[Mercury exposure and dentists' health status in two regions of centrall Morocco: descriptive cross-sectional survey]. / Exposition au mercure et état de santé des médecins dentistes de deux régions du centre du Maroc: enquête transversale descriptive.

INTRODUCTION: mercury exposure is recognized as a worldwide public health concern. However, the effect of long-term exposure to low-doses of this heavy metal is still subject to debate. Due to the use of mercury in dental amalgam, dental health care professionals are chronically exposed to low-doses of this metal. In this context, we have conducted a descriptive cross-sectional survey among liberal dentists in two regions of the center of Morocco. In parallel, the global health status of participants was investigated to assess the relevance of a subsequent etiological survey. METHODS: data were collected through a self-reported questionnaire. Occupational exposure of dentists to mercury was evaluated based on their use of dental amalgam. Moreover, the other common factors increasing the background pollution or inducing exposure peaks were also investigated. On the other hand, smoking, vaccination, fish consumption, and the number of dental amalgam in mouth were considered as non-occupational exposure sources. Finally, the self-reported global health problems of participants were collected. RESULTS: 192 dentists were included in the present study. Seventy-six percent (76.04%) of them declared using dental amalgam in their practice. Moreover, the presence of dental amalgam in mouth was identified as the main non-occupational source of exposure to mercury (63.45% of participants). Finally, most of participants (46.35%) have expressed neuropsychological complaints. CONCLUSION: altogether, our results revealed a real mercury exposure in the studied population. Thus, effective preventive measures should be promoted to minimize the mercury exposure in dental offices. Moreover, an etiological study will be of great interest to reveal the impact of mercury exposure in this population.

Forensic study of mechanical properties of dental restoration after burial in mangrove environment.

Conducting research in the field of forensic sciences with methodologies that simulate situations found in the day-to-day practice of a given field of expertise is relevant insofar as this approach can produce results that are as close as possible to reality. In this context, the present study provided situations based on burial in a mangrove environment to estimate the changes in the mechanical properties (Knoop microhardness, roughness and color) of dental restorations utilizing silver amalgam, composite resin and glass ionomer cement over the time of burial. The silver amalgam showed a significant increase in surface roughness and a reduction in Knoop microhardness. Composite resin showed a statistically significant increase in color variation, and the glass ionomer cement showed significant increases in color variation and Knoop microhardness. These results allowed us to conclude that teeth restored with silver amalgam, composite resin and glass ionomer cement submitted to burial in mangrove environments produce different changes in surface roughness, Knoop microhardness and color properties depending on the time of burial to which the victims were submitted. These proprieties could help the forensic sciences to estimate time intervals for burial in mangrove environments.

Concentration of mercury, cadmium, and lead in breast milk from Norwegian mothers: Association with dietary habits, amalgam and other factors.

Mercury (Hg), cadmium (Cd), and lead (Pb) are of great concern for food safety and infants are especially sensitive to exposure to the maternal body burden. We quantified these elements in breast milk from Norwegian mothers and determined their association with dietary habits, maternal amalgam fillings, and smoking. Breast milk (n = 300) from the Norwegian Human Milk Study (HUMIS) was analyzed using triple quadrupole inductively coupled plasma mass spectrometry, after an acidic decomposition using microwave technique. We used multiple linear regression to examine predictors of Hg and Cd in breast milk, and logistic regression to test predictors of Pb above the quantification limit. The median breast milk concentrations (minimum - maximum) were 0.20 µg Hg/kg (<0.058-0.89), 0.057 µg Cd/kg (0.017-1.2), and <0.67 µg Pb/kg (<0.2-7.5). Cadmium showed no significant relation with any exposure variable investigated. Lead was associated with intake of liver and kidneys from game. For Hg concentration in breast milk, number of amalgam fillings and high fish consumption were significant predictors (p < 0.001). We detected a significant association (p < 0.01) between Hg in breast milk and maternal consumption of Atlantic halibut, lean fish, mussels and scallops and lifetime consumption of crab. Seafood intake alone explained 10% of variance, while together with amalgam explained 46% of variance in Hg concentration in breast milk. Our findings emphasize the importance of following consumer advice with respect to fish and seafood and points to amalgam as an important source for Hg exposure.

