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Objective: To conduct a systematic review of the literature on the longevity of posterior resin composite restorations in adults. Material and methods: A systematic literature search was conducted according to predetermined criteria for inclusion and exclusion. The studies selected were prospective clinical trials with a minimum follow-up time of 4 years, 40 restorations per experimental group and an annual attrition rate of less than 5%. Initially, abstracts and full-text articles were assessed independently and the assessment was subsequently agreed on by five reviewers. The methodological quality of the studies was assessed according to the Swedish Council on Health Technology Assessment (SBU) standard checklist for determining the extent to which studies meet basic quality criteria. Results: In all, the literature search identified 4275 abstracts and 93 articles were read in fulltext. There were eighteen studies which met the criteria for inclusion, eight of which were included in the analysis. There were 80 failures of restorations with a total follow-up time at risk for failure of 62,030 months. The overall incidence rate for all causes of failure was 1.55 lost restorations per 100 restoration years. The most common biological reason for failure (a total of 31 restorations) was secondary caries, with or without fracture of the restoration. The quality of the evidence was low. Conclusions: In an efficacy setting, the overall survival proportion of posterior resin composite restorations is high. The major reasons for failure are secondary caries and restoration fracture which supports the importance of adequate follow-up time. Clinical significance: The overall survival proportion of posterior composite restorations was high, but the results cannot be extrapolated to an effectiveness setting. The importance of adequate follow-up time is supported by the finding that secondary caries often occurred after 3 years or later.

Objective. To investigate the existence of histamine-excitable nerve fibers in the oral mucosa and to compare the response to histamine provocation in healthy volunteers with that in a small group of patients with chronic oral pain. Material and methods. Thirteen healthy volunteers and six patients suffering from chronic oral pain took part in the study. Blood perfusion was monitored in the hard palate, the tongue, and the skin of the cheek using laser Doppler perfusion imaging (Perimed; Sweden). Baseline scannings were performed, followed by 15 scannings after iontophoresis of histamine (1%). A free description of the sensations was then obtained from the participants after finishing the measurements. Results. Compared to pre-histamine scanning, histamine application resulted in a considerable increase in blood perfusion in all regions (p0.001) that was significantly higher in skin than in oral mucosa (p0.001). There were no significant differences between the healthy volunteers and the patients regarding baseline blood flow, increased blood perfusion, or flare size after histamine provocation. The sensory impression was reported to be more persistent and intense in the skin than in the oral mucosa. No effect on mucosa could be detected by visual inspection. Conclusions. Intra-oral flare could be induced by activating histamine-excitable nerve fibers. Both duration and intensity of the flare were considerably less pronounced than in the control skin site. Histamine application was not clearly associated with itch.

The bactericide triclosan has found wide-spread use in e.g. soaps, deodorants and toothpastes. Recent in vitro and in vivo studies indicate that triclosan might exert adverse effects in humans. Triclosan has previously been shown to be present in human plasma and milk at concentrations that are well correlated to the use of personal care products containing triclosan. In this study we investigated the influence of age, gender, and the region of residence on triclosan concentrations in pooled samples of Australian human blood serum. The results showed no influence of region of residence on the concentrations of triclosan. There was a small but significant influence of age and gender on the serum triclosan concentrations, which were higher in males than in females, and highest in the group of 31–45 year old males and females. However, overall there was a lack of pronounced differences in the triclosan concentrations within the dataset, which suggests that the exposure to triclosan among different groups of the Australian population is relatively homogenous. A selection of the dataset was compared with previous measurements of triclosan concentrations in human plasma from Sweden, where the use of triclosan is expected to be low due to consumer advisories. The triclosan concentrations were a factor of 2 higher in Australian serum than in Swedish plasma.

The overall aim of the present work has been to obtain quantitative and qualitative data on mercury from dental amalgam in humans. The influence of amalgam removal on mercury levels in blood, plasma and urine has been studied in twelve volunteers. All amalgam fillings were removed during one dental session. A transient increase of mercury in blood and plasma was observed within 48 h after amalgam removal, and sixty days after the mercury levels in all media had decreased to about 60% of the pre removal levels. A bi-exponential model was applied on mercury in plasma with the median half-time of the second phase being 88 days. The kinetics of mercury in urine was fitted to a mono-exponential model, the median half-time being 46 days. The pharmacokinetics of mercury vapor was studied after a single dose exposure in human volunteers. Nine subjects were exposed to 400 µg/m3 mercury vapor for15 min. The retention was on average 67% of the inhaled mercury dose. A rapid absorption phase was seen in blood and plasma, followed by a bi-exponential decline. In plasma the median half-time of the second phase was 10 days with a large inter-individual variation. The estimated total amount of mercury excreted via urine during 30 daysranged from 8% to 41%. Mercury levels in saliva and feces before and after amalgam removal were studied. The fecal mercury concentrations were more than ten times higher in the pre-removal samples than those found in a reference group with no amalgam fillings. Two days after removal, the fecal mercury concentrations increased about 100 times, followed by a significant decrease. Sixty days after amalgam removal, the mercury levels in feces were still slightly higher than in the reference group. In saliva the median mercury levels declined from the pre-removal level of 200 nmol/kg to 1 nmol/kg sixtydays after amalgam removal. The kidney is a target organ for inorganic mercury and in animal studies decreased renal function has been shown after placement of