Cork University Dental School and Hospital

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Accuracy of computer-aided design/computer-assisted manufacture (CAD/CAM) fabricated dental restorations: a comparative study
(University College Cork, 2015) Nasruddin, Mohd Faiz; Burke, Francis M.; Ray, Noel J.; Theocharopoulos, Antonios; Universiti Teknologi MARA, Malaysia
Introduction: Computer-Aided-Design (CAD) and Computer-Aided-Manufacture (CAM) has been developed to fabricate fixed dental restorations accurately, faster and improve cost effectiveness of manufacture when compared to the conventional method. Two main methods exist in dental CAD/CAM technology: the subtractive and additive methods. While fitting accuracy of both methods has been explored, no study yet has compared the fabricated restoration (CAM output) to its CAD in terms of accuracy. The aim of this present study was to compare the output of various dental CAM routes to a sole initial CAD and establish the accuracy of fabrication. The internal fit of the various CAM routes were also investigated. The null hypotheses tested were: 1) no significant differences observed between the CAM output to the CAD and 2) no significant differences observed between the various CAM routes. Methods: An aluminium master model of a standard premolar preparation was scanned with a contact dental scanner (Incise, Renishaw, UK). A single CAD was created on the scanned master model (InciseCAD software, V2.5.0.140, UK). Twenty copings were then fabricated by sending the single CAD to a multitude of CAM routes. The copings were grouped (n=5) as: Laser sintered CoCrMo (LS), 5-axis milled CoCrMo (MCoCrMo), 3-axis milled zirconia (ZAx3) and 4-axis milled zirconia (ZAx4). All copings were micro-CT scanned (Phoenix X-Ray, Nanotom-S, Germany, power: 155kV, current: 60µA, 3600 projections) to produce 3-Dimensional (3D) models. A novel methodology was created to superimpose the micro-CT scans with the CAD (GOM Inspect software, V7.5SR2, Germany) to indicate inaccuracies in manufacturing. The accuracy in terms of coping volume was explored. The distances from the surfaces of the micro-CT 3D models to the surfaces of the CAD model (CAD Deviation) were investigated after creating surface colour deviation maps. Localised digital sections of the deviations (Occlusal, Axial and Cervical) and selected focussed areas were then quantitatively measured using software (GOM Inspect software, Germany). A novel methodology was also explored to digitally align (Rhino software, V5, USA) the micro-CT scans with the master model to investigate internal fit. Fifty digital cross sections of the aligned scans were created. Point-to-point distances were measured at 5 levels at each cross section. The five levels were: Vertical Marginal Fit (VF), Absolute Marginal Fit (AM), Axio-margin Fit (AMF), Axial Fit (AF) and Occlusal Fit (OF). Results: The results of the volume measurement were summarised as: VM-CoCrMo (62.8mm3 ) > VZax3 (59.4mm3 ) > VCAD (57mm3 ) > VZax4 (56.1mm3 ) > VLS (52.5mm3 ) and were all significantly different (p presented as areas with different colour. No significant differences were observed at the internal aspect of the cervical aspect between all groups of copings. Significant differences (p< M-CoCrMo Internal Occlusal, Internal Axial and External Axial 2 ZAx3 > ZAx4 External Occlusal, External Cervical 3 ZAx3 < ZAx4 Internal Occlusal 4 M-CoCrMo > ZAx4 Internal Occlusal and Internal Axial The mean values of AMF and AF were significantly (p M-CoCrMo and CAD > ZAx4. Only VF of M-CoCrMo was comparable with the CAD Internal Fit. All VF and AM values were within the clinically acceptable fit (120µm). Conclusion: The investigated CAM methods reproduced the CAD accurately at the internal cervical aspect of the copings. However, localised deviations at axial and occlusal aspects of the copings may suggest the need for modifications in these areas prior to fitting and veneering with porcelain. The CAM groups evaluated also showed different levels of Internal Fit thus rejecting the null hypotheses. The novel non-destructive methodologies for CAD/CAM accuracy and internal fit testing presented in this thesis may be a useful evaluation tool for similar applications.
