Dataset Information

Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.

ABSTRACT:

Purpose

Dental sealant materials may intraorally release their components, including bisphenol-A (BPA), but long-term health effects are uncertain. The New England Children's Amalgam Trial (NECAT) found that composite restorations were associated with psychosocial, but not neuropsychological or physical, outcomes. The previous analysis did not consider sealants and preventive resin restorations (PRRs), which were routinely placed. The purpose of this analysis was to examine sealant/PRR exposure in association with psychosocial and other health outcomes.

Methods

NECAT recruited 534 six- to 10-year-olds and provided dental care during a five-year follow-up. Annually, examiners conducted psychosocial and neuropsychological tests and measured body mass index (BMI) and fat percentage (BF%). Associations between surface years (SY) of sealants/PRRs and outcomes were tested using multivariable models.

Results

Cumulative exposure level to sealants and/or PRRs was not associated with psychosocial assessments (eg, total problems: Child Behavior Checklist, 10-SY β=-0.2 ± 0.3, P=.60) or neuropsychological tests (eg, full-scale IQ, 10-SY β=0.1 ± 0.2, P=.60). There were no associations for changes in BMI-for-age z-score (P=.40), BF% (girls 10-SY β=-0.2 ± 0.3; boys 10-SY β=-0.1 ± 0.3), or menarche (10-SY hazard ratio=0.91, 95% confidence interval=0.83-1.01, P=.08).

Conclusions

This study showed no associations between exposure level of dental sealants or PRRs and behavioral, neuropsychological, or physical development in children over 5-years.

SUBMITTER: Maserejian NN

PROVIDER: S-EPMC4854637 | biostudies-literature | 2014 Jan-Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.

Maserejian Nancy N NN Shrader Peter P Trachtenberg Felicia L FL Hauser Russ R Bellinger David C DC Tavares Mary M

Pediatric dentistry 20140101 1

<h4>Purpose</h4>Dental sealant materials may intraorally release their components, including bisphenol-A (BPA), but long-term health effects are uncertain. The New England Children's Amalgam Trial (NECAT) found that composite restorations were associated with psychosocial, but not neuropsychological or physical, outcomes. The previous analysis did not consider sealants and preventive resin restorations (PRRs), which were routinely placed. The purpose of this analysis was to examine sealant/PRR e ...[more]

PMID: 24717713

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Project description:Resin-based dental materials may intraorally release their chemical components and bisphenol A. The New England Children's Amalgam Trial found that children randomized to amalgam had better psychosocial outcomes than those assigned to composites for posterior tooth restorations. The objective of this study was to examine whether greater exposure to dental composites is associated with psychosocial problems in children.Analysis of treatment-level data from the New England Children's Amalgam Trial, a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate-based polyacid-modified composite (compomer), among 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (n = 434) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL).Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (? = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (? = 0.7, SE = 0.3, P = .02), and Personal Adjustment (? = -0.8, SE = 0.2, P = .002). Associations were stronger with posterior-occlusal (chewing) surfaces, where degradation of composite was more likely. For CBCL change, associations were not statistically significant. At-risk or clinically significant scores were more common among children with greater exposure for CBCL Total Problem Behaviors (16.3% vs 11.2%, P-trend = .01) and numerous BASC-SR syndromes (eg, ? 13 vs 0 surface-years, Interpersonal Relations 13.7% vs 4.8%, P-trend = .01). No associations were found with compomer, nor with amalgam exposure levels among children randomized to amalgam.Greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children, whereas no adverse psychosocial outcomes were observed with greater urethane dimethacrylate-based compomer or amalgam treatment levels.

Project description:BackgroundResin-based dental restorations may intra-orally release their components and bisphenol A. Gestational bisphenol A exposure has been associated with poorer executive functioning in children.ObjectivesTo examine whether exposure to resin-based composite restorations is associated with neuropsychological development in children.MethodsSecondary analysis of treatment level data from the New England Children's Amalgam Trial, a 2-group randomized safety trial conducted from 1997 to 2006. Children (N=534) aged 6-10 y with ≥2 posterior tooth caries were randomized to treatment with amalgam or resin-based composites (bisphenol-A-diglycidyl-dimethacrylate-composite for permanent teeth; urethane dimethacrylate-based polyacid-modified compomer for primary teeth). Neuropsychological function at 4- and 5-year follow-up (N=444) was measured by a battery of tests of executive function, intelligence, memory, visual-spatial skills, verbal fluency, and problem-solving. Multivariable generalized linear regression models were used to examine the association between composite exposure levels and changes in neuropsychological test scores from baseline to follow-up. For comparison, data on children randomized to amalgam treatment were similarly analyzed.ResultsWith greater exposure to either dental composite material, results were generally consistent in the direction of slightly poorer changes in tests of intelligence, achievement or memory, but there were no statistically significant associations. For the four primary measures of executive function, scores were slightly worse with greater total composite exposure, but statistically significant only for the test of Letter Fluency (10-surface-years β=-0.8, SE=0.4, P=0.035), and the subtest of color naming (β=-1.5, SE=0.5, P=0.004) in the Stroop Color-Word Interference Test. Multivariate analysis of variance confirmed that the negative associations between composite level and executive function were not statistically significant (MANOVA, P=0.18). Results for greater amalgam exposure were mostly nonsignificant in the opposite direction of slightly improved scores over follow-up.ConclusionsDental composite restorations had statistically insignificant associations of small magnitude with impairments in neuropsychological test change scores over 4- or 5-years of follow-up in this trial.

