Oral Health Prev Dent. 2022 Mar 21;20:149-156. doi: 10.3290/j.ohpd.b2831749.
The Minamata Convention resulted in restrictions in the use of amalgam in daily dental practice. This opens up new discussions about the biocompatibility of amalgam, but also of composites as alternative materials. In the following review article, these issues will be discussed in more detail to provide dentists with a knowledge base for themselves and for communication with their patients. In addition to mercury in amalgam or monomers in composites, bisphenol A and nanoparticles generated during the grinding, polishing or removal of restorations must also be included in the biocompatibility evaluation. In laboratory tests, these substances cause toxic reactions, and bisphenol A also exhibits estrogen-like effects. However, it must be taken into account that the concentrations used in laboratory tests are much higher than in clinical practice. Thus, both amalgam and composite can be used in the general population. Nevertheless, for scientifically, politically and legally defined risk groups (e.g. dental personnel, allergic persons, pregnant or lactating women, children under 15 years of age, people with certain systemic diseases), indication restrictions and precautionary measures must be observed. The well-known amalgam discussion has taught us the importance of thorough and open risk communication with the patient.
《水俣公约》限制了汞合金在日常牙科实践中的使用。这就引发了关于汞合金以及复合材料（作为替代材料）生物相容性的新讨论。在接下来的综述文章中，将更详细地讨论这些问题，为牙医提供自己和与患者沟通的知识库。除了汞合金中的汞或复合材料中的单体外，在修复体的研磨、抛光或去除过程中产生的双酚 A 和纳米颗粒也必须纳入生物相容性评估。在实验室测试中，这些物质会引起毒性反应，双酚 A 还具有类似雌激素的作用。但必须考虑到，实验室测试中使用的浓度远高于临床实践中的浓度。因此，汞合金和复合材料都可用于普通人群。尽管如此，对于科学、政治和法律上定义的风险群体（例如牙科医务人员、过敏人群、孕妇或哺乳期妇女、15 岁以下儿童、患有某些系统性疾病的人），必须观察到适应证限制和预防措施。众所周知的汞合金讨论让我们认识到与患者进行彻底和公开的风险沟通的重要性。
