Gallusi Gianni, Libonati Antonio, Piro Mario, Di Taranto Virginia, Montemurro Edoardo, Campanella Vincenzo
Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
Materials (Basel). 2021 Apr 15;14(8):1980. doi: 10.3390/ma14081980.
The aim of this study was to confirm the hypothesis that patients with one or more amalgam restorations have an increased risk for systemic diseases rather than patients with resin-based restorations.
The data search produced an initial 3568 total number of records. All titles and abstract were reviewed by five independent examiners, and only 36 records were selected for full text in depth examination. Out of these, only nine publications matched the inclusion criteria and were included in this systematic review.
Electronic databases (MEDLINE, Scopus, Embase, and Web of Knowledge) were searched up to June 2019. In addition, a manual search was carried out on journals related to this topic.
All selected human clinical studies compared patients with dental amalgam restorations to patients with non-amalgam restorations on restorative material related diseases/health conditions with at least 50 patients and a reasonable follow up. The systemic effects of dental restorations were analyzed. As for any systemic effects, there was no difference between amalgam and composite restoration.
With the limitations of the few available randomized controlled trials (RCTs) on the matter, amalgam restorations, similarly to other modern resin-based materials, were not related to an increased risk of systemic diseases or conditions.
On the basis of the available RCTs, amalgam restorations, if compared with resin-based fillings, do not show an increased risk for systemic diseases. There is still insufficient evidence to exclude or demonstrate any direct influence on general health. The removal of old amalgam restorations and their substitution with more modern adhesive restorations should be performed only when clinically necessary and not just for material concerns. In order to better evaluate the safety of dental amalgam compared to other more modern restorative materials, further RCTs that consider important parameters such as long and uniform follow up periods, number of restorations per patient, and sample populations representative of chronic or degenerative diseases are needed.
本研究的目的是验证以下假设，即与树脂类修复体患者相比，有一个或多个汞合金修复体的患者患全身性疾病的风险增加。
数据检索最初共产生3568条记录。所有标题和摘要由五名独立审查员进行审查，仅36条记录被选出来进行全文深入审查。其中，只有9篇出版物符合纳入标准并被纳入本系统评价。
检索了截至2019年6月的电子数据库（MEDLINE、Scopus、Embase和Web of Knowledge）。此外，还对与该主题相关的期刊进行了手工检索。
所有选定的人体临床研究将汞合金修复体患者与非汞合金修复体患者在与修复材料相关的疾病/健康状况方面进行了比较，每组至少50例患者，并进行了合理的随访。分析了牙科修复体的全身影响。至于任何全身影响，汞合金修复体和复合树脂修复体之间没有差异。
鉴于关于此事的可用随机对照试验（RCT）数量有限，汞合金修复体与其他现代树脂基材料一样，与全身性疾病或状况风险增加无关。
根据现有的随机对照试验，与树脂基填充物相比，汞合金修复体未显示出患全身性疾病的风险增加。仍然没有足够的证据排除或证明对总体健康有任何直接影响。仅在临床必要时，而不仅仅是出于材料方面的考虑，才应去除旧的汞合金修复体并用更现代的粘结修复体进行替代。为了更好地评估汞合金与其他更现代修复材料相比的安全性，需要进一步的随机对照试验，这些试验应考虑重要参数，如长期且一致的随访期、每位患者的修复体数量以及代表慢性或退行性疾病的样本人群。
