DENTAL MATERIALSBiocompatibility and Intermediate Restorative Materials (IRM) Flashcards
The biological reaction can take place where…
- at a local level
- far removed from the site of contact
True/False: Systemically the adverse reaction will always be readily apparent.
False
- not always readily apparent especially if dermatological, immune-mediated, or neural
What are the most common reactions to dental staff?
hand/facial dermatitis or respiratory systems
What are the possible interactions between dental restorative material and the biological environment?
- post-operative sensitivity
- toxicity
- corrosion
- hypersensitivity/allergy
What is a toxcity concern with going across the blood-brain barrier and into the CNS?
nanomaterials
Amalgam or its components may cause a type ____ allergy.
Type IV
What are the most common allergies with dental materials?
metals
- especially nickel and cobalt
What shows mucosal changes, contact stomatitis, and burning sensation?
denture resin
What metals (even small amounts) can cause allergic or hypersensitive reactions?
- mercury
- nickel
- cobalt
What is the issue with mercury?
direct contact of oral mucosa with this material can cause oral chronic inflammatory lesions on the oral mucosa
What to ask for a nickel allergy?
ask patient if they can wear costume jewelry
What is the issue with cobalt?
Complications after revision due to cobalt and chromium toxicity
________ is one of the most common causes of allergic contact dermatitis and produces more allergic reactions than all other metals combined.
Nickel
Non-precious metal crowns contain high levels of…
Nickel
What stimulates tertiary dentin formation?
calcium hydroxide
Since some alloy restorations have a negative affect on the pulp they developed ________ to apply to dentin prior to restoring.
Intermediate restorative materials (IRMs)
What are the possible roles of the intermediate restorative materials?
protective, palliative, or therapeutic
What are examples of intermediate restorative materials?
cavity varnishes
bases and liners
What is the goal of intermediate restorative materials?
- protect the pulp from chemical, electrical, or thermal properties
What is an example of an electrical issue with a restoration?
galvanic shock
What is an intermediate restorative material that is sedative like on hypersensitive pulp and is a good thermal insulator?
zinc oxide-eugenol (ZOE)
What are the properties of the intermediate restorative material?
*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
What do you need to consider when selecting an intermediate restorative material?
- should not discolor the tooth/restoration
- harden quickly
- withstand the condensation of the over laying restoration
- easily manipulated
What is a material place between dentin (or pulp) and the restoration to provide pulpal protection or response?
liners and bases
What are bases?
- thick mix of material which is placed in bulk
- Used as a dentin replacement to minimize final restorative material
- block out undercuts
What are liners?
- 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
What is the primary role of liners?
protect the pulp
What is an example of a liner?
- vitrebond (light cure resin-modified glass ionomer)
- calcium hydroxide
What is vitrebond used for?
composite, amalgam, metal or ceramic restorations
What is vitrebond not indicated for?
direct pulp capping
What is calcium hydroxide?
- highly alkaline liner
- bactericidal activity
- formation of teritary dentin
- used for direct and indirect pulp capping
What is dycal?
- a calcium hydroxide liner
- can be self curing or light cured
What is a varnish?
- a natural gum (copal), rosin, or synthetic resin dissolved in organic solvent
What are the properties of varnishes?
- antimicrobial and antiviral properties
- easily seeps into dental tubules
- prevents transfer of heat and cold to the dentin/pulp
What can you not use varnishes with?
- composite restorations (interferes with setting)
- glass ionomers (prevents fluoride release)
What is copalite?
an insulating layer of varnishes under gold and amalgam restorations
For a very deep prep what should you do?
- liner (calcium hydroxide)
- vitrebond (glass ionomer) or IRM
For a moderate depth what should you do?
liners may be placed for thermal protection and pulpal medication along with varnish
For a shallow prep what do you do?
place nothing, vitrebond, or varnish