Ex Vivo Mercury Release from Dental Amalgam after 7.0-T and 1.5-T MRI.

Purpose To evaluate ex vivo mercury release from dental amalgam after 7.0-T and 1.5-T MRI. Materials and Methods The authors evaluated 60 caries-free molar or premolar teeth that had been extracted for clinical indications. Two-sided cavities were opened in each tooth and amalgam fillings applied. After 9 days, two groups of 20 randomly selected teeth were placed in 20 mL of artificial saliva immediately followed by 20 minutes of MRI exposure at 1.5 or 7.0 T. A control group of teeth was placed in artificial saliva without undergoing MRI exposure. The teeth were removed from the artificial saliva 24 hours later, and the saliva was analyzed for mercury content by using inductively coupled plasma mass spectrometry. One-way analysis of variance was used to compare the mean mercury values among the three independent groups, and the Tukey test was used for multiple comparisons of the mean values. Results The mean mercury content of the artificial saliva was 673 µg/L ± 179 in the 7.0-T MRI group, 172 µg/L ± 60 in the 1.5-T MRI group, and 141 µg/L ± 152 in the control group. The mercury content in the 7.0-T group was greater than that in both the 1.5-T group (P < .001; 95% confidence interval: 368 µg/L, 633 µg/L) and the control group (P < .001; 95% confidence interval: 416 µg/L, 648 µg/L). There was no statistically significant difference in mercury content between the 1.5-T and control groups (P = .84; 95% confidence interval: -164 µg/L, 110 µg/L). Conclusion In an ex vivo setting, mercury was released from amalgam fillings after exposure to 7.0-T MRI but not 1.5-T MRI.

Effect of smokeless tobacco on surface roughness of dental restorations.

CLINICAL RELEVANCE: Surface alterations of dental restorations can result in increased plaque biofilm. This leads to increased risk of premature restoration failure. Smokeless tobacco, in common use by some US military personnel, represents a potential source for surface alteration. If smokeless tobacco causes an untoward effect, selection of a more resistant restorative material could increase restoration longevity, thus minimizing lost work time and costs associated with replacement of failed restorations. PURPOSE: Comparatively assess the effect of smokeless tobacco/salivary substitute mixture on altering surface roughness of amalgam, composite resin, and resin modified glass ionomer (RMGI) restorations. MATERIALS AND METHODS: Sixty cubic restorations (3 groups of 20) were fabricated using a 4 mm by 3 mm Teflon mold. One examiner assessed the restorations at time points representing zero days, one day, one week, 2 weeks, one month, and 3 months. The data obtained were collected using a surface profilometer, measured in micrometers. Data were statistically analyzed using 2-way analysis of variance (ANOVA) test. A difference was significant if P< .05. RESULTS: Confidence levels with a 95% overall rating received a clinically acceptable classification. The 2-way ANOVA test detected significant differences between baseline, one day, one week, 2 weeks, one month, and 3-month data for surface roughness (P<.05). With respect to time and restoration type, results proved statistically significant with P<.0001. All restorations were statistically significant with respect to change in surface roughness with RMGIs showing the greatest surface roughness alteration. CONCLUSION: Smokeless tobacco mixed with a salivary substitute altered restoration surface roughness over time. Resin-modified glass isonomer restorations demonstrate the greatest alteration of surface roughness, with amalgam restorations showing the least. Amalgam remains the preferential restorative material in patients who use smokeless tobacco.

Placement and replacement rates of amalgam and composite restorations on posterior teeth in a military population.

