1. Biocompatibilify Of Material For Use In The Body

Question 1

Los

Answer 1

Question 2

What is a biomaterial?

Answer 2

• biological material
  ↳ synthetic (e.g.ceramics, polymer, metal)
  OR
  ↳ natural → used as part of an implanted medical device to replace an organ or bodily function

Question 3

Eg of materials used in dent

Answer 3

• Amalgam
• Glass ionomers
• Gold
• Composites
• Ceramics
• Titanium
• Bone filling products
• Teeth bleaching products

Question 4

Now looking at more tissue engineering

Answer 4

Question 5

Eg of biomaterial applications around body

Answer 5

Question 6

Potential biocompatibility concern categories to consider

Answer 6

Question 7

What is biocompatibility?

Answer 7

Biocompatibility is the ability of a material to perform with an APPROPRIATE HOST response in a given SPECIFIC APPLICATION. (Williams 1987)

Question 8

Materials used in dent come into direct contact with?

Answer 8

• Hard tissues of the teeth
• The soft tissue of the oral mucosa
• The pulp & periapical tissues

Question 9

Key elements that materials in dentistry should be?

(Word better)

Answer 9

•Non-Toxic (both to patient and staff)

• Non-irritant (in the mouth and other tissues)

• Minimal inflammation (acute, not chronic)

•Tissue integration (e.g. Implants)

•Physical and mechanical properties (for intended application)

•Not be mutagenic or carcinogenic

Answer 10

Answer 11

Question 12

Effect the body has on implant material?

Answer 12

1
- first thing to happen is protein cover implant in layer, generally good as want to have cells adhering and new tissue formation

• however not good in blood contacting material EG stent or heart valve as thrombi will form

3
- if degradable material need to consider biocompatibility and enzyme effect
- what breakdown products will be, effect pH, etc

4
- some metals used are corrosive

Question 13

Effects the implant has on the body

Answer 13

Question 14

How is biocompatibility assessed?

Answer 14

Question 15

Factors influencing biocompatibility?

Answer 15

Answer 16

More info 13 minutes onwards on lecture vid

Question 17

Standards that regulate the measurement of biocompatibility

Answer 17

1. International Organization for Standardization (ISO)

↳ international standard-setting body composed of representatives from various national standards organizations
(ISO standard 10993 concerns Biological evaluation of medical devices Part 5: Tests for cytotoxicity- invitro methods)

2. American National Standard Institute/American Dental Association (ANSI/ADA) (1979/1982)

Question 18

Biocompatibility involves 2 components ?

Answer 18

Question 19

How do we test biocompatibility?

Answer 19

More info in lecture but have not written 18 minutes

Question 20

Requirements for biocompatibility in vitro testing methods

Answer 20

SSQ

Question 21

Test methods to assess biocompatibility

Answer 21

Question 22

1. Do adverse actions usually happen with dental biocompatibility
2. What adverse effects may occur?

Answer 22

Question 23

What tissues interact with dental materials and what can they be classified into?

Answer 23

Question 24

Toxicity risks on practitioner and staff?

Answer 24

Question 25

BIOCOMPATIBILITY OF COMMON DEMTAL MATERIALS AMALGAM

Answer 25

* Concern raised over mercury vapour released during manipulation, placement or removal of amalgam ↳ Amount usually minimal & potential of toxic reaction patients is less * Careful handling of mercury reduces risk to dentist & staff * usu harmless to gingival tissues BUT some Lichenoid episodes reported * No major adverse responses reported

Question 26

BIOCOMPATIBILITY OF COMMON DEMTAL MATERIALS Resin based composites

Answer 26

*Various components may be released from resin composite restorations into the oral environment, BUT few systemic adverse effects documented *Those reported have been associated with numerous organic compounds (e.g phosphorus-dentine bonding agents, restorative materials) effects of which are unknown *Incomplete polymerisation leads to degradation, leaching, imperfect bonding, polymerisation shrinkage *Adverse local pulp and dentin reactions, may be associated with the development of recurrent caries, and pain * Increased plaque adhesion and Lichenoid episodes reported

Question 27

BIOCOMPATIBILITY OF COMMON DEMTAL MATERIALS GIC (glass ionimer cements)

Answer 27

*No evidence of systemic effect *May see some minor irritation of the pulp, short-lived usually followed by rapid recovery *Any irritation to the pulp, is more likely to be caused by hydraulic pressure/etching during placement *Cytotoxic substances like TEGMA & HEMA can be released from unset or partially cured composites, these can diffuse through the dentin & cause pulpal inflammation *No major adverse reactions reported in gingival tissue Overall Good biocompatibility !

Question 28

BIOCOMPATIBILITY OF COMMON DEMTAL MATERIALS Gold foil and cast alloys

Answer 28

- Used for making crowns, bridges and dentures *Inert, sensitivities are rare *Potential pulp reactions due to condensation *Rare allergic reactions to alloy metals

Question 29

BIOCOMPATIBILITY OF COMMON DEMTAL MATERIALS Ceramics

Answer 29

*No known reactions except wear on opposing dentition and restoration *Generally good biocompatibility

Answer 30

All dental materials in current use are considered to be ACCEPTABLE They show biocompatibility with local tissues: *When properly handled and carefully placed in the oral cavity *Adverse systemic reactions are RARE, self-limiting, and tend to be of an allergic nature *Local reactions have been documented in only a small percentage of individuals

Question 31

SUMMARY

Answer 31