Amalgam: Eine Risikobewertung unter Berücksichtigung der neuen Literatur bis 2005

Zusammenfassung

Amalgam, welches weltweit seit 150 Jahren als Zahnfüllmaterial verwendet wird, besteht aus etwa 50 % elementarem Quecksilber und einer Mischung aus Silber, Zinn, Kupfer und Zink. Aus fertigen Amalgamfüllungen werden kontinuierlich kleine Mengen an Quecksilberdampf freigesetzt. Amalgam trägt dabei signifikant zur menschlichen Quecksilberbelastung bei. Quecksilber kann in Organen, insbesondere im Gehirn akkumulieren, da die Bindung zu Proteinen stärker als die von anderen Schwermetallen (z. B. Blei, Kadmium) ist. Im Gehirn werden Halbwertszeiten von 1 - 18 Jahren angenommen. Quecksilber gilt als eines der giftigsten nichtradioaktiven Elemente. Es bestehen Hinweise darauf, dass Quecksilberdampf stärker neurotoxisch wirkt als Methyl-Quecksilber aus Fisch. Neuere Publikationen weisen auf das Risiko von Nierenschädigungen, neuropsychologischen Beeinträchtigungen, Induktion von Autoimmunerkrankungen oder Sensibilisierungen, gesteigerte oxidative Belastung, Autismus, Haut- und Schleimhautreaktionen und unspezifische Beschwerden durch Amalgamexposition hin. Auch die Alzheimer-Erkrankung oder die Entwicklung einer MS wird z. T. mit einer Quecksilberexposition in Zusammenhang gebracht. Es bestehen, möglicherweise erblich bedingt oder erworben, unterschiedliche interindividuelle Empfindlichkeiten zur Entstehung von negativen Effekten durch Amalgambelastungen. Quecksilbermessungen in Biomarkern sind aufgrund fehlender Korrelation zu den Quecksilberkonzentrationen in den Organen nur bedingt zur Abschätzung der Quecksilberbelastung der kritischen Organe geeignet. Wegen methodischer Mängel sind manche Amalgamstudien in ihren Aussagen nur bedingt verwertbar. Eine Amalgamentfernung konnte in einigen Studien bei einem relevanten Teil der Patienten zur dauerhaften Verbesserung oder Heilung verschiedener und meistens chronischer Beschwerden führen. Aufgrund der Berücksichtigung aller verfügbaren Daten kann Amalgam weder medizinisch, arbeitsmedizinisch noch ökologisch als sicheres Zahnfüllungsmaterial bezeichnet werden.

Abstract

Amalgam, which has been in use in dentistry for 150 years, consists of 50 % elemental mercury and a mixture of silver, tin, copper and zinc. Minute amounts of mercury vapour are released continuously from amalgam. Amalgam contributes substantially to human mercury load. Mercury accumulates in some organs, particulary in the brain, where it can bind to protein more tightly than other heavy metals (e. g. lead, cadmium). Therefore, the elimination half time is assumed to be up to 1 - 18 years in the brain and bones. Mercury is assumed to be one of the most toxic non-radioactive elements. There are pointers to show that mercury vapour is more neurotoxic than methyl-mercury in fish. Review of recent literature suggests that mercury from dental amalgam may lead to nephrotoxicity, neurobehavioural changes, autoimmunity, oxidative stress, autism, skin and mucosa alterations or non-specific symptoms and complaints. The development of Alzheimer’s disease or multiple sclerosis has also been linked to low-dose mercury exposure. There may be individual genetical or acquired susceptilities for negative effects from dental amalgam. Mercury levels in the blood, urine or other biomarkers do not reflect the mercury load in critical organs. Some studies regarding dental amalgam reveal substantial methodical flaws. Removal of dental amalgam leads to permanent improvement of various chronic complaints in a relevant number of patients in various trials. Summing up, available data suggests that dental amalgam is an unsuitable material for medical, occupational and ecological reasons.

Schlüsselwörter

Amalgam - Quecksilber - Toxizität - Nebenwirkungen - Autoimmunität - Neurodegenerative Krankheiten

Key words

Amalgam - mercury - toxicity - adverse health effects - autoimmunity - neurodegenerative diseases

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