Department of Medicine, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
Pediatrics. 2010 Oct;126(4):760-8. doi: 10.1542/peds.2009-2693. Epub 2010 Sep 6.
Dental sealants and composite filling materials containing bisphenol A (BPA) derivatives are increasingly used in childhood dentistry. Evidence is accumulating that BPA and some BPA derivatives can pose health risks attributable to their endocrine-disrupting, estrogenic properties.
To systematically compile and critically evaluate the literature characterizing BPA content of dental materials; to assess BPA exposures from dental materials and potential health risks; and to develop evidence-based guidance for reducing BPA exposures while promoting oral health.
The extant toxicological literature and material safety data sheets were used as data sources.
BPA is released from dental resins through salivary enzymatic hydrolysis of BPA derivatives, and BPA is detectable in saliva for up to 3 hours after resin placement. The quantity and duration of systemic BPA absorption is not clear from the available data. Dental products containing the bisphenol A derivative glycidyl dimethacrylate (bis-GMA) are less likely to be hydrolyzed to BPA and have less estrogenicity than those containing bisphenol A dimethacrylate (bis-DMA). Most other BPA derivatives used in dental materials have not been evaluated for estrogenicity. BPA exposure can be reduced by cleaning and rinsing surfaces of sealants and composites immediately after placement.
On the basis of the proven benefits of resin-based dental materials and the brevity of BPA exposure, we recommend continued use with strict adherence to precautionary application techniques. Use of these materials should be minimized during pregnancy whenever possible. Manufacturers should be required to report complete information on the chemical composition of dental products and encouraged to develop materials with less estrogenic potential.
牙科密封剂和含有双酚 A (BPA) 衍生物的复合填充材料在儿童牙科中越来越多地被使用。越来越多的证据表明,BPA 和一些 BPA 衍生物可能会对健康造成危害,这是由于它们具有内分泌干扰、雌激素的特性。
系统地收集和批判性评估描述牙科材料中 BPA 含量的文献;评估牙科材料中的 BPA 暴露及其潜在的健康风险;并制定减少 BPA 暴露同时促进口腔健康的循证指导。
利用现有的毒理学文献和材料安全数据表作为数据来源。
BPA 通过唾液中 BPA 衍生物的酶解从牙科树脂中释放出来,并且在树脂放置后 3 小时内,唾液中仍能检测到 BPA。目前的数据尚不清楚系统吸收 BPA 的数量和持续时间。含有双酚 A 衍生物缩水甘油二甲基丙烯酸酯 (bis-GMA) 的牙科产品不太可能被水解为 BPA,并且其雌激素活性低于含有双酚 A 二甲基丙烯酸酯 (bis-DMA) 的产品。大多数其他用于牙科材料的 BPA 衍生物尚未评估其雌激素活性。通过在放置后立即清洁和冲洗密封剂和复合材料的表面,可以减少 BPA 暴露。
鉴于树脂基牙科材料的已知益处以及 BPA 暴露的短暂性,我们建议在严格遵守预防应用技术的前提下继续使用。在可能的情况下,在怀孕期间应尽量减少使用这些材料。制造商应被要求报告牙科产品化学成分的完整信息,并鼓励开发具有较低雌激素潜力的材料。