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牙科汞——一种公共卫生危害。

Dental mercury--a public health hazard.

作者信息

Pleva J

机构信息

Uddeholm Tooling AB, Research & Development, Hagfors, Sweden.

出版信息

Rev Environ Health. 1994 Jan-Mar;10(1):1-27. doi: 10.1515/reveh.1994.10.1.1.

Abstract

The aim of this review is to point out the health hazards of the uncontrolled global use of implanted mercury-leaking dental amalgam fillings. In spite of the pandemic use of amalgam, most dentists and doctors are still ignorant about the levels of mercury exposure and its health implications. This review discusses the following chronically neglected aspects in clinical practice: The use of materials science in calculating the mercury exposure levels, which may exceed the TLVs by an order of magnitude; Microbial dissolution and methylation of mercury from amalgam by oral and intestinal bacteria; Diagnostic problems and effects of chronic mercury exposure with emphasis on intestinal, cardiovascular, mental and neurologic symptoms and disorders; Diagnostic value of faeces--instead of urine examination--as the main indicator of Hg exposure; Lack of control groups unexposed to Hg (amalgam free) for epidemiologic investigations of health problems; Contribution of dental mercury to environmental pollution. In conclusion, a lack of interdisciplinary research and of a critical approach to established clinical routine appears to be the reason for the failure of the dental profession to protect the patient from Hg exposure when saving the tooth.

摘要

本综述的目的是指出全球范围内无节制使用植入后会渗漏汞的牙科汞合金填充物对健康的危害。尽管汞合金被广泛使用,但大多数牙医和医生仍然对汞暴露水平及其对健康的影响一无所知。本综述讨论了临床实践中以下长期被忽视的方面:运用材料科学计算汞暴露水平,其可能超过阈限值一个数量级;口腔和肠道细菌对汞合金中汞的微生物溶解和甲基化作用;慢性汞暴露的诊断问题及影响,重点关注肠道、心血管、精神和神经症状及紊乱;粪便作为汞暴露主要指标的诊断价值——而非尿液检查;在健康问题的流行病学调查中缺乏未接触汞(无汞合金)的对照组;牙科汞对环境污染的影响。总之,缺乏跨学科研究以及对既定临床常规的批判性方法似乎是牙科行业在补牙时未能保护患者免受汞暴露的原因。

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