Björkman Lars, Sjursen Therese T, Dalen Knut, Lygre Gunvor B, Berge Trine Lise L, Svahn Johanna, Lundekvam Birgitte F
a Dental Biomaterials Adverse Reaction Unit, Uni Research , Bergen , Norway.
b Department of Clinical Dentistry, Faculty of Medicine and Dentistry , University of Bergen , Bergen , Norway.
Acta Odontol Scand. 2017 Apr;75(3):208-219. doi: 10.1080/00016357.2016.1278262. Epub 2017 Jan 16.
Concerns over adverse effects of mercury released from dental amalgam sometimes lead patients to request removal of their amalgam restorations. Several studies report improvement of subjective health after removal of amalgam restorations, but the mechanisms are unclear. The aim of this paper is to present data on long term changes in intensity of health complaints after amalgam removal in a group of patients with health complaints self-attributed to dental amalgam. Data from the five years follow-up in a clinical trial are presented and related to potential determinants of change.
Patients previously referred to a specialty unit for health complaints attributed to amalgam restorations were included in the study. The 20 participants who were allocated to the treatment group had all amalgam restorations removed and replaced with other dental restorative materials. Intensity of health complaints was calculated from questionnaire data and personality variables were measured by MMPI-2.
At the follow-up five years after the amalgam removal was completed, intensity of general health complaints was significantly reduced (p=.001), but the symptom load was still high. The reduction was significantly correlated with concentration of mercury in urine at pre-treatment. There were no significant correlations with personality variables.
Removal of amalgam restorations was followed by a long term reduction of general health complaints, which was associated with mercury concentration in urine before amalgam removal. Additional studies are needed to confirm the potential mechanisms for the observed reduction.
对牙科汞合金释放汞的不良反应的担忧有时会导致患者要求去除其汞合金修复体。几项研究报告称,去除汞合金修复体后主观健康状况有所改善,但机制尚不清楚。本文的目的是呈现一组自认为健康问题归因于牙科汞合金的患者在去除汞合金后健康投诉强度的长期变化数据。展示了一项临床试验五年随访的数据,并将其与变化的潜在决定因素相关联。
本研究纳入了先前因汞合金修复体导致健康投诉而转诊至专科单位的患者。分配到治疗组的20名参与者均去除了所有汞合金修复体,并用其他牙科修复材料进行了替换。根据问卷数据计算健康投诉强度,并用明尼苏达多项人格调查表第二版(MMPI - 2)测量人格变量。
在完成汞合金去除五年后的随访中,总体健康投诉强度显著降低(p = 0.001),但症状负荷仍然很高。这种降低与治疗前尿液中的汞浓度显著相关。与人格变量无显著相关性。
去除汞合金修复体后,总体健康投诉长期减少,这与去除汞合金前尿液中的汞浓度有关。需要进一步的研究来证实观察到的减少的潜在机制。