DENTAL MATERIALSBiocompatibility and Intermediate Restorative Materials (IRM)

Question 1

The biological reaction can take place where…

Answer 1

• at a local level
• far removed from the site of contact

Question 2

True/False: Systemically the adverse reaction will always be readily apparent.

Answer 2

False
- not always readily apparent especially if dermatological, immune-mediated, or neural

Question 3

What are the most common reactions to dental staff?

Answer 3

hand/facial dermatitis or respiratory systems

Question 4

What are the possible interactions between dental restorative material and the biological environment?

Answer 4

1. post-operative sensitivity
2. toxicity
3. corrosion
4. hypersensitivity/allergy

Question 5

What is a toxcity concern with going across the blood-brain barrier and into the CNS?

Answer 5

nanomaterials

Question 6

Amalgam or its components may cause a type ____ allergy.

Answer 6

Type IV

Question 7

What are the most common allergies with dental materials?

Answer 7

metals
- especially nickel and cobalt

Question 8

What shows mucosal changes, contact stomatitis, and burning sensation?

Answer 8

denture resin

Question 9

What metals (even small amounts) can cause allergic or hypersensitive reactions?

Answer 9

• mercury
• nickel
• cobalt

Question 10

What is the issue with mercury?

Answer 10

direct contact of oral mucosa with this material can cause oral chronic inflammatory lesions on the oral mucosa

Question 11

What to ask for a nickel allergy?

Answer 11

ask patient if they can wear costume jewelry

Question 12

What is the issue with cobalt?

Answer 12

Complications after revision due to cobalt and chromium toxicity

Question 13

________ is one of the most common causes of allergic contact dermatitis and produces more allergic reactions than all other metals combined.

Answer 13

Nickel

Question 14

Non-precious metal crowns contain high levels of…

Answer 14

Nickel

Question 15

What stimulates tertiary dentin formation?

Answer 15

calcium hydroxide

Question 16

Since some alloy restorations have a negative affect on the pulp they developed ________ to apply to dentin prior to restoring.

Answer 16

Intermediate restorative materials (IRMs)

Question 17

What are the possible roles of the intermediate restorative materials?

Answer 17

protective, palliative, or therapeutic

Question 18

What are examples of intermediate restorative materials?

Answer 18

cavity varnishes
bases and liners

Question 19

What is the goal of intermediate restorative materials?

Answer 19

• protect the pulp from chemical, electrical, or thermal properties

Question 20

What is an example of an electrical issue with a restoration?

Answer 20

galvanic shock

Question 21

What is an intermediate restorative material that is sedative like on hypersensitive pulp and is a good thermal insulator?

Answer 21

zinc oxide-eugenol (ZOE)

Question 22

What are the properties of the intermediate restorative material?

Answer 22

*Acts as a thermal insulator
*Excellent abrasion resistance
*Good sealing properties
*Low solubility
*May be used under cements and restorative materials that do not contain resin components

Question 23

What do you need to consider when selecting an intermediate restorative material?

Answer 23

• should not discolor the tooth/restoration
• harden quickly
• withstand the condensation of the over laying restoration
• easily manipulated

Question 24

What is a material place between dentin (or pulp) and the restoration to provide pulpal protection or response?

Answer 24

liners and bases

Question 25

What are bases?

Answer 25

• thick mix of material which is placed in bulk
• Used as a dentin replacement to minimize final restorative material
• block out undercuts

Question 26

What are liners?

Answer 26

• only applied as a thin coating over
  exposed dentin
• Less than 0.5mm thick and is able to promote the health of the pulp by adhesion or antibacterial action

Question 27

What is the primary role of liners?

Answer 27

protect the pulp

Question 28

What is an example of a liner?

Answer 28

• vitrebond (light cure resin-modified glass ionomer)
• calcium hydroxide

Question 29

What is vitrebond used for?

Answer 29

composite, amalgam, metal or ceramic restorations

Question 30

What is vitrebond not indicated for?

Answer 30

direct pulp capping

Question 31

What is calcium hydroxide?

Answer 31

• highly alkaline liner
• bactericidal activity
• formation of teritary dentin
• used for direct and indirect pulp capping

Question 32

What is dycal?

Answer 32

• a calcium hydroxide liner
• can be self curing or light cured

Question 33

What is a varnish?

Answer 33

• a natural gum (copal), rosin, or synthetic resin dissolved in organic solvent

Question 34

What are the properties of varnishes?

Answer 34

• antimicrobial and antiviral properties
• easily seeps into dental tubules
• prevents transfer of heat and cold to the dentin/pulp

Question 35

What can you not use varnishes with?

Answer 35

• composite restorations (interferes with setting)
• glass ionomers (prevents fluoride release)

Question 36

What is copalite?

Answer 36

an insulating layer of varnishes under gold and amalgam restorations

Question 37

For a very deep prep what should you do?

Answer 37

• liner (calcium hydroxide)
• vitrebond (glass ionomer) or IRM

Question 38

For a moderate depth what should you do?

Answer 38

liners may be placed for thermal protection and pulpal medication along with varnish

Question 39

For a shallow prep what do you do?

Answer 39

place nothing, vitrebond, or varnish