OBJECTIVE: Replacement rates of direct dental restorations have been reported to be 37% to 70%, occupying a large proportion of a general dentist's time. Variations in the rate of initial placement and replacement of direct dental restorations may be associated with material placed (amalgam or composite), age, caries risk of the patient, and other factors. The purpose of this research was to clarify where the majority of patient care time is spent as a restorative Army dentist regarding either the initial placement or replacement of failed restorations; and how the location, caries risk, and material used (amalgam or composite) affects replacement rates. METHODS: This retrospective cross-sectional study gathered data from 600 randomly selected military patient dental records. All paper records were reviewed and cross checked with the digital record and digital x-ray databases. Record review was limited to all direct dental restorations placed in the posterior dentition within the past 2 years (March 2011 to March 2013). Statistical analysis was accomplished using chi-square tests and logistic regression analyses. RESULTS: Of the 600 charts reviewed, 525 were male, 75 were female, with an average age of 26 years (SD=6), ranging from 17 to 54 years. A third of the patients were classified as high, moderate, and low caries risk, respectively. The total number of posterior direct dental restorations placed was 2,117. Initial restorations totaled 1,429 (67.5%), and replacement restorations placed totaled 688 (32.5%). Four hundred forty-one of the 688 direct dental restorations replaced were amalgam (64%), the 247 remaining direct restorations replaced were composite (36%). Mandibular first molar dental restorations were replaced the most often (23.1%) while mandibular first premolar restorations were replaced the least often (0.9%). Older patients were more likely to have replacement of an existing restoration. CONCLUSIONS: Military dentists spend about one-third (32.5%) of their time replacing existing direct dental restorations. The majority of direct dental restorations placed and replaced were amalgam. No significant difference was found between composite and amalgam restorations. Location was shown to be significant with first molars and second molar restorations failing with the highest frequency. There was no significant difference found between male and female patients. As patient's age increased, the number of replacement restorations also increased.

Mercury Amalgam Diffusion in Human Teeth Probed Using Femtosecond LIBS.

In this work the diffusion of mercury and other elements from amalgam tooth restorations through the surrounding dental tissue (dentin) was evaluated using femtosecond laser-induced breakdown spectroscopy (fs-LIBS). To achieve this, seven deciduous and eight permanent extracted human molar teeth with occlusal amalgam restorations were half-sectioned and analyzed using pulses from a femtosecond laser. The measurements were performed from the amalgam restoration along the amalgam/dentin interface to the apical direction. It was possible to observe the presence of metallic elements (silver, mercury, copper and tin) emission lines, as well as dental constituent ones, providing fingerprints of each material and comparable data for checking the consistence of the results. It was also shown that the elements penetration depth values in each tooth are usually similar and consistent, for both deciduous and permanent teeth, indicating that all the metals diffuse into the dentin by the same mechanism. We propose that this diffusion mechanism is mainly through liquid dragging inside the dentin tubules. The mercury diffused further in permanent teeth than in deciduous teeth, probably due to the longer diffusion times due to the age of the restorations. It was possible to conclude that the proposed femtosecond-LIBS system can detect the presence of metals in the dental tissue, among the tooth constituent elements, and map the distribution of endogenous and exogenous chemical elements, with a spatial resolution that can be brought under 100 µm.

Use of Mercury in Dental Silver Amalgam: An Occupational and Environmental Assessment.

The objective of this study was to assess the occupational exposure to mercury in dentistry and associated environmental emission in wastewater of Lahore, Pakistan. A total of ninety-eight blood samples were collected comprising 37 dentists, 31 dental assistants, and 30 controls. Results demonstrate that the dentistry personnel contained significantly higher mean concentration of mercury in their blood samples (dentists: 29.835 µg/L and dental assistants: 22.798 µg/L) compared to that of the controls (3.2769 µg/L). The mean concentration of mercury was found maximum in the blood samples of older age group (62.8 µg/L) in dentists and (44.3 µg/L) in dental assistants. The comparison of mercury concentration among dentists, dental assistants, and controls (pairing based on their ages) revealed that the concentration increased with the age and experience among the dentists and dental assistants. Moreover, the mercury concentration in all the studied dental wastewater samples, collected from twenty-two dental clinics, was found to be exceeding the recommended discharge limit of 0.01 mg/L. Therefore, we recommend that immediate steps must be taken to ensure appropriate preventive measures to avoid mercury vapors in order to prevent potential health hazards to dentistry personnel. Strong regulatory and administrative measures are needed to deal with mercury pollution on emergency basis.

