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评估透明矫治器治疗期间双酚A浸出的生物学效应:系统评价和荟萃分析的伞状综述

Evaluating the Biological Effects of Bisphenol A Leaching During Clear Aligner Therapy: An Umbrella Review of Systematic Reviews and Meta-Analyses.

作者信息

Mallik Noyonika, Mohanty Biswaroop, Jena Sanghamitra, Dash Bhagabati, Sahoo Nivedita

机构信息

Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, IND.

出版信息

Cureus. 2025 Jul 24;17(7):e88704. doi: 10.7759/cureus.88704. eCollection 2025 Jul.

Abstract

The rising demand for aesthetic and comfortable orthodontic treatments has led to the widespread use of clear aligner therapy (CAT), a modern alternative to traditional braces. This umbrella review examines the biological effects of bisphenol A (BPA), a synthetic compound commonly found in clear aligner materials, focusing on its potential health risks. BPA is known for its estrogen-mimicking properties and has been associated with endocrine disruption and increased cancer risk. This review synthesizes findings from systematic reviews and meta-analyses to evaluate BPA leaching in aligner therapy and its implications for patient safety. A total of 25 studies were screened, with three high-quality systematic reviews included in the final analysis. In vitro studies generally reported minimal cytotoxicity and weak estrogenic effects, while clinical trials suggested higher BPA levels due to the dynamic oral environment. Risk of bias was assessed, and forest and funnel plots indicated consistent findings with low immediate toxicity but raised concerns regarding long-term hormonal effects. Given these findings, further research is recommended to assess BPA exposure under real oral conditions and to develop BPA-free aligner materials. This review underscores the importance of biocompatibility in orthodontic materials and the need for rigorous safety assessments to protect patient health.

摘要

对美观舒适的正畸治疗需求不断增加,导致透明矫治器疗法(CAT)广泛应用,这是传统牙套的一种现代替代方法。本伞状综述探讨了双酚A(BPA)的生物学效应,双酚A是一种在透明矫治器材料中常见的合成化合物,重点关注其潜在的健康风险。双酚A因其模拟雌激素的特性而闻名,并与内分泌干扰和癌症风险增加有关。本综述综合了系统评价和荟萃分析的结果,以评估双酚A在矫治器疗法中的浸出情况及其对患者安全的影响。共筛选了25项研究,最终分析纳入了三项高质量的系统评价。体外研究一般报告细胞毒性极小且雌激素效应较弱,而临床试验表明,由于动态口腔环境,双酚A水平较高。评估了偏倚风险,森林图和漏斗图显示结果一致,即即时毒性较低,但对长期激素效应存在担忧。鉴于这些发现,建议进一步研究以评估实际口腔条件下的双酚A暴露情况,并开发不含双酚A的矫治器材料。本综述强调了正畸材料生物相容性的重要性以及进行严格安全评估以保护患者健康的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c5e/12375140/4808a545c0eb/cureus-0017-00000088704-i01.jpg

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