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牙科复合材料、汞合金与儿童体格发育。

Dental composites and amalgam and physical development in children.

机构信息

New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA.

出版信息

J Dent Res. 2012 Nov;91(11):1019-25. doi: 10.1177/0022034512458691. Epub 2012 Sep 12.

Abstract

Resin-based composite dental restoration materials may release bisphenol-A, an endocrine-disrupting chemical. Using secondary analysis of a randomized clinical safety trial of amalgam vs. composites, we tested the hypothesis that dental restoration materials affect children's growth. Children (N = 218 boys, N = 256 girls) aged 6 to 10 yrs at baseline with ≥ 2 decayed posterior teeth were randomized to amalgam or composites (bisphenol-A-diglycidyl-dimethacrylate composite for permanent teeth, urethane-dimethacrylate compomer for primary teeth) for treatment of posterior caries throughout follow-up. Primary outcomes for this analysis were 5-year changes in BMI-for-age z-scores, body fat percentage (BF%), and height velocity; exploratory analyses (n = 113) examined age at menarche. Results showed no significant differences between treatment assignment and changes in physical development in boys [(composites vs. amalgam) BF%, 4.9 vs. 5.7, p = 0.49; (BMI-z-score) 0.13 vs. 0.25, p = 0.36] or girls (8.8 vs. 7.7, p = 0.95; 0.36 vs. 0.21, p = 0.49). Children with more treatment on primary teeth had greater increases in BF% regardless of material type. Girls assigned to composites had lower risk of menarche during follow-up (hazard ratio = 0.57, 95% CI 0.35-0.95). Overall, there were no significant differences in physical development over 5 years in children treated with composites or amalgam. Additional studies examining these restoration materials in relation to age at menarche are warranted (clinicaltrials.gov number NCT00065988).

摘要

树脂基复合牙科修复材料可能会释放出双酚 A,这是一种内分泌干扰化学物质。我们利用一项关于汞合金与复合材料随机临床安全性试验的二次分析,检验了牙科修复材料是否会影响儿童生长的假设。研究对象为基线时年龄在 6 至 10 岁、至少有 2 颗后牙龋坏的儿童(男童 218 名,女童 256 名),他们被随机分配至接受汞合金或复合材料治疗(永久性牙齿使用双酚 A 二缩水甘油二甲基丙烯酸酯复合材料,乳牙使用氨酯二甲基丙烯酸酯混合体),以治疗后牙龋病,随访期贯穿始终。本次分析的主要结局为 5 年时 BMI 年龄别 z 评分、体脂百分比(BF%)和身高增长率的变化;探索性分析(n = 113)则检测了初潮年龄。结果显示,治疗组间无显著差异,男孩在身体发育方面的变化也无显著差异[(复合材料与汞合金相比)BF%为 4.9%比 5.7%,p = 0.49;(BMI-z 评分)0.13 比 0.25,p = 0.36],女孩也无显著差异[8.8%比 7.7%,p = 0.95;0.36 比 0.21,p = 0.49]。无论材料类型如何,乳牙接受更多治疗的儿童体脂百分比增加幅度更大。接受复合材料治疗的女孩在随访期间初潮风险降低(风险比=0.57,95%CI 0.35-0.95)。总体而言,接受复合材料或汞合金治疗的儿童在 5 年内的身体发育无显著差异。需要进一步研究这些修复材料与初潮年龄之间的关系(临床试验编号 NCT00065988)。

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