Propuesta para determinar la significación forense de restos esqueléticos mediante análisis químico de la amalgama dental / Proposal for Determining the Forensic Significance of Skeletal Remains through the Chemical Analysis of Dental Amalgam

El descubrimiento de un cadáver requiere de significativos esfuerzos para identificarlo si no hay información antemortem y los restos son hallados tiempo después de fallecido. Los hallazgos en fosas comunes, típicas de guerras, genocidios o violaciones de derechos humanos suponen un problema aún mayor: las osamentas pueden no pertenecer en sus datas de muerte al momento analizado por las pericias. Un análisis minucioso y reconstructivo proveerá valiosos datos de variabilidad biológica a la investigación. En odontología forense, las restauraciones dentales pueden ofrecer información social, cultural, cronológica y geográfica del fallecido. Dado que uno de los primeros pasos en la investigación es determinar si esos restos poseen significación forense, se presenta una revisión exhaustiva, crítica y se propone al análisis químico de la aleación de la amalgama dental como una herramienta útil para diferenciar estos restos de otros hallazgos arqueológicos o fuera del contexto histórico al proceso y escenario analizados(AU)

The recovery of a corpse needs to significant efforts for the identification if there is no antemortem data and the remains have been found with a long postmortem delay. Findings in mass graves, typical pattern of wars, genocides or human rights violations, suppose an even major problem: the skeletal material cannot be consistent with the investigated time-line. A meticulous and reconstructive analysis will provide valuable information of biological variability to the investigation. In forensic dentistry, the dental fillings can demonstrate social, cultural, chronological and geographical features. Since the primary task of the investigation is to determine the forensic significance of those remains, an exhaustive and critical review was presented and the proposal of the chemical analysis of the alloy of the dental amalgam as a useful tool to differentiate these remains of other archaeological or historical decontextualized context cases was proposed

Mercury exposure in the work place and human health: dental amalgam use in dentistry at dental teaching institutions and private dental clinics in selected cities of Pakistan.

During the past two decades, mercury has come under increasing scrutiny with regard to its safety both in the general population and in occupationally exposed groups. It's a growing issue of global concern because of its adverse environmental and health impacts. Very few investigations on mercury amalgam use in the dentistry sector have been carried out in South Asia and there is little data reported on mercury contamination of indoor/outdoor air at dental sites. According to an earlier SDPI study, reported in 2013, alarmingly high mercury levels were observed in air (indoor as well as outdoor) at 11 of the 34 visited dental sites (17 dental teaching institutions, 7 general hospitals & 10 dental clinics) in five main cities of Pakistan. 88% of the sites indicated indoor mercury levels in air above the USA EPA reference level of 300 ng/m3. According to our study, carried out at 38 dental teaching institutions in 12 main cities (in Khyber Pakhtunkhwa, Punjab and Sindh provinces) of Pakistan, respondents were of the opinion that the currently offered BDS curriculum does not effectively guide outgoing dental professionals and does not provide them adequate knowledge and training about mercury/mercury amalgam and other mercury related human health and mercury waste issues. 90% of respondents supported the review and revision of the present dental curriculum offered at dental teaching institutions in the country, at the earliest. A study has also been conducted to assess the status of mercury amalgam use in private dental clinics in Gilgit, Hunza, Peshawar, Rawalpindi and Islamabad. More than 90 private dental clinics were visited and dental professionals/private clinics in-charge were interviewed during June-July, 2015. The focus areas of the study were Hg amalgam toxicity, its waste management practices and safety measures practiced among the dental practitioners. In the light of the findings described and discussed in this brief report, to safeguard public health and for the protection of environment, it is strongly recommended that since mercury amalgam use cannot be banned immediately in the country, its use may be regularized and allowed subject to use of "Amalgam Separators," "Capsulated Mercury" and "Mechanized Mixing," use of mercury amalgam be banned for children (below 12 years age) and pregnant women. The curriculum currently being taught at medical and dental colleges in the country be reviewed and revised, to ensure adequate training towards minimizing mercury exposure.