Adhesives for bonded molar tubes during fixed brace treatment
(John Wiley & Sons, Inc., 2017-02-23) Millett, Declan T.; Mandall, Nicky A.; Mattick, Rye C. R.; Hickman, Joy; Glenny, Anne-Marie; National Institute for Health Research; Cochrane Oral Health Global Alliance, United Kingdom
Background: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on the metal attachments (brackets and bands) being glued to the teeth so that they do not become detached during treatment. Brackets (metal squares) are usually attached to teeth other than molars, where bands (metal rings that go round each tooth) are more commonly used. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), are typically welded to bands but they may also be glued directly (bonded) to molars. Failure of brackets, bands and bonded molar tubes slows down the progress of treatment with a fixed appliance. It can also be costly in terms of clinical time, materials and time lost from education/work for the patient. This is an update of the Cochrane review first published in 2011. A new full search was conducted on 15 February 2017 but no new studies were identified. We have only updated the search methods section in this new version. The conclusions of this Cochrane review remain the same. Objectives: To evaluate the effectiveness of the adhesives used to attach bonded molar tubes, and the relative effectiveness of the adhesives used to attach bonded molar tubes versus adhesives used to attach bands, during fixed appliance treatment, in terms of: (1) how often the tubes (or bands) come off during treatment; and (2) whether they protect the bonded (or banded) teeth against decay. Search methods: The following electronic databases were searched: Cochrane Oral Health's Trials Register (to 15 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library (searched 15 February 2017), MEDLINE Ovid (1946 to 15 February 2017), and Embase Ovid (1980 to 15 February 2017). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria: Randomised controlled trials of participants with full arch fixed orthodontic appliance(s) with molar tubes, bonded to first or second permanent molars. Trials which compared any type of adhesive used to bond molar tubes (stainless steel or titanium) with any other adhesive, were included. Trials were also included where: (1) a tube was bonded to a molar tooth on one side of an arch and a band cemented to the same tooth type on the opposite side of the same arch; (2) molar tubes had been allocated to one tooth type in one patient group and molar bands to the same tooth type in another patient group. Data collection and analysis: The selection of papers, decision about eligibility and data extraction were carried out independently and in duplicate without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. Main results: Two trials (n = 190), at low risk of bias, were included in the review and both presented data on first time failure at the tooth level. Pooling of the data showed a statistically significant difference in favour of molar bands, with a hazard ratio of 2.92 (95% confidence intervals (CI) 1.80 to 4.72). No statistically significant heterogeneity was shown between the two studies. Data on first time failure at the patient level were also available and showed statistically different difference in favour of molar bands (risk ratio 2.30; 95% CI 1.56 to 3.41) (risk of event for molar tubes = 57%; risk of event for molar bands 25%). One trial presented data on decalcification again showing a statistically significant difference in favour of molar bands. No other adverse events identified. Authors' conclusions: From the two well-designed and low risk of bias trials included in this review it was shown that the failure of molar tubes bonded with either a chemically-cured or light-cured adhesive was considerably higher than that of molar bands cemented with glass ionomer cement. One trial indicated that there was less decalcification with molar bands cemented with glass ionomer cement than with bonded molar tubes cemented with a light-cured adhesive. However, given there are limited data for this outcome, further evidence is required to draw more robust conclusions.
Adhesives for fixed orthodontic bands
(John Wiley & Sons, Ltd., 2016-10) Millett, Declan T.; Glenny, Anne-Marie; Mattick, Rye C.R.; Hickman, Joy; Mandall, Nicky A.
Background: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period. :Objectives: To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of: (1) how often the bands come off during treatment; and (2) whether they protect the banded teeth against decay during fixed appliance treatment. Search methods: The following electronic databases were searched: Cochrane Oral Health's Trials Register (searched 2 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 5) in the Cochrane Library (searched 2 June 2016), MEDLINE Ovid (1946 to 2 June 2016) and EMBASE Ovid (1980 to 2 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria: Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. Data collection and analysis: All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. Main results: Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria. Authors' conclusions: There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.
