Tichy A, Srolerova T, Schwendicke F
Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Munich, Germany.
Institute of Dental Medicine, First Faculty of Medicine of the Charles University, Prague, Czech Republic.
J Dent Res. 2025 Jun 16;104(10):220345251337728. doi: 10.1177/00220345251337728.
The gradual phaseout of dental amalgam has contributed to a significant increase in the use of resin-based materials. While these materials offer several desirable properties, concerns persist regarding their biocompatibility, particularly the release of bisphenol A (BPA). BPA is an endocrine-disrupting chemical linked to adverse effects on human health, including reproductive, developmental, and metabolic disorders. Although food contact materials are the primary source of human BPA exposure and the contribution of dental materials is minor, the associated risks cannot be dismissed due to BPA's nonmonotonic dose-response relationship. In 2023, the European Food Safety Authority proposed a 20,000-fold reduction in the tolerable daily intake of BPA to 0.2 ng/kg body weight, citing immune system effects at extremely low doses. This proposal has sparked regulatory and scientific debate, as adopting such a stringent limit would effectively ban the use of BPA in food contact materials and many other products. Given this context, it is essential to assess the release of BPA from dental materials both in vitro and in vivo. However, data interpretation is complicated by methodological inconsistencies, including variations in material composition, specimen preparation, choice of extraction media, experimental duration, and analytical methods. In addition, pivotal differences in reporting results make it difficult to synthesize findings and draw reliable conclusions. This review examines the controversy surrounding BPA, critically evaluates evidence on its release from dental materials, and explores mitigation strategies. By highlighting gaps in knowledge and proposing future research directions, this review aims to provide clinicians, researchers, and policymakers with a clearer understanding of BPA-related complexities, ultimately contributing to patient safety and material innovation.
逐步淘汰牙科汞合金导致树脂基材料的使用显著增加。虽然这些材料具有一些理想的特性,但人们对其生物相容性仍存在担忧,尤其是双酚A(BPA)的释放。双酚A是一种内分泌干扰化学物质,与对人类健康的不良影响有关,包括生殖、发育和代谢紊乱。尽管食品接触材料是人类双酚A暴露的主要来源,牙科材料的贡献较小,但由于双酚A的非单调剂量反应关系,相关风险不能被忽视。2023年,欧洲食品安全局提议将双酚A的每日可耐受摄入量降低20000倍,至0.2纳克/千克体重,理由是极低剂量下对免疫系统的影响。这一提议引发了监管和科学辩论,因为采用如此严格的限制将有效禁止在食品接触材料和许多其他产品中使用双酚A。在此背景下,评估牙科材料在体外和体内双酚A的释放至关重要。然而,数据解释因方法上的不一致而变得复杂,包括材料成分、标本制备、提取介质的选择、实验持续时间和分析方法的差异。此外,报告结果的关键差异使得难以综合研究结果并得出可靠结论。本综述探讨了围绕双酚A的争议,批判性地评估了其从牙科材料中释放的证据,并探索了缓解策略。通过突出知识差距并提出未来研究方向,本综述旨在让临床医生、研究人员和政策制定者更清楚地了解与双酚A相关的复杂性,最终为患者安全和材料创新做出贡献。