Dental Biomaterials & Biocompatibility

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Questions and Answers

What are biomaterials?

Biological materials- either synthetic (e.g. ceramics, polymer, metal), or natural that are used as part of an implanted medical device to replace an organ or bodily function

What are some examples of biomaterials used in dentistry?

Amalgam, Glass ionomers, Gold, Composites, Ceramics, Titanium, Bone filling products, Teeth bleaching products

Describe the broad range of applications for biomaterials.

Biomaterials are used in medical devices, implants, tissue engineering, and drug delivery systems to enhance, repair, or replace tissues or bodily functions.

What 4 categories do we have to consider when thinking about biocompatibility in dentistry?

Safety to the patient, Safety to the staff, Regulatory compliance issues, Legal liability Signup and view all the answers

What is the definition of biocompatibility?

Biocompatibility is the ability of a material to perform with an APPROPRIATE HOST response in a given SPECIFIC APPLICATION Signup and view all the answers

What do materials used in dentistry often come into direct contact with?

Hard tissues of the teeth, The soft tissue of the oral mucosa, The pulp & periapical tissues Signup and view all the answers

What are some key elements that materials used in dentistry should have?

Non-toxic (both to patient and staff), Non-irritant (in the mouth and other tissues), Minimal inflammation (acute, not chronic), Tissue integration (e.g. implants), Physical and mechanical properties (for intended application) Not be mutagenic or carcinogenic Signup and view all the answers

What is the effect when we place a material/implant in the body?

It creates a new interface that is not normally present so the body's normal homeostasis is disturbed and a 'two-way' biological interaction takes place: <ol> <li>The effect the body has on the implant material</li> <li>The effect the implant has on the body</li> </ol> Signup and view all the answers

What interaction is biocompatibility concerned with?

That of the LIVING tissue with the NON-LIVING tissue Signup and view all the answers

What are the effects that the body has on the implant material?

<ol> <li>PROTEIN ADSORPTION- dependent on material properties</li> <li>ENVIRONMENTAL- body fluid is 0.9% saline, plus cells, proteins</li> <li>DEGRADATION- enzymatic (on certain materials)</li> <li>CORROSION- may cause metal to corrode</li> </ol> Signup and view all the answers

What are the effects that the implant has on the body?

<ol> <li>Blood clot-equilibrium disturbed</li> <li>Inflammatory response (should be short lived)</li> <li>Chronic inflammation (if prolonged)</li> <li>Evokes immune response (activation of macrophages, lymphocytes)</li> <li>Wound healing repair/regeneration</li> </ol> Signup and view all the answers

How do you assess cytotoxicity?

Cytotoxicity screening tests which provide an indication of cell death caused by either the material directly or their extracts Signup and view all the answers

What kinds of things can we assess in vitro to assess cytotoxicity?

Cell number, Growth rate, Cell metabolism, Gene up-regulation Signup and view all the answers

Are in vitro cytotoxicity tests expensive?

False (B) Signup and view all the answers

What factors can affect biocompatibility?

Location of material, Duration of exposure, Health of host, Physical, chemical, & biological stresses placed on the material Signup and view all the answers

What are the two components of biocompatibility we must consider?

General aspect: BIOSAFETY Specific aspect: BIOFUNCTIONALITY Signup and view all the answers

What do biosafety and biofunctionality mean?

Biosafety- this concerns and deals with the exclusion of deleterious effects of a biomaterial on the organism itself Biofunctionality- this concerns and addresses the need of a material not only to be free from damaging effects on the host, but to be able to elicit a beneficial host-response for optimal functioning of the medical device Signup and view all the answers

How can we test these two components of biocompatibility?

Various in vitro and in vivo tests can assess biosafety by examining cytotoxicity, inflammation, and immune responses. Biofunctionality can be tested through assays that measure the material's ability to support cell adhesion, proliferation, and differentiation. Signup and view all the answers

What are you required to consider for biocompatibility in vitro testing methods?

Specificity- appropriate cells for material being tested Sensitivity- methods used should be sensitive and suitable for cell culture medium Quality controls- both negative and positive and also, material and cell culture control Signup and view all the answers

What are some adverse effects with dental materials, whether they are rare or common?

Common: Inflammation Allergic reaction Rare: Immunotoxicity Systemic & local toxicity Signup and view all the answers

What is important to remember as the practitioner dealing with dental materials?

Often the risk is greater to you than to the patient because you are seeing patients all day, whereas the patient will be exposed at the clinic and then go home until their next appt. Inhalation of particulates during surgical procedures can activate immune cells (e.g dust from alginate impression materials, also some products containing lead and tin). Effects can range from cumulative irritation to severe allergenic responses Signup and view all the answers

What are the concerns that have been raised around dental amalgams?

Concern has been raised over the mercury vapour released during manipulation, placement or removal of amalgam. Amount is usually minimal & potential of toxic reaction patients is less. Careful handling of mercury reduces the risk to dentist & staff. They're generally harmless to gingival tissues. Some lichenoid episodes have been reported but no major adverse responses have been reported Signup and view all the answers

What are some concerns around resin-based composites?

Some concerns around resin-based composites include potential release of bisphenol A (BPA) or other monomers, which can have estrogenic effects. Allergic reactions to composite components can also occur but are rare. Polymerization shrinkage leading to microleakage and secondary caries is also a concern. Signup and view all the answers

Are there any concerns around the biocompatibility of GIC?

False (B) Signup and view all the answers

Describe the biocompatibility of gold foil and cast alloys.

They're considered to be inert: sensitivities are rare. Any potential pulp reactions due to condensation. There may be rare allergic reactions to alloy metals but overall has a good biocompatibility Signup and view all the answers

Describe the biocompatibility of ceramics.

No known reactions except wear on opposing dentition and restoration. Generally good biocompatibility Signup and view all the answers

In vitro cytotoxicity tests are expensive

False (B) Signup and view all the answers

There are concerns around the biocompatibility of GIC

False (B) Signup and view all the answers

How can we test biosafety and biofunctionality?

Biosafety is tested with in vitro and in vivo assays evaluating toxicity, while biofunctionality is assessed through tests measuring cell adhesion, proliferation, and tissue integration. Signup and view all the answers

Flashcards

What are biomaterials?

Synthetic or natural materials used in medical devices to replace organs or bodily functions.

Examples of biomaterials in dentistry?

Amalgam, glass ionomers, gold, composites, ceramics, titanium, bone filling products, teeth bleaching products.