GREEN DENTISTRY:

JOURNAL CLUB

GUIDED BY:
PRESENTED BY:
Dr. P Jaya Krishna Babu
Dr. Gazal Saxena
HOD, Department of Prosthodontics
PG First year
 • Introduction
• Review Article 1

CONTENTS • Review Article 2

• Review Article 3
• Conclusion
• References

2
INTRODUCTION
• “Approach to dentistry that implements sustainable practices by keeping
resource consumption in line with nature's economy, by safeguarding the
external environment by virtue of eliminating or reducing outgoing wastes,
and by promoting the well-being of all those in the clinical environment by
conscious reduction of the chemicals in the breathable air.”

Mulimani, P. Green dentistry: the art and science of sustainable practice. Br

Dent J 222, 954–961 (2017). https://doi.org/10.1038/sj.bdj.2017.546 3
REVIEW
ARTICLE 1
“Recycling and Reuse of Dental
Rajkumar et al Materials: An Overview”
Journal of Emerging
Technologies and Innovative
Research,
Volume 7, Issue 8
August, 2020 Recycling and Reuse of Dental Materials: An Overview",
International Journal of Emerging Technologies and Innovative
Research (www.jetir.org), ISSN:2349-5162, Vol.7, Issue 8,
page no.186-190, August-2020

4
INTRODUCTION • Dentistry is a profession that promotes and enhances oral health and
well‒being by providing various dental treatments by using a variety of
materials and instruments.

• Thus, a large amount of waste is generated like waxes, gypsum

products, dental amalgam, lead, silver, and biomedical waste which
have a detrimental effect on the environment.

5
 MATERIALS
AND METHODS: • Large amount of gypsum waste is generated in the field of dentistry.
GYPSUM • This gypsum waste is discarded into the landfills whose reduction
PRODUCTS causes the production of hydrogen sulfide, which has a characteristic
rotten egg smell.

• The respiratory tract and nervous system are the most sensitive
targets of hydrogen sulfide toxicity.

6
 GYPSUM • Currently, gypsum waste harboring biomedical material is disposed off

PRODUCTS by incineration which is extremely environmentally unfriendly.

• The eco–friendly and rapid disintegration of such waste can be done by

treatment with ammonium bicarbonate solution with a concentration of
20% that exhibits antibacterial and antifungal properties.

G. R. Navale, K. N. Gohil, M. S. Dharne. Rapid and greener method for utilization of plaster of
paris(POP) waste generated from biomedical samples. International Journal of Environmental
Science and Technology, 2019, Vol. 16, P2475–2480
7
 • This solution disintegrates the waste into high-value and non–toxic chemicals
GYPSUM such as ammonium sulfate and calcium bicarbonate in the form of sludge in

PRODUCTS 24 hours to 36 hours at room temperature.

• Ammonium sulfate can be utilized as nitrogen fertilizer, fire–extinguishing

powder, and in industries like pharmaceutical, textile, and wood pulp.

• Calcium bicarbonate can be used in the metallurgy industry, mainly in steel

manufacturing.

8
 DENTAL
ALGINATE • Irreversible hydrocolloid impressions are an indispensable part of routine
dental practice.

• Alginate is one of the most frequently used dental materials owing to its
convenient and controllable texture, uncomplicated handling, minimal
equipment prerequisites, flexibility, precision, and economical nature.

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 • These alginate molds are discarded in regular trash alongside other infectious
waste and subsequently managed as part of household waste disposal.

• This alginate impression waste can be recycled by the process of washing,

DENTAL
drying and meshing until the size is approximately 2-3 mm.
ALGINATE

Discarded alginate impressions being meshed for recycling

Frahdian, Tommy & Hasratiningsih, Zulia & Karlina, Elin & Herdiyantoro, Diyan & Takarini, Veni. (2018). Dental alginate
impression waste as additional fertiliser for plant yields and soil quality. Padjadjaran Journal of Dentistry. 30.
10.24198/pjd.vol30no1.16231. 10
 DENTAL
ALGINATE • The recycled alginate demonstrates an ample supply of nutrients beneficial for
soil fertility and crop growth. Its elevated calcium content can serve as a soil
enhancement material.

• Furthermore, the dental alginate waste yields essential nutrients such as

Nitrogen, Sodium, Phosphate, Potassium, Calcium, Manganese, and Sulfur, all
of which contribute effectively to crop yields.

11
DENTAL
WAXES • These waxes are mainly used to construct occlusal rims during the
fabrication of complete dentures, partial dentures, etc.

• About 80 – 90 % of wax can be recollected and purified by simple

laboratory techniques by removing adhering impurities.

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 SILVER
AMALGAM • Dental amalgam, traditionally used for tooth fillings, has seen reduced
usage due to tooth-colored alternatives like composites.

