{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T02:37:03Z","timestamp":1773715023515,"version":"3.50.1"},"reference-count":57,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T00:00:00Z","timestamp":1557360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and\/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.<\/jats:p>","DOI":"10.3390\/ijerph16091627","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T11:22:35Z","timestamp":1557400955000},"page":"1627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Once Resin Composites and Dental Sealants Release Bisphenol-A, How Might This Affect Our Clinical Management?\u2014A Systematic Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-4173","authenticated-orcid":false,"given":"Anabela Baptista","family":"Paula","sequence":"first","affiliation":[{"name":"Institute of Integrated Clinical Practice, Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), CNC.IBILI, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Debbie","family":"Toste","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Alfredo","family":"Marinho","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"In\u00eas","family":"Amaro","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9269-5417","authenticated-orcid":false,"given":"Carlos-Miguel","family":"Marto","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), CNC.IBILI, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-7926","authenticated-orcid":false,"given":"Ana","family":"Coelho","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), CNC.IBILI, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Manuel","family":"Marques-Ferreira","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), CNC.IBILI, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5759-5557","authenticated-orcid":false,"given":"Eunice","family":"Carrilho","sequence":"additional","affiliation":[{"name":"Institute of Integrated Clinical Practice, Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), CNC.IBILI, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.14219\/jada.archive.2006.0185","article-title":"Exposure to bisphenol A from bis-glycidyl dimethacrylate\u2013based dental sealants","volume":"137","author":"Joskow","year":"2006","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6981","DOI":"10.1038\/s41598-018-24815-z","article-title":"A novel high sensitivity UPLC-MS \/ MS method for the evaluation of bisphenol A leaching from dental materials","volume":"8","author":"Putzeys","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_3","first-page":"179","article-title":"Is There a Risk of Harm or Toxicity in the Placement of Pit and Fissure Sealant Materials?","volume":"74","author":"Azarpazhooh","year":"2008","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"576","DOI":"10.5005\/jp-journals-10024-1582","article-title":"The Effect of Temperature on Bisphenol: An Elution from Dental Resins The Effect of Temperature on Bisphenol: An Elution from Dental Resins","volume":"15","author":"Atabek","year":"2014","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.ajodo.2016.07.019","article-title":"Bisphenol A release from orthodontic adhesives measured in vitro and in vivo with gas chromatography","volume":"151","author":"Moreira","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.3346\/jkms.2012.27.9.1098","article-title":"Salivary bisphenol-A levels due to dental sealant\/resin: A case-control study in Korean children","volume":"27","author":"Han","year":"2012","journal-title":"J. Korean Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1001\/2012.jama.11461","article-title":"Association between urinary bisphenol A concentration and obesity prevalence in children and adolescents","volume":"308","author":"Trasande","year":"2012","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/cdoe.12014","article-title":"Obesity and dental caries in children: A systematic review and meta-analysis","volume":"41","author":"Hayden","year":"2013","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"745","DOI":"10.14219\/jada.2014.34","article-title":"Dental sealants and restorations and urinary bisphenol A concentrations in children in the 2003\u20132004 National Health and Nutrition Examination Survey","volume":"145","author":"McKinney","year":"2015","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"51","DOI":"10.14219\/jada.archive.2000.0019","article-title":"Pharmacokinetics of bisphenol A released from a dental sealant","volume":"131","author":"Fung","year":"2000","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1542\/peds.2009-2693","article-title":"Bisphenol A and Related Compounds in Dental Materials Abby","volume":"126","author":"Fleisch","year":"2010","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"65","DOI":"10.7326\/0003-4819-151-4-200908180-00136","article-title":"The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.ijsu.2010.02.007","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"8","author":"Moher","year":"2010","journal-title":"Int. J. Surg."