Assessment of exposures and potential risks to the US adult population from wear (attrition and abrasion) of gold and ceramic dental restorations.

Little has been published on the chemical exposures and risks of dental restorative materials other than from dental amalgam and composite resins. Here we provide the first exposure and risk assessment for gold (Au) alloy and ceramic restorative materials. Based on the 2001-2004 US National Health and Nutrition Examination Survey (NHANES), we assessed the exposure of US adults to the components of Au alloy and ceramic dental restorations owing to dental material wear. Silver (Ag) is the most problematic component of Au alloy restorations, owing to a combination of toxicity and proportional composition. It was estimated that adults could possess an average of four tooth surfaces restored with Au alloy before exceeding, on average, the reference exposure level (REL) for Ag. Lithium (Li) is the most problematic component of dental ceramics. It was estimated that adults could possess an average of 15 tooth surfaces restored with ceramics before exceeding the REL for Li. Relative risks of chemical exposures from dental materials decrease in the following order: Amalgam>Au alloys>ceramics>composite resins.

Investigação de perda de heterozigosidade e expressão da proteína Ki-67 em lesão liquenóide oral associada ao amálgama / Investigation of loss of heterozygosity and expression the Ki-67 protein in oral Lichenoid lesion associated with the amalgam

A Lesão liquenóide oral associada ao amálgama (LLOAA) é uma lesão incomum de patogênese ainda incerta. A lesão apresenta características clínicas e histopatológicas semelhantes ao líquen plano bucal (LPB), que é considerada uma lesão com potencial de transformação maligna. Pesquisas moleculares a fim de aprimorar os conhecimentos sobre a patogênese e o comportamento clínico de LLOAA ainda são escassas. O objetivo do estudo foi investigar a perda de heterozigosidade (loss of heterozygosity ­ LOH) em amostras de LLOAA, LPB e mucosa bucal normal (MBN) em regiões cromossômicas 9p22, 11q13.4 e 17p13.1 e avaliar o índice de proliferação celular das mesmas amostras, buscando uma associação entre o índice de proliferação celular e LOH. Foram selecionadas 9 amostras de LLOAA, 10 de LPB e 8 de MBN, pareadas por sexo e idade. A LOH nas regiões cromossômicas 9p22, 11q13.4 e 17p13.1 foi avaliada por meio dos marcadores microssatélites polimórficos D9S157, D9S162, D9S171, D11S1369, TP53, AFM238WF2. O índice de proliferação celular foi avaliado pela expressão imuno-histoquímica da proteína Ki-67 (MIB-1) em 8 amostras de LLOAA, 10 de LPB e 8 de MBN. Amostras de LLOAA exibiram LOH em 3 dos 6 marcadores (AFM238WF2, D9S157 e D11S1369), de LPB exibiram LOH em 2 destes marcadores (AFM238WF2, D9S157) enquanto que amostras de MBN não apresentaram LOH. A perda alélica foi mais frequente para os marcadores AFM238WF2 (17p13.1, 21%) e D9S157 (9p22, 17,64%) e a média da frequência de perda alélica na amostras de LLOAA foi de 26,6% enquanto que nas amostras de LPB foi de 7,5%. A imuno-histoquímica apresentou positividade nuclear nas células variando entre 0,29% a 28% e não houve associação entre o índice de proliferação celular e LOH em LLOAA e LPB (p>0,05). Este estudo demonstrou que LLOAA, semelhante ao LPB, apresentou LOH nas regiões cromossômicas 9p22, 11q13.4 e 17p13.1, independentemente da taxa de proliferação celular. Apesar de não ter sido encontrada tal associação, LOH ocorre em LLOAA e pode estar envolvida na patogênese desta lesão