• It's mainly employed in dental colleges for training and as a posterior

restorative material in clinics. Approximately 100% of amalgam is
discarded in teaching institutions and 25% in clinics.

A Jokstad, P L Fan. Amalgam waste management. International Dental

Journal. 2006, Vol. 56. No.0, P1‒7. 13
 SILVER
AMALGAM • Dental amalgam waste, generated during placement and replacement of
restorations, comprises 50-60% silver, 20-30% tin, and 10-15%
various silver-mercury and copper-tin phases.

• By heating the waste above 450⁰C, mercury vaporizes and can be

purified and reused.

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 SILVER
AMALGAM • The remaining mixture, dissolved in concentrated nitric acid, forms
soluble nitrates of silver and copper, and the addition of a metal with
lower electrode potential displaces and recovers the silver from the
silver nitrate solution.

• Silver and mercury can be reused in many industries & and dentistry
leading to the conservation of earth resources.

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 • Base metal alloys are used in the fabrication of metal copings, crowns,
and bridges, cast partial denture frameworks, metal denture bases, and
implant‑supported frameworks and crowns.
CASTING • Casting technique generates about 50%–60% of the alloy that remains
ALLOYS as waste in the form of buttons and sprues.

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 • The remaining wasted materials can be effectively reused for
fabricating new restorations or appliances by proper cleaning
techniques like sandblasting, and electropolishing.

CASTING • This material can be recasted up to 4 times without any compromise in

ALLOYS its mechanical properties.

Vaillant-Corroy AS, Corne P, De March P, Fleutot S, Cleymand F. Influence of recasting on the quality of dental alloys: A systematic
review. J Prosthet Dent. 2015 Aug;114(2):205-11.e3. doi: 10.1016/j.prosdent.2015.02.004. Epub 2015 Apr 30. PMID: 25935082.
17
DENTAL
X-RAYS • Another prevalent waste product in dentistry is unused X-ray films,
which should not be casually disposed off in general waste due to its
unreacted silver content.

• Hence, recycling X-rays is a prudent approach. In the recycling

process, the films undergo a chemical wash that isolates the silver,
which is then melted and transformed into bars.

18
REVIEW
ARTICLE 2

Navale et al
“Rapid and greener method for utilization of Plaster
International journal of of Paris (POP) waste generated from biomedical samples”
Environmental Science and
Technology
Volume 16, Issue 3
October 2018 G. R. Navale, K. N. Gohil, M. S. Dharne. Rapid and greener method
for utilization of plaster of paris(POP) waste generated from
biomedical samples. International Journal of Environmental Science
and Technology, 2019, Vol. 16, P2475–2480.

19
 1%
3% 1%

15%

INTRODUCTION
80%

Non infectious waste

Pathological and infectious waste
Chemical and pharmaceutical waste
Sharps
radioactive, cytotoxic and heavy metals

20
 • Prepared plaster was kept for 10–15 days at room temperature. Dental caste
and POP plaster were cut into small pieces and dipped into 20% ammonium
bicarbonate (Merck India) (ABC) solution and stirred on a magnetic stirrer for
POP WASTE 24–36 h.
DISINTEGRATION • POP to ABC ratio was kept as 1:1 (wt./ wt.). The reaction mechanism was:

2(NH4) HCO3 (Ammonium Bicarbonate) + CaSo4 (Calcium

Sulphate) (POP) ⟶ (NH4)2SO4 (Ammonium sulphate) +
CaCo3 (Calcium carbonate) + H2O (Water) + CO2 (Carbon
dioxide)

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POP from healthcare
waste sources
disintegrated by
20% ABC solution

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ANTIMICROBIAL
ACTIVITY

A. Effect of different concentrations of ABC solution B. Per cent (%) inhibition of biofilm of S. aureus, P.
on direct biomass of A. fumigatus (orange) and F. aeruginosa, S. epidermidis and mixture of three
oxysporum (purple) after 7 days of incubation bacteria, after 24 h of treatment with various
concentrations of ABC solution.

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 • This method is simple, economical, safer (non-toxic) and very effective for
the disintegration of POP containing biomedical waste.
CONCLUSION • Complete dissolution of POP by use of ammonium bicarbonate solution gives
value-added products.

24
 • Both by-products have applications in agriculture (as a fertilizer) and
construction sector (additive), respectively. This process is cost-effective and
eco-friendly.
CONCLUSION
• Therefore, it can be concluded that this method is a good alternative for POP
incineration, which would potentially avoid air pollution and keep the
environment safe.

25
REVIEW
ARTICLE 3
“Eco‑friendly Dentistry: Need of Future. An
Arora et al Overview”
JOURNAL OF DENTAL
AND ALLIED SCIENCES
Volume 6, Issue 1
January, 2017 Arora, Savy & Mittal, Sanjeev & Dogra, Veronika. (2017). Eco-
friendly dentistry: Need of future. An overview. Journal of Dental and
Allied Sciences. 6. 22. 10.4103/2277-4696.205446.

