口腔内金属修复物的成分分析

Metal elements from intraoral metal restorations

目的:测定口腔内金属修复物的成分,确定使用的合金种类,以使牙科金属过敏患者避免再次使用此种合金。方法:用细砂纸及圆锥形抛光磨头,采取微量口腔内金属修复物,通过EDXRF(荧光X线分析仪)测定所含金属成分,确定合金种类。结果:14例可疑牙科金属过敏患者中,牙科金属修复物120个,按照检出频度的高低,排在前10位的金属元素分别是Ag、Cu、Au、Pd、Zn、Sn、Co、Cr、In和Mo。Au-Ag-Pd合金的使用频度为65%,Ag-Sn-Hg合金为2.5%,Ag合金为5.4%,Au合金为14.6%,Ni-Cr、Co-Cr合金为10.1%,其他2.4%。2种以上异种合金共存同一口腔环境中的患者12例,5种合金同时存在者1例。含Hg的银汞合金的使用频度为2.5%,与10年前的使用频度16%相比下降明显。Ni、Cr、Co的使用频度未见明显改变。结论:被疑牙科金属过敏的患者中,异种金属同存的现象严重,提示在口腔科临床工作中,尽量避免使用异种金属及含Hg和Ni等易诱发过敏的金属合金。

PURPOSE: To detect the metal element from intraoral metal restorations. METHODS: A small sample was taken from each intraoral metal restorations. Energy-dispersive X ray fluorescence spectrometry (EDXRF) was used to detect the metal elements from them. RESULTS: From 14 suspected patients of dental metal allergy, 120 intraoral metal restorations were detected. The ten most frequent elements detected ,in decreasing order of frequency, were Ag, Cu, Au, Pd, Zn, Sn, Co,Cr,In and Mo. The types and percentages of alloys containing these elements were Au-Ag-Pd alloys(65%),Ag-Sn-Hg amalgams(2.5%),Ag alloys(5.4%),Au alloys (14.6%),Ni-Cr alloys and Co-Cr alloys(10.1%),other alloys (2.4%). In these,Ag-Sn-Hg amalgams (2.5%)are in lower using rate than 10 years before(16%). Ni,Co,Cr alloys are in same using rate as 10 years before. There are 12 patients with two to five kinds of different alloys present at an oral environment. In one of 12 patients,five kinds of different alloys were present within an oral environment. CONCLUSIONS: In patients suspicious of dental metal allergy, co-existence of different metals alloys was often detected, which indicated that in order to prevent dental metal allergy, heterogeneous metal and metal alloys containing Hg and Ni should be avoided as much as possible.