The Journal of the American Dental Association
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Am Dent Assoc, Vol 139, No 11, 1496-1505.
© 2008 American Dental Association
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shenker, B. J.
Right arrow Articles by McKinlay, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shenker, B. J.
Right arrow Articles by McKinlay, S.
Related Collections
Right arrow Restoratives

RESEARCH

JADA Continuing Education

Immune Function Effects of Dental Amalgam in Children

A Randomized Clinical Trial



Bruce J. Shenker, PhD, Nancy N. Maserejian, ScD, Annie Zhang, MS and Sonja McKinlay, PhD

Background. Dental amalgam is a widely used restorative material containing 50 percent elemental mercury that emits mercury vapor. No randomized clinical trials have determined whether there are adverse immunological effects associated with this low-level mercury exposure in children. The objective of this study was to evaluate a subpopulation of the participants in the New England Children’s Amalgam Trial for in vitro manifestations of immunotoxic effects of dental amalgam.

Methods. The authors conducted a randomized clinical trial in which children requiring dental restorative treatment were randomly assigned to receive either amalgam for posterior restorations or resin-based composite restorations. They assessed 66 children, aged 6 to 10 years, for total white blood cell counts, specific lymphocyte (T-cell and B-cell) counts and lymphocyte, neutrophil and monocyte responsiveness across a five-year period. Because of the small number of participants, the authors acknowledge that the study is exploratory in nature and has limited statistical power.

Results. The mean number of tooth surfaces restored during the five-year period was 7.8 for the amalgam group and 10.1 for the composite group. In the amalgam group, there was a slight, but not statistically significant, decline in responsiveness of T cells and monocytes at five to seven days after treatment; the authors consistently observed no differences at six, 12 or 60 months.

Conclusions. The findings of this study confirm that treatment of children with amalgam restorations leads to increased, albeit low-level, exposure to mercury. In this exploratory analysis of immune function, amalgam exposure did not cause overt immune deficits, although small transient effects were observed five to seven days after restoration placement.

Clinical Implications. These findings suggest that immunotoxic effects of amalgam restorations are minimal and transient in children and most likely do not need to be of concern to practitioners considering the use of this restorative dental material.

Key Words: Dental amalgam; mercury; immunotoxicity

Abbreviations: CD: Cluster of differentiation • DHE: Dihydroethidium • Hg: Mercury • H2O2: Hydrogen peroxide • Ig: Immunoglobulin • NECAT: New England Children’s Amalgam Trial • O2–· Superoxide • PHA: Phytohemagglutinin • PMA: Phorbol myristate acetate • PWM: Pokeweed mitogen • Rho: Dihydrorhodamine • U-Hg: Total urinary mercury • WBC: White blood cell






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright©1995-2008 American Dental Association (ADA).
Reproduction or republication strictly prohibited without prior written permission of ADA.