Adolescent and parent perceptions of expected benefits of orthodontic treatment: a mixed-methods study
(University College Cork, 2021-06-30) Smyth, Joshua Peter Richard; Millett, Declan
Aims: 1: To investigate expected benefits of orthodontic treatment from both an adolescent and parent perspective. 2: To rank the expected benefits of orthodontic treatment identified by adolescents and parents in order of perceived importance. Materials and Methods: Ethical approval was granted to carry out both parts of this study. Part 1 used qualitative methodology with one-to-one semi-structured interviews by a trained interviewer. Twenty adolescents (10 males; 10 females) referred for orthodontic assessment and their parents (8 males; 12 females) were interviewed independently to explore expectations of the benefits of orthodontic treatment. Interviews were transcribed verbatim and interpretive phenomenological analysis carried out. Part 2 quantitatively assessed the benefits identified in Part 1. Twelve additional adolescents (6 males; 6 females) who were referred for orthodontic assessment and a parent (6 males; 6 females), completed a card ranking exercise to determine the rank order of the perceived importance of each benefit. The mean rank was then calculated and a two-sample t-test, with the level of significance set at P < 0.05, used to determine if a difference existed between adolescents and parents for the mean rank of any of the expected benefits. Results: The expected benefits of orthodontic treatment from both adolescent and parent perspectives included 11 benefits which could be grouped into four categories: oral health (improved appearance of teeth; ease of maintaining good oral health; improved jaw alignment; aiding dental development), psychosocial (improved self-confidence; improved perception of dental appearance by others), functional (improved ability to chew food; improved speech) and behavioural change (improved oral hygiene habits; improved diet; cessation of bad habits). Adolescents and parents placed a similar level of importance on these benefits with “improved self-confidence” ranked highest and “improved speech” ranked lowest. The only benefit where the mean rank differed significantly between adolescents and parents was “improved ability to chew food” (two-sample t-test; P = 0.042) which was ranked higher by adolescents. Conclusions: Adolescents and parents perceived 11 expected benefits from orthodontic treatment affecting oral health, psycho-social, functional and behavioural categories. Adolescents and parents ranked the expected benefits similarly with psycho-social ranked highest. Within functional benefits, speech improvement was ranked lowest by both but improved masticatory function was ranked of significantly greater importance by adolescents.
Adult orthodontics: internet information and a national survey
(University College Cork, 2015) McMorrow, Siobhán; Millett, Declan; Harding, Mairead
Aims: 1. To investigate the reliability and readability of information on the Internet on adult orthodontics. 2. To evaluate the profile and treatment of adults by specialist orthodontists in the Republic of Ireland (ROI). Materials and methods: 1. An Internet search was conducted in May 2015 using three search engines (Google, Yahoo and Bing), with two search terms (“adult orthodontics” and “adult braces”). The first 50 websites from each engine were screened and exclusion criteria applied. Included websites were then assessed for reliability using the JAMA benchmarks, the DISCERN and LIDA tools and the presence of the HON seal. Readability was assessed using the FRES. 2. A pilot-tested questionnaire about adult orthodontics was distributed to 122 eligible specialist orthodontists in the ROI. Questions addressed general and treatment information about adult orthodontic patients, methods of information provision and respondent demographics. Results: 1. Thirteen websites met the inclusion criteria. Three websites contained all JAMA benchmarks and one displayed the HON Seal. The mean overall score for DISCERN was 3.9/5 and the mean total LIDA score was 115/120. The average FRES score was 63.1. 2. The questionnaire yielded a response rate of 83%. The typical demographic profile of adult orthodontic patients was professional females between 25-35 years. The most common incisor relationship and skeletal base was Class II, division 1 (51%) and Class II (61%) respectively. Aesthetic upper brackets and metal lower brackets were the most frequently used appliances. Only 30% of orthodontists advise their adult patients to find extra information on the Internet. Conclusions: 1. The reliability and readability of information on the Internet on adult orthodontics is of moderate quality. 2. The provision of adult orthodontic treatment is common among specialist orthodontists in the Republic of Ireland.