},{"key":"ref_14","first-page":"38","article-title":"Avalia\u00e7\u00e3o do risco de vi\u00e9s de ensaios cl\u00ednicos randomizados pela ferramenta da colabora\u00e7\u00e3o Cochrane","volume":"18","author":"Silva","year":"2013","journal-title":"Rev. Diagn\u00f3stico Trat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.14219\/jada.archive.2012.0090","article-title":"Bisphenol A and other compounds in human saliva and urine associated with the placement of composite restorations","volume":"143","author":"Kingman","year":"2012","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.ajodo.2011.04.022","article-title":"Release of bisphenol A from resin composite used to bond orthodontic lingual retainers","volume":"140","author":"Kang","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_19","first-page":"145","article-title":"Bisphenol A blood and saliva levels prior to and after dental sealant placement in adults","volume":"84","author":"Shuman","year":"2010","journal-title":"J. Dent. Hyg. JDH"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s10856-005-0627-8","article-title":"Salivary bisphenol-A levels detected by ELISA after restoration with composite resin","volume":"16","author":"Sasaki","year":"2005","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1875-595X.2011.00089.x","article-title":"Dental composite fillings and bisphenol A among children: A survey in South Korea","volume":"62","author":"Chung","year":"2012","journal-title":"Int. Dent. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.adaj.2016.02.020","article-title":"Changes in urinary bisphenol A concentrations associated with placement of dental composite restorations in children and adolescents","volume":"147","author":"Maserejian","year":"2016","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.chemosphere.2016.12.123","article-title":"Salivary bisphenol A levels and their association with composite resin restoration","volume":"172","author":"Lee","year":"2017","journal-title":"Chemosphere"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1007\/s00784-017-2055-9","article-title":"Bisphenol A concentration in human saliva related to dental polymer-based fillings","volume":"21","author":"Berge","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.ajodo.2016.07.022","article-title":"Comparative evaluation of salivary bisphenol A levels in patients wearing vacuum-formed and Hawley retainers: An in-vivo study","volume":"151","author":"Raghavan","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.ajodo.2018.02.008","article-title":"High-performance liquid chromatography analysis of salivary bisphenol A levels from light-cured and chemically cured orthodontic adhesives","volume":"154","author":"Manoj","year":"2018","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s007840050089","article-title":"Time-related bisphenol-A content and estrogenic activity in saliva samples collected in relation to placement of fissure sealants","volume":"3","author":"Breinholt","year":"1999","journal-title":"Clin. Oral Investig."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1600-0722.2011.00897.x","article-title":"Detection and quantification of monomers in unstimulated whole saliva after treatment with resin-based composite fillings in vivo","volume":"120","author":"Michelsen","year":"2012","journal-title":"Eur. J. Oral Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1289\/ehp.96104298","article-title":"Estrogenicity of resin-based composites and sealants used in dentistry","volume":"104","author":"Olea","year":"1996","journal-title":"Environ. Health Perspect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/ipd.12064","article-title":"Dental sealants and composite restorations and longitudinal changes in immune function markers in children","volume":"24","author":"Maserejian","year":"2014","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.1038\/sj.bdj.2014.36","article-title":"Dental composite materials and renal function in children","volume":"216","author":"Trachtenberg","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.toxrep.2017.12.013","article-title":"Bisphenol A (BPA) the mighty and the mutagenic","volume":"5","author":"Jalal","year":"2018","journal-title":"Toxicol. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.14219\/jada.archive.2013.0232","article-title":"The impact of the Great Recession on untreated dental caries among kindergarten students in North Carolina","volume":"144","author":"Abasaeed","year":"2013","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1001\/jama.289.10.1258","article-title":"Association of pediatric dental caries with passive smoking","volume":"289","author":"Aligne","year":"2003","journal-title":"JAMA"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.dental.2015.04.020","article-title":"BPA qualtitative and quantitative assessment associated with orthodontic bonding in vivo","volume":"31","author":"Kloukos","year":"2015","journal-title":"Dent. Mater."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jdent.2013.04.012","article-title":"In vivo bisphenol-A release from dental pit and fissure sealants: A systematic review","volume":"41","author":"Kloukos","year":"2013","journal-title":"J. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Rodriguez-Farre, E., Testai, E., Bruzell, E.M., and Jong, W.H.D. (2015). The Safety of Dental Amalgam and Alternative Dental Restoration Materials for Patients and Users. Regulatory Toxicology and Pharmacology, Elsevier.","DOI":"10.1016\/j.yrtph.2015.12.015"},{"key":"ref_38","unstructured":"Scientific Committee on Emerging and Newly Identified Health Risks (2015). The Safety of the Use of Bisphenol A in Medical Devices, European Commission."