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[汞合金及替代品——关于减少环境中汞含量的讨论]

[Amalgam and alternatives-discussions on mercury reduction in the environment].

作者信息

Frankenberger Roland, Winter Julia, Schmalz Gottfried

机构信息

Abteilung für Zahnerhaltungskunde, Med. Zentrum für Zahn‑, Mund- und Kieferheilkunde, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Deutschland.

Poliklinik für Zahnerhaltung und Parodontologie, Universitätsklinikum Regensburg, Regensburg, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Jul;64(7):847-855. doi: 10.1007/s00103-021-03355-4. Epub 2021 Jun 18.

Abstract

Dental amalgam has been successfully used for the restoration of carious lesions for more than 180 years. It is clinically characterized by high longevity and low technique sensitivity. For decades, dental amalgam has been discussed in the public, especially due to its roughly 50% mercury content. Since the Minamata Convention was published in 2013 with the primary goal of reducing the anthropogenic mercury release into the environment, the previously muted amalgam discussion has received fresh impetus. Another considerable disadvantage of amalgam is its silver/greyish color, which simply no longer matches patients' esthetic demands.The present paper describes the basic problems with amalgam against the background of multiple biological, clinical, and health policy factors. Possible consequences of the Minamata Convention concerning legal regulations as well as the use of dental biomaterials and therefore also relating to the future national healthcare system are discussed. Finally, possible amalgam alternatives and the urgent need for biomedical research towards restorative dentistry are presented, embedded into the crucial question of whether we are actually conducting the correct debate.

摘要

牙科汞合金已成功用于修复龋损超过180年。其临床特点是使用寿命长且技术敏感性低。几十年来,牙科汞合金一直是公众讨论的话题,尤其是因其汞含量约为50%。自2013年《水俣公约》发布,其主要目标是减少人为汞排放到环境中以来,此前被搁置的汞合金讨论获得了新的推动力。汞合金的另一个相当大的缺点是其银灰色外观,这已不再符合患者的美学需求。本文在多种生物学、临床和卫生政策因素的背景下描述了汞合金的基本问题。讨论了《水俣公约》在法律法规以及牙科生物材料使用方面可能产生的后果,因此也涉及未来国家医疗保健系统。最后,介绍了可能的汞合金替代品以及对口腔修复学进行生物医学研究的迫切需求,并将其置于我们是否真正在进行正确辩论这一关键问题之中。

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