An analysis of the attitudes of dental patients attending general dental practice in Galway
(Irish Dental Association, 2013-08) Hayes, Martina; Burke, Francis M.; McKenna, Gerald; Madden, Jamie M.; Cronin, Michael
Aim: To describe the patterns of dental attendance and attitudes towards tooth loss of general dental practice patients in Galway. Objectives: 1. To determine the pattern of adult dental attendance in general practices in Galway; and, 2. To examine the oral health attitudes of these patients. Method: Questionnaires were distributed to 311 consecutive adult patients in the waiting rooms of ten general dental practices in Galway, which were randomly selected from the telephone directory. Results: A total of 254 of the 311 questionnaires distributed were fully completed, returned and included in the results, giving a response rate of 81.7%. A total of 59% of dentate participants attended their dentist for annual or biannual examinations compared to 23% of edentate patients. Some 10.5% of medical card holders and 0.5% of non-medical card holders were edentulous. Conclusions: The data from the survey indicated that medical card holders in Galway were more likely to be edentulous than nonmedical card holders. Edentate patients were less likely to be regular dental attenders than dentate patients.
Assessing periodontal health and the British Society of Periodontology implementation of the New Classification of Periodontal Diseases 2017
(George Warman Publications, 2019-11) Milward, Mike; Roberts, Anthony
Periodontal disease is a highly prevalent, chronic, inflammatory condition which is a major contributor to tooth loss and poor oral health-related quality of life. For the vast majority of patients, the disease is entirely preventable/manageable often aided by input from dental health professionals. As dental health professionals, understanding the periodontal disease process, the risk factors associated with it, standardized ways of detecting, diagnosing and monitoring the disease, along with the special tests needed to aid this process are essential skills for successful disease management. This article summarizes the need for assessing periodontal disease including key aspects of detection, a brief history of periodontal disease classification and the new classification. The paper goes on to discuss the British Society of Periodontology implementation plan of new classification and how this can be utilized for use in general dental practice. CPD/Clinical Relevance: This paper introduces the practitioner to the 2017 Classification of Periodontal Disease along with how this is implemented in general dental practice. The paper provides useful cases for practice as well as flowcharts to aid diagnosis.
Assessment of the environmental and health impacts arising from mercury-free dental restorative material
(Environmental Protection Agency, 2022) Harding, Máiréad; Sullivan, Timothy; Binner, Hannah; Kamali, Naghmeh; Hayes, Martina; Department of the Environment, Climate and Communications
Assessment of the potential environmental impacts arising from mercury-free dental restorative materials
(University College Cork, 2019-12) Binner, Hannah; Sullivan, Timothy; Harding, Mairead; Environmental Protection Agency
The field of dentistry and with it, the application of dental filling materials, is currently undergoing changes to adopt sustainability and environmental considerations into the clinical environment. This was largely triggered by the reduction of all products in use that contain Hg (mercury), including dental amalgam, through the Minamata Convention of 2013, which has in turn caused a rise in Hg-free dental filling materials that are now becoming increasingly nano-filled. The focus of this study is on the particles released from Hg-free dental fillings. Knowledge gaps regarding the particle load and potential ecotoxicity of the particulate matter resulting from Hg-free materials exist. Moreover, the widely known environmental and human health impacts of Hg contained in dental amalgam have led to the widespread introduction of an amalgam capture device, the amalgam separator. Amalgam separators capture Hg and dental amalgam particles before wastewater discharge occurs. These amalgam separators are required to be installed in Ireland since the 1st of January 2019 in accordance with EU Directive 2017/852. The overarching objective of this thesis has been to assess whether existing amalgam separators are also effective in capturing particulate matter resulting from the use of Hg-free dental filling materials. In order to meet this objective, this study has assessed the wastewater and amalgam separator capture efficiency in three dental practices in Cork, Ireland. Three dental practices were selected based on the type of amalgam separator in use and focus of service based on private or public practice and high, medium or low utilisation. Physical and chemical parameters of dental wastewater (DWW), including pH, temperature, conductivity, Total suspended solids (TSS) and Total Dissolved Solids (TDS) have been measured. Detailed analysis of particles found in these wastewater streams has been conducted using optical and scanning electron microscopy. The potential ecotoxicity of these waste streams has also undergone preliminary assessment by conducting standardised Daphnia magna immobilisation tests. The results indicate that variation in the discharged DWWs exists, which is likely linked to the use of disinfection products, and has led to extreme observations of pH, conductivity, Total suspended solids and Total dissolved solids. Ecotoxicity results confirmed this and showed that the raw DWW caused an EC50 response at concentrations between 0.1 to 6.69 % DWW/L medium. The particulate load in the three DPs was substantial. A high abundance of microparticles was identified and trends were consistent across the three DPs. It was therefore concluded that amalgam separators may not be sufficient in capturing the particulate matter released from Hg-free dental filling materials. Further research is needed to identify the environmental fate of the particles that are released, particularly nanomaterials, as they have the potential to remain in the water after wastewater treatment has occurred.
