Environmental impacts from intraoral polymer devices: A systematic review

This systematic review assessed scientific evidence regarding the release of monomeric eluates or degradation compounds and polymer nano- and micro-sized particles (NMP) from intraoral polymer devices (IPD), during fabrication/processing within dental operatory settings, and into patient body fluids after placement.

Peer-reviewed articles in English were identified through multiple bibliometric databases, grey literature, website searches, and hand-searching. Eligible studies quantified (i) monomeric eluates or polymer NMPs in air or wastewater in dental operatory settings, (ii) monomeric eluates or degradation compounds and polymer NMPs in human body fluids at defined intervals after intraoral placement of an IPD.

Two reviewers independently screened/extracted 50 studies: 13 on operatory air/wastewater during IPD fabrication/processing; 16 on body-fluid levels from removable/semi-permanent IPDs; and 21 on permanent IPDs. Outcomes included monomeric eluates or degradation compound count or mass concentration after minutes, hours, days, weeks, months, and years, and polymer NMP counts, size distributions, mass concentrations, and chemical composition. Risk of bias was assessed using study-design-specific tools. Estimates of monomeric eluates or degradation compounds and polymer NMP levels varied widely across interventions, materials, and settings. Transient increases in body fluid eluates were common post-placement, typically returning to baseline within 48 h. Methodological heterogeneity, inconsistent units, and limited ecological context hindered meta-analysis and environmental risk appraisal.

IPDs can release monomeric eluates, degradation compounds, and polymer NMPs during fabrication/processing and following intraoral placement, contributing to environmental contamination and, where significant, pollution. Standardized research protocols and reporting standards are needed to quantify these impacts.