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5604\/12321966.1141390","article-title":"Release of bisphenol A and its derivatives from orthodontic adhesive systems available on the European market as a potential health risk factor","volume":"22","author":"Kluska","year":"2015","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ajodo.2014.09.013","article-title":"Bisphenol A release from orthodontic adhesives and its correlation with the degree of conversion","volume":"147","author":"Purushothaman","year":"2015","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.ajodo.2010.02.037","article-title":"Bisphenol A release from an orthodontic adhesive and its correlation with the degree of conversion on varying light-curing tip distances","volume":"140","author":"Sunitha","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ajodo.2009.12.026","article-title":"Release of bisphenol-A from a light-cured adhesive bonded to lingual fixed retainers","volume":"139","author":"Eliades","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1080\/23337931.2018.1476869","article-title":"Presence and leaching of bisphenol a (BPA ) from dental materials","volume":"4","author":"Becher","year":"2018","journal-title":"Acta Biomater. Odontol. Scand."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1590\/S0102-311X2002000200015","article-title":"Endocrine disruptors and dental materials: Health implications associated with their use in Brazil","volume":"18","author":"Coelho","year":"2002","journal-title":"Cad. Saude Publica"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0016-6480(03)00199-0","article-title":"Sex reversal effects on Caiman latirostris exposed to environmentally relevant doses of the xenoestrogen bisphenol A","volume":"133","author":"Stoker","year":"2003","journal-title":"Gen. Comp. Endocrinol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1095\/biolreprod.104.036301","article-title":"Long-Term Effects of Fetal Exposure to Low Doses of the Xenoestrogen Bisphenol-A in the Female Mouse Genital Tract1","volume":"72","author":"Markey","year":"2005","journal-title":"Biol. Reprod."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4138","DOI":"10.1210\/en.2005-0340","article-title":"Perinatal Exposure to Bisphenol-A Alters Peripubertal Mammary Gland Development in Mice","volume":"146","author":"Markey","year":"2005","journal-title":"Endocrinology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.mce.2006.04.033","article-title":"Endocrine disruptors and reproductive health: The case of bisphenol-A","volume":"254\u2013255","author":"Maffini","year":"2006","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.toxlet.2010.02.002","article-title":"Bisphenol A may cause testosterone reduction by adversely affecting both testis and pituitary systems similar to estradiol","volume":"194","author":"Nakamura","year":"2010","journal-title":"Toxicol. Lett."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/j.dental.2009.10.006","article-title":"Distribution of 14C-bisphenol A in pregnant and newborn mice","volume":"26","author":"Tanaka","year":"2010","journal-title":"Dent. Mater."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.dental.2005.04.029","article-title":"The effects of BIS-GMA and TEG-DMA on female mouse fertility","volume":"22","author":"Darmani","year":"2006","journal-title":"Dent. Mater."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jdent.2004.08.001","article-title":"In vitro embryotoxicity assessment with dental restorative materials","volume":"33","author":"Schwengberg","year":"2005","journal-title":"J. Dent."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1742-7843.2009.00479.x","article-title":"Induced DNA Damage by Dental Resin Monomers in Somatic Cells","volume":"106","author":"Arossi","year":"2010","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1093\/mutage\/gen066","article-title":"In vivo genotoxicity of dental bonding agents","volume":"24","author":"Arossi","year":"2008","journal-title":"Mutagenesis"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00204-010-0558-0","article-title":"Induction of DNA strand breaks by dental composite components compared to X-ray exposure in human gingival fibroblasts","volume":"85","author":"Durner","year":"2011","journal-title":"Arch. Toxicol."},{"key":"ref_56","first-page":"108","article-title":"Cross-reactivity among epoxy acrylates and bisphenol F epoxy resins in patients with bisphenol A epoxy resin sensitivity","volume":"13","author":"Lee","year":"2002","journal-title":"Am. J. Contact Dermat."},{"key":"ref_57","first-page":"397","article-title":"Pilot study of contact sensitization to rubber allergens and bisphenol A amongst dental students","volume":"30","author":"Lyapina","year":"2017","journal-title":"Int. J. Occup. Med. Environ. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/9\/1627\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:50:35Z","timestamp":1760187035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/9\/1627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,9]]},"references-count":57,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["ijerph16091627"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16091627","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,9]]}}}