Vamnes Jan Sverre, Lygre Gunvor Bentung, Grönningsaeter Arne Geir, Gjerdet Nils Roar
Department of Odontology, Dental Biomaterials, University of Bergen, Norway.
Community Dent Oral Epidemiol. 2004 Apr;32(2):150-7. doi: 10.1111/j.0301-5661.2004.00148.x.
We describe the function of, and results from, the Norwegian National Dental Biomaterials Adverse Reaction Unit after 4 years of activity from 1993 to 1997.
During this period of time, 296 patients were examined at the unit, which is located at the Dental School, University of Bergen. The most prevalent age group was 40-49 years, and 70% were women. Dental amalgam was the primary reason for referral to the unit for nearly 85% of the patients, followed by metals in crowns and bridges (11%). Materials in removable dentures, resin-based filling materials and cements, endodontic materials, and others, including temporary materials, were also involved. Nearly all (96%) patients reported general subjective symptoms, such as muscle and joint pain, fatigue, and memory problems. Complaints involving the orofacial region (lips, face, temporomandibular joint) and intraoral subjective symptoms were also common.
Of the patients who were patch tested with substances in dental materials, 23% were positive to gold, 28% to nickel, 14% to cobalt, 9% to palladium, 6% to mercury, and 8% to one or more components of resin-based materials. Mercury concentrations in blood and urine were statistically higher in the patients with amalgam fillings compared with those without.
Generally, we could not establish a straightforward cause-and-effect relationship between the presence of dental biomaterials and general symptoms. Twenty patients were advised to replace restorative materials because of contact lesions. Another 20 patients were recommended replacement of materials because of allergy verified with positive patch tests. The complex nature of most of the reactions requires a multidisciplinary approach to the care taking of patients who are concerned about reactions from dental materials, particularly amalgam.
我们描述了挪威国家牙科生物材料不良反应机构在1993年至1997年4年活动期间的功能及成果。
在此期间，296名患者在位于卑尔根大学牙科学院的该机构接受了检查。最常见的年龄组为40 - 49岁，70%为女性。牙科汞合金是近85%的患者被转诊至该机构的主要原因，其次是冠桥中的金属（11%）。可摘义齿材料、树脂基填充材料和粘固剂、牙髓材料以及其他材料（包括临时材料）也有涉及。几乎所有（96%）患者都报告了一般主观症状，如肌肉和关节疼痛、疲劳及记忆问题。涉及口面部区域（嘴唇、面部、颞下颌关节）和口腔内主观症状的投诉也很常见。
在对牙科材料中的物质进行斑贴试验的患者中，23%对金呈阳性反应，28%对镍呈阳性反应，14%对钴呈阳性反应，9%对钯呈阳性反应，6%对汞呈阳性反应，8%对树脂基材料的一种或多种成分呈阳性反应。与无汞合金填充物的患者相比，有汞合金填充物的患者血液和尿液中的汞浓度在统计学上更高。
一般来说，我们无法在牙科生物材料的存在与一般症状之间建立直接的因果关系。20名患者因接触性病变被建议更换修复材料。另外20名患者因斑贴试验呈阳性证实过敏而被建议更换材料。大多数反应的复杂性需要采用多学科方法来照顾那些担心牙科材料（尤其是汞合金）反应的患者。
