Hansen D J, Hørsted-Bindslev P, Tarp U
Aarhus Universitet, Institut for Miljø- og Arbejdsmedicin.
Ugeskr Laeger. 1993 Sep 20;155(38):2990-4.
During the latest decades the use of dental amalgam has been discussed with respect to potential toxic effects of the mercury component. In order to evaluate potential risks from this practice the recent literature is reviewed. Corrosion of fillings results in liberation of mercury. The absorption from this source in the Danish population can be estimated to be one to five micrograms/24 hrs. This exposure level is far below that accepted in occupational exposure and far below the minimum toxic level. Investigation of placental transfer of mercury has not provided any reason to avoid using amalgam during pregnancy. Micromercurialism or metal syndrome is claimed to be related to amalgam fillings. This syndrome consists mainly of complaints from the central nervous system, but also from muscles, joints and the gastrointestinal tract. The symptoms are non-specific and the documentation of the existence of such a syndrome related to mercury exposure is weak. The symptoms reported can be due to other chemical exposures, but psycho-social conditions may also play an important role. Information on disappearance of symptoms after removal of fillings may be a result of a placebo effect, which may be suggested until controlled experiments are performed. For this reason the use of chelating therapy is not indicated. Allergic contact eczema observed in few individuals is the only problem documented in connection with the use of amalgam fillings.
在最近几十年里,人们一直在讨论牙科汞合金的使用,涉及汞成分的潜在毒性作用。为了评估这种做法的潜在风险,对近期文献进行了综述。补牙材料的腐蚀会导致汞的释放。据估计,丹麦人群从这个来源吸收的汞为1至5微克/24小时。这个暴露水平远低于职业暴露所允许的水平,也远低于最低毒性水平。关于汞的胎盘转运的研究没有提供任何理由在怀孕期间避免使用汞合金。有人声称微汞中毒或金属综合征与汞合金补牙有关。这种综合征主要表现为中枢神经系统的症状,也包括肌肉、关节和胃肠道的症状。这些症状不具有特异性,而且与汞暴露相关的这种综合征存在的证据不足。报告的症状可能是由于其他化学物质暴露引起的,但心理社会状况也可能起重要作用。关于补牙材料去除后症状消失的信息可能是安慰剂效应的结果,在进行对照实验之前只能这样推测。因此,不建议使用螯合疗法。在少数个体中观察到的过敏性接触性皮炎是与使用汞合金补牙相关的唯一有记录的问题。