The NIDCR/USAF Dental Amalgam Study

NIDCR/USAF 牙科汞合金研究

• 批准号: 6432028
• 负责人: ALBERT KINGMAN
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF DENTAL & CRANIOFACIAL RESEARCH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6432028
• 关键词: biomaterial evaluation; blood chemistry; clinical research; dental amalgam; dental disorder diagnosis; human subject; male; mercury; mercury poisoning; neurotoxicology; oral health; toxicant interaction; toxicology; urinalysis; veterans

The clinical areas of primary focus of the NIDCR study include the neurological, renal, endocrine, immunological, and numerous psychological conditions. The oral health examination included an assessment of caries, soft-tissue lesions, and a complete tooth and surface based inventory of dental restorative materials, including amalgams. This study, a collaboration with the U.S. Air Force, involves a multi-disciplinary team of mercury toxicologists, neurologists, psychologists, immunologists, statisticians, laboratory experts, other medical specialists and clinical dentists. The mean age of the 1,166 study participants was 52.8 years. Overall, 5.2 percent of the participants were edentulous. Dentate individuals averaged 19.9 amalgam surfaces per person, with amalgam contributing slightly more than one-half of all restored surfaces in dentate individuals. We estimate that this cohort has a higher exposure to dental amalgams than their age-matched U.S. male population. The total mercury level in urine was 3.1 mg per liter and 2.6 mg for whole blood. A clear dose-response was observed between the levels of mercury (total and inorganic) in urine and the amount of exposure to amalgam. The frequency of abnormal neurological conditions was very low, with most response measures affecting between 1 and 5 percent of these participants. There was no evidence of a clear dose-response relationship between amalgam exposure and the level of neurological abnormalities. A couple of specific response measures associated with amalgam exposure, but these were inconsistently manifested among various subgroups, being both positively or negatively associated with amalgam levels. As a consequence of external expert reviews further analyses incorporating important exclusionary criteria (previously unavailable, but recently incorporated into the databases) are in the final stages. The major findings of this study will be important to validate. A second examination of the full study cohort of 2,200 participants is underway in an attempt to better delineate the significance of the associations detected on the first cycle. These examinations were completed in the spring of 1998. The oral health data were received from the contractor and are being edited in consultation with the Contractor. The neurological data have been received from the Air Force and the creation of the databases has begun. Th effects of amalgam exposure on the neurological measures is currently underway.

NIDCR 研究的主要临床领域包括神经、肾脏、内分泌、免疫和众多心理疾病。 口腔健康检查包括对龋齿、软组织病变的评估，以及基于牙齿和表面的牙科修复材料（包括汞合金）的完整清单。 这项研究是与美国空军合作进行的，涉及一个由汞毒理学家、神经学家、心理学家、免疫学家、统计学家、实验室专家、其他医学专家和临床牙医组成的多学科团队。 1,166 名研究参与者的平均年龄为 52.8 岁。 总体而言，5.2% 的参与者无牙颌。 有齿状个体平均每人有 19.9 个汞合金表面，其中汞合金略多于齿状个体所有修复表面的一半。 我们估计，这一群体比同龄的美国男性人群接触牙科汞合金的比例更高。 尿液中的总汞含量为每升 3.1 毫克，全血中的总汞含量为 2.6 毫克。 在尿液中的汞（总汞和无机汞）含量与汞合金暴露量之间观察到明显的剂量反应。异常神经系统疾病的发生率非常低，大多数反应措施只影响 1% 到 5% 的参与者。 没有证据表明汞合金暴露与神经异常水平之间存在明确的剂量反应关系。 有一些与汞合金暴露相关的具体反应措施，但这些措施在各个亚组中表现不一致，与汞合金水平呈正相关或负相关。 经过外部专家审查后，纳入重要排除标准（以前不可用，但最近已纳入数据库）的进一步分析已进入最后阶段。 这项研究的主要发现对于验证非常重要。 对 2,200 名参与者组成的完整研究队列的第二次检查正在进行中，试图更好地描述第一个周期中检测到的关联的重要性。 这些检查于 1998 年春季完成。口腔健康数据是从承包商处收到的，并正在与承包商协商后进行编辑。 已从空军收到神经学数据，数据库的创建已开始。 目前正在研究汞合金暴露对神经系统测量的影响。