Applied Dental Materials 2 Lecture 11 (Biocompatibility Of Dental Materials)

Front 1

Something is ___ if it is harmonious with life and not having toxic or injurious effects on biologic function

Back 1

biocompatible

Front 2

A ___ is any substance, other than a drug, that can be used as part of a system to treat, augment or replace any tissue, organ or function of the body

Back 2

biomaterial

Front 3

What three things play a role in biocompatibility?

Back 3

host, application, material

biological response of HOST... to a specific MATERIAL... in a specific APPLICATION of the material

Front 4

In a host/material interaction, (only 1/both) are affected and it is (unique/the same) for each combination

Back 4

both, unique

Front 5

biocompatibility is a (static/dynamic) interaction

Back 5

dynamic

Front 6

True or False, most dental materials are inert in the body

Back 6

False, we just want an acceptable response bc it's not feasible to have inertness

Front 7

True or False, adverse reactions have been reported in only 20% of dental materials

Back 7

False, all classes

Front 8

What are three worries with dental material sensitivity?

Back 8

hypersensitivity
contact sensitivity
estrogenicity

Front 9

Contact sensitivity to latex and __ is common

Back 9

resins (HEMA, TEGDMA, camphoroquinone)

Front 10

There's an entre slide about how dental materials need to not be toxic and carcinogenic, etc... it's pretty sel-explanatory

Back 10

BOOM!

Front 11

A ___ is a substance that is not irritating on first exposure but produces reaction on subsequent exposure to similar concentrations

Back 11

allergen

Front 12

___ is defined as an inflammatory response brought about without intervention of an antibody or immune system

Back 12

irritation

Front 13

___ is defined as an inflammatory response requiring participation of an antibody system specific for the allergenic material

Back 13

sensitization

Front 14

A ___ molecule is an organic compound that is not a normal component of the organism

Back 14

Xenobiotic

Front 15

What ADA/ANSI document deals with biocompatibility?

What is the ISO document dealing with this?

Back 15

ADA/ANSI Document No. 4 and ISO 10993

Front 16

What are the three tiers of biocompatibility testing?

Back 16

1. primary tests
2. secondary tests
3. preclinical usage trials

Front 17

What are two reasons (other than duhhhhh) that we standardize biocompatibility tests?

Back 17

tests are complex
standardization allows direct comparison of materials

Front 18

Tier 1 tests are done in (vivo/vitro)

Back 18

vitro

Front 19

What are the advantages and disadvantages of tier 1 tests?

Back 19

adv:
experimentally controllable, quick, isolation of variables, repeatable, simple, inexpensive, no ethical issues

dis:
questionable relevance, incomplete modeling

Front 20

one would test cytotoxicity and genotoxicity with a tier __ test

Back 20

1

Front 21

Tier 2 tests are done in (vitro/vivo)

Back 21

vivo, animals specifically

Front 22

True or false, tier 2 tests are not usage tests

Back 22

true

Front 23

LD50 is a measure of what?

Back 23

systemic toxicity

Front 24

systemic toxicity, dermal toxicity, inhalation toxicity and implantation response tests are done with tier __ tests

Back 24

2

Front 25

What are the advantages and disadvantages in tier 2 tests?

Back 25

adv:
intact biological organism

dis:
not a usage test, no controls, difficult to interpret, expensive, questionable relevance, ethical treatment questioned

Front 26

Tier __ tests are usage tests

Back 26

3

Front 27

Clinical trials are considered tier __ tests

Back 27

3

Front 28

materials used in human volunteers are tier __ tests

Back 28

3

Front 29

True or False, tier 3 tests are often difficult to define

Back 29

True

Front 30

pulp and dentin, pulp capping and pulpotomy, and endodontic tests on humans would fall under tier __ tests

Back 30

3

Front 31

What are the advantages and disadvantages of tier 3 tests?

Back 31

adv:
direct evidence of success or failure, relevant, measures complete response

dis:
time-consuming, expensive, difficult to control, difficult to interpret, ethics questioned

Front 32

Which of these is LEAST toxic in vitro but MOST toxic in clinical trials?

silicate cement
resin composite
ZOE cement

Back 32

silicate cement

Front 33

Which of these is the least toxic in clinical trials but the MOST toxic in vitro?

silicate cement
resin composite
ZOE cement

Back 33

ZOE cement

Front 34

False negatives and false positives can occur when using (one/many) screening tests

Back 34

many (it's better to constantly screen throughout the evaluation process)

Front 35

Dental materials are considered ___ by the FDA

Back 35

devices

Front 36

dental materials only need to show safety and efficacy, T or F

Back 36

True

Front 37

According to the FDA, "devices" have (extensive/no) chemical action in the body

Back 37

no

Front 38

drugs must show safety and efficacy like devices, but must ALSO show ___

Back 38

usage

Front 39

ISO 10993 classifies dental materials by ___ conditions

Back 39

exposure

such as:
duration
surface-contact
externally-communicating device
implanted device

Front 40

Historically, materials were used (before/after) tested

Back 40

before

Front 41

True or False, nowadays, public pressure and hysteria can accompany discoveries in biocompatibility and past materials are in question with a lack of data

Back 41

True

Front 42

In the future, materials will be tested (before/after) use

Back 42

before

Front 43

The following are considerations for biocompatibility:

corrosion in metals and degradation in ___

release of agents (what, how much, how long?)

routes of ___ to the body like oral mucosa or respiratory

The population exposed

the ___ of released agents

Back 43

resins, entrance, effects

Front 44

What 4 factors play a part in the effects of an agent released from dental materials?