Based on current evidence how often should an individual visit their dental practitioner for a dental examination?
(2014-05) Ansong, Nana; Hayes, Martina
Brief communication: Dentists' reproducibility in scoring the Plaque Index using a fluorescent colouring agent
(Irish Dental Association, 2017-08) Nishi, Makiko; Roberts, Anthony; Harding, Máiréad; Allen, P. Finbarr
Statement of the problem: Fluorescein is a plaque detection agent, which fluoresces yellow-green when excited with blue light (dental light curing lamp). Little is known about the reproducibility of scoring with the Silness-Löe plaque index (1964) when using this agent. Purpose of the study: To evaluate the level of agreement of the plaque index measurements using a fluorescent colouring agent among eight dentists. Materials and methods: Eight dentists in Cork were recruited as examiners for a randomised clinical study investigating the impact of a personalised caries prevention approach. They were trained and calibrated in the use of the plaque index using Plaque Test (Ivoclar Vivadent, Liechtenstein) in the Oral Health Services Research Centre and School of Dental Hygiene, University College Cork. For inter-examiner and intra-examiner reproducibility, a previously calibrated ‘gold standard’ examiner and seven dentists examined 10 to 12 subjects each, while one dentist examined four subjects only for inter-examiner reproducibility. The adult subjects were recruited at the Cork University Dental School and Hospital. To evaluate inter-examiner and intra-examiner reproducibility at site level, squared weighted kappa statistics were calculated. Results: The weighted kappa statistics varied from 0.31 to 0.54 for inter-examiner reproducibility under the acceptable level (kappa statistics = 0.60) for research purposes and from 0.43 to 0.65 for intra-examiner reproducibility. Conclusions: The levels of agreement were fair to good. Further studies are needed, preferably including a qualitative study to analyse feedback from dentists to determine the cause of such variation. This study re-emphasises the importance of clinician calibration ahead of clinical studies.
Brief report: analysis of dental treatment provided under general anaesthesia for children and young adults with autistic spectrum disorder and identification of challenges for dental services
(Springer, 2021-02-08) Parry, Jennifer Ann; Brosnan, Sinead; Newton, J. Tim; Linehan, Conor; Ryan, Christian
Dental treatment provided under general anaesthesia (DGA) is an expectation for many children and young adults (CYA) diagnosed with Autistic Spectrum Disorder (ASD). Planning and delivery of DGA requires consideration of morbidity and mortality risks and implications for families and healthcare services. One hundred patient records of CYA with special healthcare needs were analysed to examine characteristics and experience of DGA revealing that 79% of CYA had a diagnosis of ASD. Forty-seven percent of CYA diagnosed with ASD had at least one previous hospital admission for DGA. For 24% of this repeat DGA group, the previous DGA was within a two-year period. Results highlight a high rate of DGA and need to investigate more effective primary dental care strategies.
