity when compared materials without These findings, combined trend later among those composite, suggest should remain viable option children.Trial Registrationclinicaltrials.gov Identifier: NCT00066118