Back 44

physical form
chemical form
duration
amount released

Front 45

True or False, the amount of something present in a material ir proportional to the amount released

Back 45

False!!!

Front 46

T or F, dental materials only cause local effects

Back 46

False

Front 47

If something is mutagenic, it can cause changes in ___

Back 47

DNA sequence

Front 48

What type of hypersensitivity is acute anaphylactic and which is delayed?

Back 48

1, 4

Front 49

Latex is a type __ hypersensitivity and Ni is a type __

Back 49

1, 4

Front 50

True or False, dental materials can illicit an immune response

Back 50

True

Front 51

Ortho wire typically has (more/less) Ni than Endo files

Back 51

less (or = at 55%)

Front 52

Crown and partials have (more/less) Ni than Endo files and ortho wires

Back 52

more

Front 53

> __% of crowns in the US contain Ni

Back 53

33

Front 54

Ni has non-dental uses, T or F

Back 54

True

Front 55

Ni is:

toxic in (high/low) conc.

a (potent/non-potent) allergen

(carcinogenic/non-carcinogenic) [in some forms]

Back 55

high, potent, carcinogenic

Front 56

The release of Ni depends on what?

Back 56

the alloy and the conditions like pH

presence of passivating film and changes to it

Front 57

What are the systemic effects of Ni?

Back 57

none except allergy

Front 58

What are the local effects of Ni?

Back 58

none except allergy (limited # of studies)

Front 59

In our diet, we get about how many micrograms of Ni per day?

Back 59

500

Front 60

Mercury is toxic is significant conc., T or F

Back 60

True

Front 61

What are the three forms of mercury?

Back 61

Hg^0
Hg^+2
methyl or ethyl mercury

Front 62

Which of these is absorbed via skin or inhalation of vapor and is found in AMALGAMS?

Hg^0
Hg^+2
methyl or ethyl mercury

Back 62

Hg^0

Front 63

Which of these is absorbed poorly in the gut?

Hg^0
Hg^+2
methyl or ethyl mercury

Back 63

Hg^+2

Front 64

Which of these is produced from Hg^0 by bacteria, is most toxic, and is very efficiently absorbed in the gut?

Hg^0
Hg^+2
methyl or ethyl mercury

Back 64

methyl or ethyl mercury

Front 65

True or False, the form of mercury has no effect on its toxicity

Back 65

False, it does effect the toxicity

Front 66

What is the half-life of Mercury in the body?

Back 66

20-90 days

Front 67

> _ micrograms/kg is considered a toxic amount of mercury

Back 67

3

Front 68

What are the systemic and local effects of mercury release from dental amalgams?

Back 68

none other than allergy

Front 69

What is leached out of dental resins for several weeks to months?

Back 69

unpolymerized monomer

Front 70

Small amounts of unpolymerized monomer are leached out in (vitro/vivo) for several weeks to months

Back 70

vivo

Front 71

True or False, the allergenicity of methyl methacrylate is unknown

Back 71

False, well known

Front 72

The ability of chemicals from the environment to mimic the effects of estrogen is called what?

Back 72

estrogenicity

(called 'xenoestrogens')

Front 73

In 1996, it was determined that bis__ A (BPA) into saliva and hypothesized that it was a xenoestrogen

Back 73

bisPHENOL A (BPA)

Front 74

Studies since 1996 have found that (large/small) amounts of BPA are released from sealants an restorative resins

Back 74

small

Front 75

What is the most common occupational disease?

Back 75

allergic contact dermatitis

Front 76

allergic contact dermatitis is (independent/dependent) on dose

Back 76

independent

Front 77

allergic contact dermatitis can be caused by a reaction to bonding agent monomers, latex (_____), acrylic components of dental ___ and polyethers

Back 77

thiuram, cements

Front 78

What is the most common adverse reaction to dental materials?

Back 78

Allergic contact stomatitis

Front 79

Allergic contact stomatitis is a reaction fo what 3 elements plus eugenol, components of resin, and formaldehyde?

Back 79

Cr, Co, Hg

Front 80

Future considerations include what 2 things?

Back 80

the risk-benefit ratio

are materials more than just 'devices'?

Front 81

There is a slide titles "pulp responses" and it just lists materials...

Back 81

BOOM