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      Association between dental amalgam restoration and urine mercury concentrations among young women: a cross-sectional study

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          Abstract

          Background

          The association between dental amalgam fillings and urine mercury concentrations was investigated in this study to assess the health risks associated with dental amalgams.

          Methods

          This cross-sectional study included 99 women in their 20s who visited the dental clinic in Daegu, Korea. The 99 participants were composed of 68 subjects who had dental amalgam fillings (exposure group) and 31 subjects who did not have dental amalgam fillings (nonexposure group). Oral examinations were conducted by a single dental hygienist, sociodemographic features were investigated as confounding variables, and urine mercury concentrations were measured using an automatic mercury analyzer.

          Results

          The mean±standard deviation of the urine mercury concentrations of the exposure and nonexposure groups were 1.50±1.78 μg/g creatinine and 0.53±0.63 μg/g creatinine, respectively. The exposure group showed significantly higher levels than the nonexposure group ( p<0.01). The urine mercury concentration significantly increased with an increase in the number of teeth filled with amalgam, cavity surfaces involved, and number of defective amalgam fillings, and according to the latest exposure time ( p<0.001). In the multiple regression analysis of amalgam-related factors and urine mercury concentrations after correction for confounding factors, the urine mercury concentration in the group with six or more amalgam-filled teeth, 11 or more cavity surfaces, and two or more defective amalgams was significantly higher than that in the nonexposure group ( p<0.001).

          Conclusion

          According to this study, exposure to dental amalgams was confirmed to significantly affect urine mercury concentrations.

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          Most cited references30

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          The toxicology of mercury and its chemical compounds.

          This review covers the toxicology of mercury and its compounds. Special attention is paid to those forms of mercury of current public health concern. Human exposure to the vapor of metallic mercury dates back to antiquity but continues today in occupational settings and from dental amalgam. Health risks from methylmercury in edible tissues of fish have been the subject of several large epidemiological investigations and continue to be the subject of intense debate. Ethylmercury in the form of a preservative, thimerosal, added to certain vaccines, is the most recent form of mercury that has become a public health concern. The review leads to general discussion of evolutionary aspects of mercury, protective and toxic mechanisms, and ends on a note that mercury is still an "element of mystery."
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            Human Exposure and Health Effects of Inorganic and Elemental Mercury

            Mercury is a toxic and non-essential metal in the human body. Mercury is ubiquitously distributed in the environment, present in natural products, and exists extensively in items encountered in daily life. There are three forms of mercury, i.e., elemental (or metallic) mercury, inorganic mercury compounds, and organic mercury compounds. This review examines the toxicity of elemental mercury and inorganic mercury compounds. Inorganic mercury compounds are water soluble with a bioavailability of 7% to 15% after ingestion; they are also irritants and cause gastrointestinal symptoms. Upon entering the body, inorganic mercury compounds are accumulated mainly in the kidneys and produce kidney damage. In contrast, human exposure to elemental mercury is mainly by inhalation, followed by rapid absorption and distribution in all major organs. Elemental mercury from ingestion is poorly absorbed with a bioavailability of less than 0.01%. The primary target organs of elemental mercury are the brain and kidney. Elemental mercury is lipid soluble and can cross the blood-brain barrier, while inorganic mercury compounds are not lipid soluble, rendering them unable to cross the blood-brain barrier. Elemental mercury may also enter the brain from the nasal cavity through the olfactory pathway. The blood mercury is a useful biomarker after short-term and high-level exposure, whereas the urine mercury is the ideal biomarker for long-term exposure to both elemental and inorganic mercury, and also as a good indicator of body burden. This review discusses the common sources of mercury exposure, skin lightening products containing mercury and mercury release from dental amalgam filling, two issues that happen in daily life, bear significant public health importance, and yet undergo extensive debate on their safety.
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              Molecular mechanisms triggered by mercury.

              Mercury is an ubiquitous environmental toxin that causes a wide range of adverse health effects in humans. Three forms of mercury exist: elemental, inorganic and organic. Each of them has its own profile of toxicity. Exposure to mercury typically occurs by inhalation or ingestion. Mercury can be an indoor air pollutant, however industry emission remains the most important source of inhaled mercury. Furthermore, fresh water and ocean fish may contain large amounts of mercury and dental amalgam can be another important source of inorganic and mercury vapor. The present review discusses the current information on mercury toxicity and the distinct toxicologic profile of the three forms of mercury. The existing therapeutics, new therapeutics development or agents for treating mercury poisoning will also discussed. Since in general low levels of mercurial are tolerable, herein, we also discuss the defensive mechanisms developed by the cell to protect itself against mercury injury. This aspect may be useful to provide a biological protection against toxic effects exerted by mercury or by specific forms of mercury in view of a medicinal purposes.
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                Author and article information

                Journal
                J Yeungnam Med Sci
                J Yeungnam Med Sci
                JYMS
                Journal of Yeungnam Medical Science
                Journal of Yeungnam Medical Science
                2799-8010
                October 2023
                21 March 2023
                : 40
                : 4
                : 373-380
                Affiliations
                [1 ]Department of Public Health, Graduate School of Environment and Public Health Studies, Yeungnam University, Daegu, Korea
                [2 ]Department of Dental Hygiene, College of Science and Technology, Kyungpook National University, Sangju, Korea
                [3 ]Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine, Daegu, Korea
                [4 ]Department of Dentistry, Yeungnam University College of Medicine, Daegu, Korea
                Author notes
                Corresponding author: Eun Young Park, DDS, PhD Department of Dentistry, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3282 • Fax: +82-53-629-1772 • E-mail: acidic@ 123456yu.ac.kr
                [*]

                These authors contributed equally to this work.

                Author information
                http://orcid.org/0000-0001-9582-1415
                http://orcid.org/0000-0003-3623-7619
                http://orcid.org/0000-0002-1860-5425
                Article
                jyms-2022-00955
                10.12701/jyms.2022.00955
                10626308
                36941777
                ea5f2a3d-699a-4301-b5ab-f00e6d2b4df9
                Copyright © 2023 Yeungnam University College of Medicine, Yeungnam University Institute of Medical Science

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 December 2022
                : 12 January 2023
                : 25 January 2023
                Categories
                Original Article

                dental amalgam,mercury,urine,women
                dental amalgam, mercury, urine, women

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