26
 REDUCE REUSE
THE FOUR R’S OF
BEING
ECO‑FRIENDLY

RETHINK RECYCLE

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 Nonanatomic waste such as gloves, and dental
materials

Biomedical waste

Anatomic wastes including extracted teeth

DENTAL
Silver‑containing waste including used fixer
WASTE: solution and unused X‑ray films

CATEGORIES Mercury‑containing wastes‑element mercury,

scrap amalgam

Sharps and lead containing wastes

Chemicals‑disinfectants and sterilizing agents.

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Table 1: Color coding of waste disposal bags/containers
Category Type of waste Type of bag/container Disposal treatment
I (yellow) Human/animal anatomical waste Yellow colored Incineration or plasma pyrolysis or deep burial
nonchlorinated plastic bags

Soiled waste Yellow colored Incineration or plasma pyrolysis or deep burial

nonchlorinated plastic bags

Expired/discarded medicine Yellow colored Yellow colored nonchlorinated plastic bags incineration/
nonchlorinated plastic bags encapsulation/plasma pyrolysis

Chemical waste Yellow colored containers or Incineration/encapsulation/plasma pyrolysis

nonchlorinated plastic bags

Chemical liquid waste Separate collection system Pretreated before mixing with other wastewater. Sludge from effluent
treatment plant given to common biomedical waste treatment facility for
incineration or to hazardous waste treatment, storage and disposal facility
for disposal

Discarded linen, mattresses,
beddings contaminated with blood
or body fluid
Microbiology, biotechnology and
other clinical laboratory waste
Yellow colored Nonchlorinated chemical disinfection followed by incineration or plasma
nonchlorinated plastic bags pyrolysis
Autoclave safe plastic bags or Pretreat to sterilize with nonchlorinated chemicals on-site thereafter for
containers incineration

II (red) Contaminated waste (recyclable) Red colored nonchlorinated Autoclaving or micro-waving/hydroclaving followed by shredding or
such as tubing, bottles, intravenous plastic bags or containers mutilation or combination of sterilization and shredding
tubes and gloves

III (white or Waste sharps such as blades, scalpels Puncture proof, leak proof, Autoclaving or dry heat sterilization followed by shredding or mutilation
translucent) and needles tamper proof containers or encapsulation. Final disposal to iron foundries or sanitary landfill or
concrete waste sharp pit

IV (blue) Glassware (like vials) and metallic Cardboard boxes with blue Disinfection (by soaking the washed glass waste after cleaning with
body implants markings detergent and sodium hypochlorite treatment) or through autoclaving or
microwaving or hydroclaving and then sent for recycling

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 • In developing countries like India, it is important that we realize the
importance of being environment-friendly and understand that the efforts of

CONCLUSION each individual count.

• More research and funds are required to regulate and promote eco-friendly
practices. Dental practitioners should be trained in Workplace Hazardous
Materials Information Systems and waste management practices.

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 1. Mulimani, P. Green dentistry: the art and science of sustainable practice. Br Dent
J 222, 954–961 (2017). https://doi.org/10.1038/sj.bdj.2017.546
2. Recycling and Reuse of Dental Materials: An Overview", International Journal of
Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162,
Vol.7, Issue 8, page no.186-190, August-2020

REFERENCES 3. G. R. Navale, K. N. Gohil, M. S. Dharne. Rapid and greener method for utilization
of plaster of paris(POP) waste generated from biomedical samples. International
Journal of Environmental Science and Technology, 2019, Vol. 16, P2475–2480.
4. Frahdian, Tommy & Hasratiningsih, Zulia & Karlina, Elin & Herdiyantoro, Diyan
& Takarini, Veni. (2018). Dental alginate impression waste as additional fertiliser
for plant yields and soil quality. Padjadjaran Journal of Dentistry. 30.
10.24198/pjd.vol30no1.16231.

31
 5. A Jokstad, P L Fan. Amalgam waste management. International Dental Journal. 2006,
Vol. 56. No.0, P1‒7.
6. Vaillant-Corroy AS, Corne P, De March P, Fleutot S, Cleymand F. Influence of
recasting on the quality of dental alloys: A systematic review. J Prosthet Dent. 2015
REFERENCES Aug;114(2):205-11.e3. doi: 10.1016/j.prosdent.2015.02.004. Epub 2015 Apr 30. PMID:
25935082.
7. Arora, Savy & Mittal, Sanjeev & Dogra, Veronika. (2017). Eco-friendly dentistry:
Need of future. An overview. Journal of Dental and Allied Sciences. 22. 10.4103/2277-
4696.205446.

32
THANK YOU!

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