Dental composite restorations and psychosocial function in children.
OBJECTIVE
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.


METHODS
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).


RESULTS
Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (β = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (β = 0.7, SE = 0.3, P = .02), and Personal Adjustment (β = -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.


CONCLUSIONS
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.
Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts 02472, USA. nmaserejian@neriscience.com
Nancy N
NN
Maserejian
Felicia L
FL
Trachtenberg
Russ
R
Hauser
Sonja
S
McKinlay
Peter
P
Shrader
Mary
M
Tavares
David C
DC
Bellinger
D000293:Adolescent; D000342:Affective Symptoms / Q000139:chemically induced* / Q000175:diagnosis; D017438:Bisphenol A-Glycidyl Methacrylate / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000175:diagnosis; D003188:Composite Resins / Q000008:administration & dosage / Q000009:adverse effects*; D003723:Dental Amalgam / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000008:administration & dosage / Q000009:adverse effects*; D010552:Personality Assessment; D011140:Polyurethanes / Q000008:administration & dosage / Q000009:adverse effects*; D019279:Resin Cements / Q000009:adverse effects*; D012917:Social Adjustment
D003188:Composite Resins; D008689:Methacrylates; D011140:Polyurethanes; D019279:Resin Cements; C029824:urethane dimethacrylate luting resin; D017438:Bisphenol A-Glycidyl Methacrylate; D003723:Dental Amalgam