The Amalgam-associated oral lichenoid lesion (AAOLL) is an infrequent disease of uncertain pathogenesis. The lesion shows clinical and histopathological features similar to oral lichen planus (OLP), which is considered a lesion with malignant transformation potential. Molecular researches in order to improve knowledge of the pathogenesis and clinical behavior of AAOLL are still scarce. The purpose of the current study was to evaluate the loss of heterozygosity - LOH in AAOLL, in OLP, and in normal oral mucosa (NOM) using polymorphic microsatellite markers at chromosome regions 9p22, 11q13.4 and 17p13.1, located around important tumor suppressor genes and to evaluate the immunohistochemical expression of Ki67 protein in the same samples. The sample comprised 09 AAOLLs, 10 OLPs and 8 NOMs matched by patients' gender and age. The LOH at chromosome regions 9p22, 11q13.4 and 17p13.1 was evaluated by microsatellite polymorphic markers D9S157, D9S162, D9S171, D11S1369, TP53, AFM238WF2. Cell proliferation was assessed by immunohistochemical expression of Ki-67 (MIB-1) in eight AAOLL, ten OLP and eight NOM. AAOLL exhibited LOH at 3 of 6 LOH markers (AFM238WF2, D9S157 AND D11S1369), while OLP demonstrated LOH at two of these markers (AFM238WF2, D9S157) while NOM showed no LOH. The allelic loss were most frequently in marker AFM238WF2 (17p13.1, 21%) and D9S157 (9p22, 17,64%). The mean fractional allelic loss of AAOLL was 26,6% whereas mean fractional allelic loss of OLP was 7,5%. Immunohistochemistry revealed nuclear positivity ranging from 0,29% to 28% of the cells and there was no association between cell proliferation and LOH in LLOAA e LPB (p>0,05). Our study shows that AAOLL, similar to OLP, exhibits LOH, irrespective of cell proliferation index. Despite the lack of association between LOH and cell proliferation we can assume that LOH occurs in AAOLL and it should be considered in the pathogenesis of this lesion

Acción de los agentes blanqueadores sobre materiales de restauración / Action of bleaching agents on restorative materials

El propósito del trabajo será analizar comparativamente los diversos efectos que producen sobre las restauraciones dentales agentes blanqueadores.El objetivo será valorar los cambios que experimentan en la superficie los materiales de restauración, sometidos a la acción de un agente blanqueador. La metodología utilizada será visualización microscópica electrónica de barrido ambiental. Los resultados obtenidos tendrán transferencia relevante a Insti-tuciones formadoras de recursos humanos en Salud Bucal, al campo profesional odontológico y a empresas o fabricantes para el mejoramiento de su producto...

Evaluation of mercury contamination in patients and water during amalgam removal.

AIM: The aim of this study was to evaluate mercury levels in wastewater and in patients during the removal of dental amalgam restorations. MATERIALS AND METHODS: To test for mercury levels, patients were tested before and after amalgam restoration removal. To test for mercury emissions, samples of constant volume of wastewater from high-speed drills were collected before and during amalgam restoration removal. RESULTS: Although the systemic mercury levels were lower than the limit of biological tolerance, all patients had increased levels after dental restorations. All samples of wastewater had increased mercury levels too. CONCLUSION: The urinary levels of mercury increased with dental amalgam removal using a high-speed drill. During the process of amalgam removal, water used for cooling the dental drill was contaminated with mercury. CLINICAL SIGNIFICANCE: The mercury released by the physical action of the drill, the replacement material and especially the final destination of the amalgam waste can increase contamination levels that can be a risk for human and environment health.

New science challenges old notion that mercury dental amalgam is safe.

