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牙科治疗中双酚A暴露的系统评价

A Systematic Review of Exposure to Bisphenol A from Dental Treatment.

作者信息

Marzouk T, Sathyanarayana S, Kim A S, Seminario A L, McKinney C M

机构信息

1 Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.

2 Department of Pediatrics / Seattle Children's Research Institute, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.

出版信息

JDR Clin Trans Res. 2019 Apr;4(2):106-115. doi: 10.1177/2380084418816079. Epub 2019 Jan 25.

Abstract

INTRODUCTION

Dental composite restorations and dental sealants containing bisphenol A glycidyl methacrylate (BisGMA) are commonly used materials in dentistry. Bisphenol A (BPA) is used to manufacture BisGMA and can be a by-product in BisGMA-based dental materials. BPA is an endocrine-disrupting chemical that may affect reproductive, psychological, cognitive, and endocrine-related health. We conducted a systematic review of clinical studies that measured urinary BPA (uBPA) concentrations before and after dental treatment to evaluate the extent to which individuals are exposed to BPA from dental treatment.

METHODS

Eligibility included studies that measured uBPA concentrations before and after dental treatment with any type of resin-based dental material. We searched PubMed, Cochrane, Web of Science, Virtual Health Library, Science Direct, ProQuest, and Clinical Trials with no date or language restrictions to identify published studies. We summarized eligible studies across participant characteristics, amount of treatment, and time of follow-up measures. Because methods of measuring uBPA varied, our primary outcome was the direction and percentage change between baseline and 24 h posttreatment and at later time points as available.

RESULTS

We identified 1,190 abstracts and 7 eligible studies: 4 in children and 3 in adults. In all studies, BPA concentrations increased 24 h after treatment. The 2 studies with the largest sample sizes found statistically significant increases >40% in uBPA concentrations at 24 h posttreatment (both P values <0.01). The 1 study to examine uBPA concentrations beyond 1 mo posttreatment found that concentrations returned to baseline by 14 d after treatment and remained at baseline 6 mo after treatment.

CONCLUSIONS

Our findings suggest that uBPA concentrations increase 24 h after dental treatment. One study showed that uBPA concentrations return to baseline by 14 d. Additional research is needed to determine the magnitude of change from pre- to post-dental treatment and the trajectory of uBPA concentrations posttreatment.

KNOWLEDGE TRANSFER STATEMENT

BPA is an endocrine-disrupting chemical that may have negative human health effects. Our findings suggest that urinary BPA concentrations increase in the short term after dental treatment. The extent to which such an increase may affect the health of patients remains an open question, particularly since there are no established thresholds for safety or harm related to BPA exposure.

摘要

引言

含双酚A甲基丙烯酸缩水甘油酯(BisGMA)的牙科复合树脂修复材料和牙釉质封闭剂是牙科常用材料。双酚A(BPA)用于制造BisGMA,且可能是基于BisGMA的牙科材料中的副产物。BPA是一种内分泌干扰化学物质,可能影响生殖、心理、认知及内分泌相关健康。我们对测量牙科治疗前后尿中双酚A(uBPA)浓度的临床研究进行了系统评价,以评估个体从牙科治疗中接触BPA的程度。

方法

纳入标准包括测量使用任何类型基于树脂的牙科材料进行牙科治疗前后uBPA浓度的研究。我们检索了PubMed、Cochrane、科学引文索引、虚拟健康图书馆、科学Direct、ProQuest和临床试验数据库,无日期或语言限制,以识别已发表的研究。我们总结了符合条件的研究的参与者特征、治疗量和随访测量时间。由于测量uBPA的方法各不相同,我们的主要结局是基线与治疗后24小时以及后续可用时间点之间的变化方向和百分比变化。

结果

我们识别出1190篇摘要,7项符合条件的研究:4项针对儿童,3项针对成人。在所有研究中,治疗后24小时BPA浓度均升高。样本量最大的2项研究发现,治疗后24小时uBPA浓度有统计学意义的升高,超过40%(P值均<0.01)。1项研究在治疗后1个月以上检测uBPA浓度,发现治疗后14天浓度恢复至基线水平,治疗后6个月维持在基线水平。

结论

我们的研究结果表明,牙科治疗后24小时uBPA浓度升高。1项研究表明,uBPA浓度在治疗后14天恢复至基线水平。需要进一步研究以确定牙科治疗前后uBPA浓度变化的幅度以及治疗后uBPA浓度的变化轨迹。

知识转移声明

BPA是一种内分泌干扰化学物质,可能对人类健康产生负面影响。我们的研究结果表明,牙科治疗后短期内尿中BPA浓度会升高。这种升高对患者健康的影响程度仍是一个悬而未决的问题,尤其是因为尚无与BPA暴露相关的安全或危害既定阈值。

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