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biocompatibility e lec Flashcards

to introduce the concept of biocompatibility and the relevance to dentistry

1
Q

what is the definition of biocompatibility

A

it is any substance other than drugs, natural or manmade that can be used for any period of time as a whole or part of a system which can treat, augments or replaces any tissue organ or function of the body

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2
Q

give common examples of biocompatible materials in medicine

A

heart artificial valves or hip joints

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3
Q

examples in dentistry

A

amalgams or casting alloy or implants

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4
Q

biocompatibility

A

the ability pf a material to elicit an appropriate biological response in a given application

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5
Q

is there absolute biocompatibility

A

no

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6
Q

what are the three important factors in biocompatibility

A

interaction with host, material and function of the material

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7
Q

biocompatibility is…

A

dynamic, ongoing

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8
Q

what host related factors can affect biocompatibility

A

aging and disease or the material might change due to corrosion or fatigue

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9
Q

what local factors can affect biocompatibility

A

loads places, occlusion/diet

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10
Q

how is biocompatibility affecting dentists

A

safety of the patient
legal liability
safety of dental staff

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11
Q

which potential biological effects can occur

A

toxic reactions

allergic reactions

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12
Q

what toxic reactions can occur

A

cancer or allergies

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13
Q

what causes a toxic reaction

A

direct contact with the material

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14
Q

what also causes a toxic reaction

A

leaching or degradation products

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15
Q

what is the definition of a toxic material

A

a toxic material is one that releases a chemical in sufficient quantities to kill cells either through direct or indirect inhibition of metabolic pathways

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16
Q

eg of toxic reactions

A

carcinogenic reactions are dose dependant

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17
Q

how do we get toxic effects

A

one large dose or small doses over the threshold

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18
Q

in dentistry toxic reactions occurs not as

A

a one time dose dependant reactions

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19
Q

toxic reactions are

A

dose dependant

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20
Q

allergic reactions are

A

dose independent

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21
Q

name some materials that can cause allergic reactions

A 
mercury 
eugenol 
nickel
chromium 
cobalt 
resin based materails 
formaldehyde(allergic and direct toxic effects)
methylmethacrylate
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22
Q

name some known allergens

A

nickel
methylcrylacytes
resin based material
latex

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23
Q

why can these materials be more dangerous to dentists

A

due to exposure for a long time which can cause cumulative irritation allergic response

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24
Q

risks are greater for dental technicians from

A

gypsum
resin
mentals

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25
how can these materials affect technicians
due to inhalation
26
intra oral reactions
lichen planus swelling tenderness redness burning sensation and ulceration blisters
27
hands wrists for finger reactions
``` dermatitis urticaria eczema itching dry flaky skin swelling redness or blisters ulceration ```
28
face or lip reactions
swelling redness and tenderness ulceration or blisters dermatitis eczema and urticaria burnign or tingling
29
general reactions
``` breathing issues runny irritated eyes coughing sneezing closed throat headache nausea dizziness ```
30
what needs to be carried out for safety
risk assessments
31
what is LOAEL
lowest observed adverse effect levels
32
NOAEL
no observed adverse effect levels
33
what is the numerical value for LOAEL
50 micrograms/m3 nephrotoxicity levels
34
what is the general public threshold for NOAEL
5 micrograms/m3
35
what is the factory threshold for NOAEL
25micrograms/m3
36
what is the threshold for children, sick , pregnant people
1 micrograms/m3
37
which factors should be considered
sex, age , allergic potential foetal exposure diet pre existing conditions and nutritional status
38
what exposure factors do we need to consider
``` quantity route length of exposure accumulation in tissues and excretion ```
39
what are the essential elements by WHO
``` zinc iodine selenium cobalt iron chromium copper molybdenum ```
40
why might a material not biocompatible
just because it is in the body doesnt men it will be biocompatible
41
what must also be considered
that reactions between the elements in the body already occur and the implant material must also be considered
42
what do metals undergo
electrochemical reactions with the environment which results in dissolution= corrosion
43
what can happen to casting alloys
they can result in leaching into the oral environment
44
is amalgam safe to use
yes
45
when was amalgam first used
mid 19th century
46
what did the hatters suffer from
``` neulogical poisoning of the Hg resulting in poor walking unable to speak clearly suffered from palsy ```
47
what type of mercury is associated with biosynthesis and bioaccumulation in fish
methylmercury
48
how many people have been estimated to have minamata disease in minamata, japan
over 3000
49
how are dentists exposed to mercury
due to spillage waste mercury incorrect storage
50
where does the amalgam come from
from prep removal polishing placement of amalgam
51
when was the highest merucry level recorded
1980
52
what was the level of mercury in 1980
19.5 micrograms/ litre
53
what was the level of mercury in 1986
6.7micrograms/litre
54
what factors are looked at when measuring the biological response of the material
the location | the duration the stress thats placed on the material
55
what tests are used to measure biocompatibility
the in vitro test the animal test and the usage test
56
where are intro tests carried out
outside an organism in a test tube or dish
57
what is the material placed in contact with
biological systems- mammalian cells or tissues
58
advantages of in vinto test
``` controllable isolation repeatable fast cheap simple ```
59
disadvantages of in vitro test
provide misleading results
60
how do you carry out a usage test
place into intact organsims
61
which organisms is used
``` rats mice hamsters ferrets guinea pigs ```
62
advantage of usage tests
most relevant test
63
what is it called when a usage test is carried out on a human
clinical trials
64
disadvantages of usage tests
``` expensive time consuming hard to control hard to interpret results legal and ethical issues ```
65
FDA
food drug administration
66
ANSI
american national standard institute
67
ISO
international standards organisation
68
things to consider when we need a filling
systemic health patients habits expectations dynamic relationship between the host function and material

CSA (51 decks)

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