Mercury dental amalgam has a long history of ostensibly safe use despite its continuous release of mercury vapor. Two key studies known as the Children's Amalgam Trials are widely cited as evidence of safety. However, four recent reanalyses of one of these trials now suggest harm, particularly to boys with common genetic variants. These and other studies suggest that susceptibility to mercury toxicity differs among individuals based on multiple genes, not all of which have been identified. These studies further suggest that the levels of exposure to mercury vapor from dental amalgams may be unsafe for certain subpopulations. Moreover, a simple comparison of typical exposures versus regulatory safety standards suggests that many people receive unsafe exposures. Chronic mercury toxicity is especially insidious because symptoms are variable and nonspecific, diagnostic tests are often misunderstood, and treatments are speculative at best. Throughout the world, efforts are underway to phase down or eliminate the use of mercury dental amalgam.

Occupational and environmental exposure to mercury among Iranian hairdressers.

OBJECTIVES: The aim of this study was to describe the mercury concentrations in female hairdressers associated with occupational and environmental exposure through cosmetic products and amalgam fillings. METHODS: Sixty-two hair and nail samples were collected randomly from Iranian hairdressers. Hg level determination was carried out using a LECO, AMA 254, Advanced Mercury Analyzer according to ASTM, standard No. D-6722. RESULTS: The mean mercury levels were 1.15 ± 1.03 ug/g and 1.82 ± 1.12 µg/g in the hair and nail samples, respectively with a positive correlation among them (r=0.98). A significant relation was also observed between Hg levels and the number of amalgam fillings (p<0.001), use of cosmetics (p<0.001), and use of gloves (p=0.02). CONCLUSIONS: The Hg levels in about one-third of the studied samples were higher than the USEPA-recommended 1 ug/g, which represents a serious health risk. Hairdressers with continuous use of cosmetics and a high number of amalgam fillings had significantly elevated mercury concentrations in their hair and nails, suggesting the importance of mercury exposure assessment in hidden, less-explored sources of Hg in the workplace.

The Minamata Convention on Mercury: attempting to address the global controversy of dental amalgam use and mercury waste disposal.

In October 2013, a new international binding treaty instrument called the Minamata Convention on Mercury opened for signature in Minamata City, Japan, the site of arguably the worst public health and environmental disaster involving mercury contamination. The treaty aims to curb the significant health and environmental impacts of mercury pollution and includes provisions addressing the mining, export and import, storage, and waste management of products containing mercury. Importantly, a provision heavily negotiated in the treaty addresses the use of dental fillings using mercury amalgam, an issue that has been subject to decades of global controversy. Though use of dental amalgam is widespread and has benefits, concerns have been raised regarding the potential for human health risk and environmental damage from emissions and improper waste management. While the Minamata Convention attempts to address these issues by calling for a voluntary phase-down of dental amalgam use and commitment to other measures, it falls short by failing to require binding and measurable targets to achieve these goals. In response, the international community should begin exploring ways to strengthen the implementation of the dental amalgam treaty provisions by establishing binding phase-down targets and milestones as well as exploring financing mechanisms to support treaty measures. Through strengthening of the Convention, stakeholders can ensure equitable access to global oral health treatment while also promoting responsible environmental stewardship.

Forensic or archaeological issue: is chemical analysis of dental restorations helpful in assessing time since death and identification of skeletonized human remains?

In 2011, small mass grave with completely skeletonized remains was discovered in Belgrade suburb. An eyewitness claimed that skeletons belonged to German soldiers killed in WWII. Anthropologists were engaged to investigate whether the skeletal remains correspond to the indicated German group or represent more recent case requiring court trial. Numerous dental restorations were noticed. Owing to the fact that different dental materials were used in dental practice at certain times, the aim of this study was to explore whether analysis of dental restorations could help in identification and estimation of time since death. Inductively coupled plasma optical emission spectrometry revealed that dental fillings corresponded to copper amalgam, conventional silver amalgam, silicophosphate cement, and zinc phosphate cement. Chemical results combined with anthropological and historical facts suggest that the individuals lived before the 1960s in country with well-developed dental service at that time. Therefore, chemical analysis of dental fillings was useful to distinguish between skeletal remains that are too old to be of forensic interest and the remains relevant to legal investigations.

Staining of dentin from amalgam corrosion is induced by demineralization.

