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Dental Materials > Biocompatibility 2 > Flashcards

Biocompatibility 2 Flashcards

1
Q

What reactions can occur when material is placed in the mouth?

A
  • allergic reaction to materials
  • material degradation
  • material interaction with tissues
  • and with bacteria
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2
Q

Why can allergic reactions occur to material?

A
  • the body’s way of responding to an ‘invader’
  • immune system triggered when antigen sensed
  • begins immediately after exposure usually
  • anaphylaxis - most severe hypersensitivity reaction
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3
Q

Clincial appearance of allergic reactions

A
  • redness/whiteness of mucosa
  • swelling of lips, tongue, cheek
  • ulcers/blisters
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4
Q

Frequency of allergic reactions

A
  • 1:000 to 1:10000
  • rare
  • more common when using deoderants or antiperspirants
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5
Q

How are allergies recorded?

A
  • often not noticed by patients
  • recorded in routine dental exams
  • questioned about existing allergiesn at first exam and updated with new ones every time
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6
Q

Who has increased potential for reaction?

A
  • children have increased sensitivity to food additives
  • dental practitioners more at risk repeated handling of unset products
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7
Q

3 groups that can cause reactions

A
  • metals
  • polymers
  • cements
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8
Q

Types of metal we can have a reaction to

A
  • metal and/or ionic metal hydroxides/oxides
  • corrosion products
  • wear products
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9
Q

Kinds of polymers that cause reactions

A
  • residual monomers
  • leachable compounds
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10
Q

Cements that cause reactions

A
  • eugenol
  • acids
  • leachable compounds
  • residual monomers
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11
Q

Common problems in patients with material caused hypersensitivity

A
  • stomatitis (chromium, cobalt, mercury, monomers, formaldehyde, eugenol)
  • lichenoid reactions (amalgam, composite resins)
  • plasma cell gingivitis
  • angioedema
  • erythema multiforme
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12
Q

Issues for the dentist with material caused hypersensitivity

A
  • contact dermititis
  • when surface contacts allergen like nickel or monomers
  • like monomers of bonding agent
  • mainly distal parts of fingers and palmer aspects of fingertips
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13
Q

List reasons why materials degrade

A
  • oral environment
  • corrosion
  • wear
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14
Q

How does the oral env degrade material?

A
  • chemical degradation in aqueous env, hydrolysis and saliva esterases breaking down resins
  • pH range
  • temp
  • solvents
  • bacteria
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15
Q

How does corrosion degrade material?

A
  • metals and alloys
  • dietary acids increase it
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16
Q

How does wear degrade materials?

A
  • contact and relative motion
  • roughness effect
  • loss of material
  • wear debris - increase wear, biological response of inflammation and osteolysis/bone resorption)
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17
Q

Consequences of degradation

A
  • loss of materials (less mechanical proporties and reduction in mass)
  • degradation products increase wear and cause immunological response locally and systemically
18
Q

Bulk properties of material

A
  • chemical composition
  • structure
  • purity
  • presence of leachables
19
Q

Bulk properties cause …

A

irritation

20
Q

Surface proporties of material

A
  • roughness
  • geometry
  • hydrophilicity
  • surface change
21
Q

Surface properties cause what?

A

adhesion (protein and cellular)

22
Q

Mechanical properties of material

A
  • loading
  • wear
  • creep
  • deformation
  • stress corrosion cracking
23
Q

Mechanical properties cause what?

A

particulate release

24
Q

Interaction of material depends on …

A

application

25
Q

Materials of dental implants

A
  • titanium and its alloys
  • coatings with ceramics
  • all-ceramic implants available (zirconia)
26
Q

Osseointegration
Biointegration
of dental implants

A
  • direct bone contact with implant surface. Gap less than 10nm
  • no gap
27
Q

Materials in fracture fixation plates

A
  • titanium and its alloys commonly
  • resorbable polymers (polylactic acid, polyglycolic acid, copolymers)
28
Q

Negatives to titanium as a fracture plate

A
  • post-op complications
  • stress shielding
  • screw fixation
29
Q

Features of resorbable polymers

A
  • lower stiffness than titanium
  • resorb over time
  • acidic byproducts
30
Q

Immediate biological reactions that happen within seconds and minutes

A
  • water and ion interaction
  • protein adsorption
  • cellular deposition and spreading
  • activation of body’s cellular and immune response
31
Q

Biological interactions that happen intermediately (hours/days)

A
  • inflammation
  • infection
32
Q

Biological interactions that occur long term (months/years)

A
  • remodelling of surrounding tissues
  • calcification
  • tumour or cancer formation
33
Q

Local response to implanted material

A
  • infection
  • toxicity
  • modification of normal healing
  • tumorigenesis
34
Q

Systemic effects to implanted material

A
  • embolization
  • hypersensitivity
  • elevation of implant elements in blood
35
Q

Patient characteristics can influence how tissues react. Which ones?

A
  • age and health (immunology and metabolism)
  • tissue damage - the procedure
  • contamination (exposure to operating env, patient’s response to infection)
36
Q

Bacteria adhere to … and form …

A
  • surfaces and form nucleated colonies
  • form biofilms and all surfaces
  • inflammation forms at interface of bacteria and tissues e.g gingivitis
37
Q

Material dependent factors that help attachment ofbacteria

A
  • chemical composition of material
  • hydrophobic or philic
  • material surface - morphology e.g roughness
38
Q

Which is more resistant to bacterial adhesion? Hydrophobic or philic materials

A

hydrophobic

39
Q

Bacteria dependent factors favouring attachment of bacteria

A
  • hydrophobicity of bacteria
  • surface charge of bacteria
40
Q

Excluding material dependent and bacteria dependent factors, what other factors can affect bacterial adhesion?

A

fluid dynamics

41
Q

Are there any links between oral and systemic health?

A
  • yes between the oral biofilm and periodontal disease and systemic
  • systemic dissemination of oral bacteria and their metabolites is linked to pathophysiology of atherosclerosis

Dental Materials (17 decks)

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