BSP News Winter 2009/10
(British Society of Periodontology, 2009) Roberts, Anthony
BSP News Winter 2010/11
(British Society of Periodontology, 2010) Roberts, Anthony
BSP News Winter 2011/12
(British Society of Periodontology, 2011) Roberts, Anthony
BSP News Winter 2012/13
(British Society of Periodontology, 2012) Roberts, Anthony
Calcifying odontogenic cyst: a case report
(Wiley, 2020-01-29) Mulvihill, Ciara; Ní Mhaolcatha, Sarah; Brady, Paul; McKenna, Jill E.; Sleeman, Duncan; Fitzgibbon, James
A calcifying odontogenic cyst (COC) is a rare odontogenic lesion with a vast variety of clinical, radiological, histopathological features and biological behaviours. In this article, we illustrate a case of an 18‐year‐old male patient with a complaint of an 18‐month history of swelling in his right maxilla. The lesion was diagnosed as a COC associated with an impacted 18 using radiological, cytological and histopathological investigations. The present study examines and considers the case.
Cancer-related financial hardship among head and neck cancer survivors: risk factors and associations with health-related quality of life
(Wiley, 2019-02-19) Lu, Liya; O'Sullivan, Eleanor; Sharp, Linda; Health Research Board
Objective: Cancer survivors are susceptible to financial hardship. In head and neck cancer (HNC) survivors, we investigated (a) predictors for cancer‐related financial hardship and (b) associations between financial hardship and health‐related quality of life (HRQoL). Methods: We conducted a cross‐sectional study in HNC survivors identified from the National Cancer Registry Ireland. HRQoL was based on the Functional Assessment for Cancer Therapy General (FACT‐G) plus Head and Neck Module (FACT‐HN). Objective cancer‐related financial hardship (financial stress) was assessed as household ability to make ends meet due to cancer and subjective financial hardship (financial strain) as feelings about household financial situation due to cancer. Modified Poisson regression was used to identify predictors for financial hardship. Bootstrap linear regression was used to estimate associations between hardship and FACT domain scores. Results: Pre‐diagnosis retirement (relative risk [RR] 0.50, 95% confidence interval [CI] 0.37‐0.67), pre‐diagnosis financial stress (RR 1.85, 95% CI 1.58‐2.15), and treatment were significantly associated with objective financial hardship. Predictors of subjective financial hardship were similar: aged greater than or equal to 65 years, pre‐diagnosis financial stress, and treatment. Participants with objective financial hardship reported significantly lower physical (coefficient −3.45, 95% CI −4.39 to −2.44), emotional (−2.01, 95% CI −2.83 to −1.24), functional (−2.56, 95% CI −3.77 to −1.33) and HN‐specific HRQoL (−3.55, 95% CI −5.04 to −2.23). Physical, emotional, and functional HN‐specific HRQoL were also significantly lower in participants with subjective financial hardship. Conclusion: Cancer‐related financial hardship is common and associated with worse HRQoL among HNC survivors. This supports the need for services and supports to address financial concerns among HNC survivors.
Caries prevention for older people
(Connect Publications, 2012-09) Hayes, Martina
Characteristics of wastewater originating from dental practices using predominantly mercury-free dental materials
(Elsevier B.V., 2022-01-07) Binner, Hannah; Kamali, N.; Harding, Mairead; Sullivan, Timothy; Environmental Protection Agency; Department of Communication, Climate Action and Environment, Ireland
Dental materials are currently undergoing a revolution. Mercury use, including traditional amalgam (mercury-containing) material used in dental fillings, is now being widely regulated under the Minamata convention, and dental amalgam is currently being replaced by resin formulations in dentistry. These resin-based materials can be tuned to offer varying material properties by incorporation of a range of nano- and micro-particle based 'fillers' for different dental properties and applications. However, these innovations may have a concomitant effect on the waste streams associated with common dental applications, in particular the potential for higher concentrations of novel micro- and nanomaterials within wastewater streams, and a potential route for novel nanomaterials into the wider Environment. These new materials may also mean that wastewater filtering apparatus commonly deployed at present, such as amalgam separators, may be less efficient or insufficient to capture these new filler materials in dental facility wastewater. In this work, we analyse dental wastewater streams from three dental facilities in Ireland with differing amalgam separators in place. The potential overall toxicity, particulate load and physicochemical properties are analysed. The overall risk posed by these new materials is also discussed.

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