Project description:Bisphenol A-glycidyl methacrylate (bis-GMA)-based dental composite restorations may release bisphenol A (BPA). The authors assessed changes in urinary BPA concentrations over a 6-month follow-up period in children and adolescents who received bis-GMA-based restorations.The authors collected data from 91 study participants aged 3 to 17 years who needed composite restorations. Participants provided urine samples and information on BPA-related exposures before and at approximately 1 day, 14 days, and 6 months after treatment. The authors used multivariable linear regression models to test associations between the number of surface restorations placed and the changes in urinary BPA concentrations.Participants had a mean (standard deviation [SD]) of 1.4 (1.0) for surfaces restored with composite at the first treatment visit and 2.3 (1.6) for surfaces restored during the entire study period. Mean (SD) change in urinary BPA concentrations between pretreatment and day 1 was 1.71 (9.94) nanograms per milliliter overall and 0.87 (5.98) after excluding 1 participant who had 8 surfaces restored at the visit. Overall, the authors observed an association between a greater number of composite surface restorations placed and higher urinary BPA concentrations in the 1-day sample (posterior-occlusal exponentiated coefficients [e(?)] = 1.47; 95% confidence interval [CI], 1.18-1.83; P < .001), but the association was attenuated after the authors restricted the sample to the 88 participants who had up to 4 restorations (e(?) = 1.19; 95% CI, 0.86-1.64), and they did not observe any association using 14-day (e(?) = 0.94; 95% CI, 0.75-1.18) or 6-month (e(?) = 0.88; 95% CI, 0.74-1.04) samples.Placement of bis-GMA-based restorations in children and adolescents may produce transient increases in urinary BPA concentrations that are no longer detectable in urine samples taken approximately 14 days or 6 months after treatment. After placement of a few restorations, increases in urinary BPA concentrations may not be detectable, owing to a high level of variation in background BPA exposure.These results suggest that leaching of BPA from newly placed composite restorations ceases to be detectable in urine within 2 weeks after restoration placement. The potential human health impact of such short-term exposure remains uncertain.

Project description:AimThis study aimed to assess different aspects of teaching posterior composite restorations in two dental schools in Palestine.Materials and methodsA questionnaire was emailed to the heads of the operative and conservative dentistry departments to collect detailed information on the teaching practices related to posterior composite restorations. The questionnaire comprised 22 questions structured to collect information on the time dedicated to teaching the topic, competency assessments, future plans for allocating time for each restoration type, relevant indications and contraindications, specific materials and techniques utilized in the application, and fees charged for posterior restorations. The gathered responses were collated in Excel and analyzed.ResultsBoth dental schools allocated similar teaching times to posterior composites and amalgam in their preclinical operative dentistry courses. However, there was a greater emphasis on composites in the clinical course than in the preclinical course at both institutions. Despite these differences, both institutions expressed a shared intention to allocate more time to teaching posterior composites while reducing the emphasis on teaching amalgam procedures. Consistency was observed across competency testing, cavity design preferences, and contraindications, with both schools favoring slot-type cavities. Furthermore, uniformity was noted in the management of operatively exposed dentin and matrix techniques, although variations existed in moisture isolation. Notably, both schools taught circumferential and sectional metal matrices but did not teach clear sectional matrices or use of bulk-fill composites. Additionally, the adhesive and light-curing practices remained consistent across both institutions.ConclusionThe findings of this study indicate that the teaching of posterior composite restorations is consistent across both Palestinian dental schools. Their curricula are aligned with contemporary international practices, demonstrating a strong commitment to modern operative dentistry and adherence to global standards. These findings offer valuable insights for educators and researchers and emphasize the need for ongoing adaptations to maintain high clinical standards.

Dataset Information

Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.

Purpose

Methods

Results

Conclusions

Publications

Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.

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