Evidence map›Paper›PMID 41565631›Full record

ReviewBDJ open2026

Environmental impact of dental amalgam and alternative restorative materials: a systematic review.

Simon Briscoe, Liz Shaw, Hassanat Mojirola Lawal, Clara Martin Pintado, Noreen Orr, Lauren Asare, G J Melendez-Torres, Ruth Garside, Jo Thompson Coon

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BDJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Simon BriscoeExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK. s.briscoe@exeter.ac.uk.ORCID http://orcid.org/0000-0002-6982-4521
Liz ShawExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
Hassanat Mojirola LawalExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.ORCID http://orcid.org/0000-0001-6940-5805
Clara Martin PintadoExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
Noreen OrrExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
Lauren AsareExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
G J Melendez-TorresExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
Ruth GarsideExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
Jo Thompson CoonExeter Policy Research Programme Evidence Review Facility, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionConcern about the environmental impact of dental restorative materials has grown in recent years. The most common material for dental restorations has historically been amalgam, but this has seen a decline due to concerns about the health and environmental impact of mercury. Alternative dental restorative materials include resin-based composite (RBC) and glass-ionomer cement (GIC), but both have uncertain environmental impacts. This systematic review aimed to compare the environmental impact of dental amalgam versus other restorative materials used for direct restorations.

methodsWe undertook a systematic review which followed established guidance and prospectively registered our protocol on PROSPERO (CRD42024608563). Searches of bibliographic databases included Environment Complete, GreenFILE, Science Citation Index, CAB Abstracts, MEDLINE and CINAHL. These were supplemented with checking reference lists and forward citation searching of included studies. Retrieved records were screened by two independent reviewers at title and abstract and full text using pre-defined inclusion criteria. Data extraction and quality appraisal were undertaken by one reviewer and checked by a second. Findings were narratively synthesised.

resultsTwenty-one studies (n = 22 study reports) were included. Eleven were in a clinic setting, three were in a lab setting, five were in both clinic and lab settings and two were in a crematorium setting. Six studies included a comparison between different restorative materials, the remainder only measured environmental impact of one material (or multiple without comparison). Some studies were framed as potential environmental impact due to limited data. Materials included dental amalgam, RBC and GIC. Studies were highly heterogenous which limited the scope for synthesis of findings. All materials were associated with environmental impact.

conclusionWhilst the evidence included in this review indicates that both amalgam and non-amalgam dental materials are associated with environmental impacts, confidence in these findings is limited due to the heterogeneity of study designs, outcome measures, and limited comparative data. Further research is needed to inform future policies which aim to reduce the environmental impact of restorative dental activities.

Identifiers

PMID41565631
PMCPMC12824146

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.