Re: Amalgam still best for children?
- From: "Barnesdale" <gogo@xxxxxxxx>
- Date: Sun, 30 Apr 2006 15:36:46 GMT
Stuart Hyderman wonderful chiropractor
Peter Moran <pmoran@xxxxxxxxxxxxxxxx> wrote in message
news:4453d8d9$0$7605$afc38c87@xxxxxxxxxxxxxxxxxxxxxxx
This is a large prospective and randomised controlled trialclinical
JAMA. 2006 Apr 19;295(15):1835-6.
Neurobehavioral effects of dental amalgam in children: a randomized
trial.University
DeRouen TA, Martin MD, Leroux BG, Townes BD, Woods JS, Leitao J,
Castro-Caldas A, Luis H, Bernardo M, Rosenbaum G, Martins IP.
Department of Dental Public Health Sciences, School of Dentistry,
of Washington, Seattle, WA 98195, USA. derouen@xxxxxxxxxxxxxxxxvapor.
CONTEXT: Dental (silver) amalgam is a widely used restorative material
containing 50% elemental mercury that emits small amounts of mercury
No randomized clinical trials have determined whether there aresignificant
health risks associated with this low-level mercury exposure. OBJECTIVE:To
assess the safety of dental amalgam restorations in children. DESIGN: Awith
randomized clinical trial in which children requiring dental restorative
treatment were randomized to either amalgam for posterior restorations or
resin composite instead of amalgam. Enrollment commenced February 1997,
annual follow-up for 7 years concluding in July 2005. SETTING ANDand
PARTICIPANTS: A total of 507 children in Lisbon, Portugal, aged 8 to 10
years with at least 1 carious lesion on a permanent tooth, no previous
exposure to amalgam, urinary mercury level <10 microg/L, blood lead level
<15 microg/dL, Comprehensive Test of Nonverbal Intelligence IQ > or =67,
with no interfering health conditions. INTERVENTION: Routine,in
standard-of-care dental treatment, with one group receiving amalgam
restorations for posterior lesions (n = 253) and the other group receiving
resin composite restorations instead of amalgam (n = 254). MAIN OUTCOME
MEASURES: Neurobehavioral assessments of memory, attention/concentration,
and motor/visuomotor domains, as well as nerve conduction velocities.
RESULTS: During the 7-year trial period, children had a mean of 18.7 tooth
surfaces (median, 16) restored in the amalgam group and 21.3 (median, 18)
restored in the composite group. Baseline mean creatinine-adjusted urinary
mercury levels were 1.8 microg/g in the amalgam group and 1.9 microg/g in
the composite group, but during follow-up were 1.0 to 1.5 microg/g higher
the amalgam group than in the composite group (P<.001). There were nostudy,
statistically significant differences in measures of memory, attention,
visuomotor function, or nerve conduction velocities (average z scores were
very similar, near zero) for the amalgam and composite groups over all 7
years of follow-up, with no statistically significant differences observed
at any time point (P values from .29 to .91). Starting at 5 years after
initial treatment, the need for additional restorative treatment was
approximately 50% higher in the composite group. CONCLUSIONS: In this
children who received dental restorative treatment with amalgam did not,on
average, have statistically significant differences in neurobehavioralwho
assessments or in nerve conduction velocity when compared with children
received resin composite materials without amalgam. These findings,combined
with the trend of higher treatment need later among those receiving
composite, suggest that amalgam should remain a viable dental restorative
option for children. TRIAL REGISTRATION: clinicaltrials.gov Identifier:
NCT00066118.
Peter Moran
.
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- Amalgam still best for children?
- From: Peter Moran
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