PURPOSE: To evaluate the effect of artificial demineralization upon color change of dentin in contact with dental amalgam. METHODS: Sound human molars (n = 34) were embedded in resin and coronal enamel was removed. Dentin was exposed to artificial caries gel (pH 5.5) at 37 degrees C for 12 weeks (n = 24). Non-demineralized teeth served as controls (n = the 10). A dispersive high-Cu amalgam or conventional low-Cu amalgam was condensed onto dentin surfaces of all groups. After 10 weeks storage in saline, amalgam was removed and teeth were cut into three slices. Surfaces were inspected under optical microscopy and photographed. RESULTS: Penetration of black pigments was observed in dentin underneath both high-Cu and low-Cu amalgams in demineralized specimens. Black deposits were unevenly distributed and observed predominantly in dentin near to pulp horns. Discoloration was not limited to outer demineralized dentin but extended beyond this zone. Evenly distributed bluish-green discoloration was observed underneath all high-Cu amalgam specimens independent of demineralization.

Contaminação por mercúrio na Odontologia: a utilidade da análise quantitativa em ambiente de prática restauradora com amálgama / Mercury contamination in Dentistry: the utility of quantitative analysis in environment with amalgam restorative practice

Objetivo - Verificar o uso e aplicação de um medidor portátil de análise quantitativa de vapores de mercúrio. Os locais de escolha foram a Clínica Odontológica e o Laboratório Multidisciplinar 104 da Faculdade de Odontologia das Faculdades São José, Rio de Janeiro-RJ, Brasil. Nesses locais ocorrem muitas atividades restauradoras com amálgama dentário realizadas por alunos, tornando-se importante a verificação da possível contaminação por vapores tóxicos de mercúrio existente naqueles ambientes. Métodos - Para a medição foi utilizado um aparelho analisador Zeeman quantitativo avançado de mercúrio portátil da marca Lumex modelo RA-915+. O aparelho foi acionado no final da tubulação de rejeito das cuspideiras das cadeiras A, C, D, E, F, J, H e ar do amalgamador recém-acionado. No Laboratório Multidisciplinar 104 foram inspecionados: ar/ambiente e em manequim usado para treino. Foram feitas também inspeções no ar em ambiente onde não se usa amálgama a fim de verificação do teor zero. Resultados - Na Clínica Odontológica as cadeiras C, E, F e H foram as que apresentaram os maiores índices de contaminação, dentre estas a cadeira H destacou-se com 26.140 ngHg/m³. Os locais onde não se manipula amálgama o índice foi 0ngHg/m³. Conclusões - Os altos índices de vapores de mercúrio nas tubulações das cadeiras indicam que as medidas seguras de descartes de resíduos não estão sendo realizadas adequadamente. Este sistema de medição quantitativa direta mostrou-se simples no manuseio e extremamente útil no monitoramento de ambientes sujeitos à contaminação por vapores tóxicos de mercúrio.

Objective - To examine the use and application of a portable meter for quantitative analysis of mercury vapors. The places of choice were the Dental Clinic and Laboratory Training 104 of the School of Dentistry of São José College, Rio de Janeiro-RJ, Brazil. In these places many activities occur restorative dental amalgam made by students, making it important to check the possible contamination by toxics vapors mercury existing in those environments. Methods - For the measurement we used an advanced device analyzer Zeeman quantitative mercury brand laptop Lumex model RA-915+. The device was fired at the end of the waste pipe spitting chairs A, C, D, E, F, J, H and air amalgamator newly activated. In the Laboratory Training 104 were inspected: air/environment and dummy used for training. Inspections were performed also on air at ambient where amalgam is not used to check content zero. Results - In Dental Clinic chairs C, E, F and H were the ones that showed the highest levels of contamination, among these the seat H stood out with 26.140 ngHg / m³. Places where no handles amalgam index was 0ngHg/m³. Conclusions - The high levels of mercury vapor in the pipes of the chairs indicate that measures of safe waste disposal are not being carried out properly. This direct quantitative measurement system proved simple in handling and extremely useful in monitoring environments subject to contamination by toxic mercury vapors.