Paradigmaváltás a fogmegtartó kezelésben: az amalgámkorszak vége

Abstract

Dental amalgam has been used for more than 150 years due to its beneficial mechanical properties and durability in dentistry. In the past and to date, many questions about amalgam restorations have arisen, especially regarding the mercury content, which has been the subject of global disputes. By presenting the past and present of the ‘amalgam issue’, the aim of our paper is to display the current position of international literature. This summary is based on the publications in the PubMed database, the guidelines of the Council of European Dentists. Although the use of dental amalgam is widespread, concerns have been raised about the adverse effect on human health and the environment, focusing on its heavy metal pollution during waste treatment. In 2017, the European Union (EU) adopted the so-called Mercury Regulation, based on the United Nations Minamata Convention on Mercury, the recommendations of which are presented in the present review. This Regulation includes the requirement for EU Member States to develop a national action plan for the phase-down of amalgam. The feasibility plan for complete phase-out may be guaranteed by 2030. The authors discuss the advantages and disadvantages of possible amalgam alternatives by presenting glass-ionomers and resin-based composites. In the future, more material research programmes and long-term follow-up studies are necessary. In addition to several global health organizations, the Council of European Dentists also draws attention to prevent dental caries, expecting to reduce the number of restorations. Orv Hetil. 2018; 159(42): 1700–1709.

Fracture Behavior of Short Fiber-Reinforced Direct Restorations in Large MOD Cavities

“…With the development of adhesive techniques and composite resin restorative materials, composite fillings have come to be routinely used in the posterior region of the mouth [ 1 , 2 ]. The number of direct posterior composite restorations is expected to increase further with the worldwide phasing out of the use of amalgam [ 3 , 4 , 5 ]. In addition to aesthetic considerations, modern direct restorations must also restore function and protect the remaining tooth structure against fractures [ 6 ].…”

Crack propensity of different direct restorative procedures in deep MOD cavities

“…According to Forster et al, in this clinical situation, 5 mm is the critical depth at which material-related disadvantages (such as suboptimal fracture toughness) start to show [36]. It is important to note that the number of direct posterior composite restorations is expected to increase in such deep cavities with the worldwide phasing out of the use of amalgam [41][42][43]. Therefore, in our study, we analyzed polymerization shrinkage-induced crack formation of different restorative materials in deep MOD cavities via transillumination.…”

Műgyanta alapú kompozíciós helyreállító anyagok és azok egészségre gyakorolt hatása : Irodalmi áttekintés

“…A felhasznált fogászati anyagok a közvetlen környezetükben lévő szövetekre is fejthetnek ki hatást, mint például monomerek hatására történő pulpanekrózis [1,35], a gingiva gyulladása [37] a restaurátumok mellett kialakuló marginális gingivitis vagy egyéb, fehér színű nyálkahártya-elváltozások [19,20]. Szisztémás szöveti reakció az alkalmazási területtől távol lévő szervekben léphet fel.…”

“…A res tau rá tum szájba kerülése után közvetlenül a nyálban mérhető monomerek szintje kofferdám gumilepedő használatával elvileg csökkenthető [14]. Ugyanakkor vize let vizsgálat alapján a szervezetben a monomer, kifejezetten a biszfenol A (BPA) szintje ideiglenesen megemelkedik, ez azonban 2-14 nap elteltével visszaáll a kiindulási állapotra, és ezt a kofferdám használata nem tudta befolyásolni [14,17,19]. A monomerek tömésből való kilépését befolyásolja még a monomer tulajdonsága, polaritása, ugyanis a TEGDMA és a HEMA önmaga is hidrofil [9].…”