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CSA Dental materials > CSA Biocompatibility > Flashcards

CSA Biocompatibility Flashcards

1
Q

What is a biomaterial ?

A

substance ) or combination of substances synthetic or natural in origin, used for any period of time, as whole or asa part of system which treats, augments, or replaces any tissue, organ, or function of body’.

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2
Q

What are examples of biomaterials?

A
  • Artificial heart valves
  • Hip joints
  • Adhesive bridge
  • Subperiostal implant
  • Amalgam
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3
Q

What can happen sometimes when material placed into living tissues?

A

• Interactions may result in inflammation

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4
Q

What is biocompatibility ?

A

ability of material to elicit appropriate biological response in given application

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5
Q

What factors involved in biocompatibility?

A
  1. Patient (host)
  2. Material
  3. Function of material
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6
Q

Why does bodies response to biomaterials change over time?

A 
Host related general factors
•	Disease
•	Ageing
Changes to material
•	Corrosion
•	Fatigue
Local factors
•	Changes to loading on material due to Occlusion/ Diet
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7
Q

What are biological effects of materials?

A

o Leaching, leading to toxic and allergic reactions

o Formation of degradation product

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8
Q

Why are toxic reactions unlikely with dental materials ?

A
  • Materials largely insoluble
  • Only one time exposure
  • Slow dissolution rates
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9
Q

What are allergic responses mediated through ?

A

Immune system

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10
Q

What allergens are found in dental materials?

A
  • Eugenol
  • Mercury
  • Nickel
  • Chromium
  • Cobalt
  • Components of resin-based materials (TEGDMA, HEMA)
  • Formaldehyde (allergic and direct toxic effects)
  • Methyl methacrylate
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11
Q

What allergens cause hypersensitivity ?

A

 Nickel
 Methacrylates
 Resin based materials
 Latex

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12
Q

What causes allergic reactions with dental staff?

A 
	Amalgam
	Casting alloys
	Resin-based materials
	Latex
-o	Inhalation of particulates
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13
Q

what are intra oral adverse reactions to dental materials?

A

 Lichen planus type reaction
 Swelling, tenderness or reddening
 Burning sensation or taste changes
 Ulceration or blisters

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14
Q

what are Hands, wrists and finger adverse reactions to dental materials?

A

 Dermatitis, eczema or urticaria
 Itching, dry, cracked or burning skin
 Swelling, tenderness or reddening
 Ulceration, blisters or vesicles

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15
Q

what are face/lip adverse reactions to dental materials?

A

 Swelling, tenderness or reddening
 Ulceration or blisters
 Dermatitis, eczema or urticaria
 Burning sensation or tingling

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16
Q

what are general adverse reactions to dental materials?

A

 Breathing problems wheezing and asthma
 Runny, irritated eyes or nose
 Coughing, sneezing or sore throat
 Headache, nausea or dizziness

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17
Q

What are patients most at risk from?

A

metals

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18
Q

What are dental staff most at risk from?

A

rubber products/latex

19
Q

What are technicians most at risk from ?

A

resin polymers

20
Q

Why are risk assessments needed?

A
  1. Exposure potential is different among patients, dental workers and industrial workers
21
Q

What are exposure factors ?

A 
o	Quantity
o	Route
o	Length of exposure
o	Accumulation in tissues
o	Excretion characteristics
22
Q

What are human factors ?

A 
o	Age
o	Sex
o	Foetal exposure
o	Allergic potential
o	Diet
o	Pre-existing disease
o	Nutritional status
23
Q

What are toxic in high concs?

A 
o	Zinc
o	Iodine
o	Selenium
o	Cobalt
o	Iron
o	Molybdenum
o	Copper
o	Chromium
24
Q

What reactions must be considered between elements?

A

between elements in biological enviro and dental material

o E.g. proteins in saliva and bacteria in plaque

25
Q

What do metals undergo?

A

chemical or electrochemical reactions with environment

o Results in dissolution or formation of chemical compounds

26
Q

What can casting allow cause?

A

contain more than 25 elements which can corrode and leach into oral cavity

27
Q

What is methyl mercury?

A

associated with biosynthesis and bio-accumulation

- very toxic and readily absorbed in tissues of fish and mammals

28
Q

How can a dentist be exposed to mercury?

A
  1. Incorrect storage or spillage of mercury/waste amalgam
  2. Preparation of amalgam
  3. Placement of amalgam
  4. Removal of amalgam
  5. Polishing of amalgam
29
Q

How is biological response of material measured?

A

o Location of placed material
o Duration of material
o Stress placed on the material

30
Q

What tests are used to measure biocompatibility of dental materials

A
  1. In vitro tests
  2. Animal tests
  3. Usage tests
31
Q

How do in vitro tests work?

A 
• Material  into contact with biological system:
	Mammalian cells
	Cellular organelles
	Tissues
	Bacteria
	Enzyme
32
Q

What are in vitro cell culture used to investigate?

A

 Toxicity of material

 Influence of different setting conditions etc.

33
Q

What are advantages of in vitro ?

A
  • Controllable
  • Can isolate and test specific function of cell
  • Repeatable
  • Fast
  • Relatively inexpensive
  • Relatively simple
34
Q

What are disadvantages of in vitro

A

misleading results

35
Q

What are usage tests?

A

• Places materials into intact organism in enviro clinically relevant to use of material
o Known as ‘clinical trials’ with humans
o Used as gold standard

36
Q

What animals used for usage test?

A

mice rats hamsters ferrets guinea pigs

37
Q

What are advantages of usage tests?

A
  • Most relevant test

* Allows for complex interactions

38
Q

What are disadvantages of usage tests?

A
  • Expensive
  • Time consuming
  • Difficult to control
  • Difficult to interpret
  • Legal and ethical issues
39
Q

What aspects to consider with a filling ?

A
  • Systemic health
  • Patient’s habits
  • Our expectations
  • Dynamic relationship between material, host and function
40
Q

What systemic health aspect to consider?

A

o Is patient diabetic or a smoker?

- Response of gingiva to placement of subgingival restoration may be affected

41
Q

What patient habits to consider?

A

o Does patient drink acidic drinks?

- Corrosion properties of amalgam and tissue response may be affected

42
Q

What to expect ?

A

o Don’t assume material biologically acceptable in different role
- E.g. resin materials biologically acceptable as denture bases but may not be as resin-based cements

43
Q

Why do we monitor patient over time?

A

 A patient who is not allergic to nickel may become allergic in the future

CSA Dental materials (7 decks)

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