02. Bio Compatibility of Dental Material 2012 | Nickel | Allergy

BIOCOMPATILITY of DENTAL MATERIALS

Biomaterial may be defined as a non living designed to interact with biological system Biocompatibility is the ability to elicit an appropriate biological response in a given application in the body Biological response will changes in the host, the application material, material its self A materials may be said to be biocompatible when it has the quality of being non destructive in the biological environtment

A single material may not be acceptable in all application Possible interaction between material and environment: - postoperative sensitivity - toxicity - hypersensitivity/allergic - corrosion In the development of any biomaterial must be consider: - strength - esthetic - functional & biocompatibility

initials test) .usage test .Measuring Biocompatibility    Is not simple About the interactions between dental material oral tissue and technologies for testing improve Must be extensively screened for biocompatibility before are used in human .in vitro (primary test.animal (in vivo. secondary test) .

lest expensive .good excellence for mechanism of interaction Disadvantages : relevance to in vivo is questionable .can be standardized .large scale screening .good experiment control .Advantages and Disadvantages  In vitro test Advantages: .quick to perform .

relevance to use of materials questionable .more relevant Disadvantages: .legal / ethical concerns .allows complex systemic interaction .difficult to interpret and quantity .response more comprehensive .time consuming .difficult to control . In vivo test : Advantages: .

can be difficult to control .very time consuming .relevance to use of material is assured Disadvantages: .major legal/ethical issue .very expensive .difficult to interpret and quantity . Usage test Advantages : .

  ANSI / ADA Specification 41 3 category of test (1982): . first in larger animal / primates c. placement of the materials in intended b.ISO 7405 (1997) revised .initial test .secondary test .usage test : a.ISO 10993 ( 1992) . Food & drug Administration approval ISO 10993 .

Standard that regulate the measurement of biocompatible The reason    The vast advance of cellular & molecular biology The variety of test available for assessing biocompatibility of material The lack of standardization of these test .

Cytotoxicity test (Millipore filter) .Inhalation toxicity test .In vitro cytotoxicity test (Cr release) .Dominant lethal test .Short term systemic toxicity test: Oral route .Hemolysis test .Ames mutagenicity test .Tissue culture agar overlay test .Acute systemic toxicity test: Intravenous route .Recommended Levels of Biologic Testing (ANSI /ADA)  Initials Tests .Styles cell transformation test .

Oral mucous membrane irritation test .Subcutaneous implant test .Oral mucous membrane irritation test Usage Test .Bone Implant .Bone implant usage test  .Pulp capping and pulpotomy test .Endodontic usage test . Secondary Tests .Pulp and dentin test .Sensitization test .

dan timbang BB/hr Euthanasia dgn eter (inhalasi) kmd necropsy Interprestasi: mati. 5 tikus. BB. 130-150 mg BB Kandang: 33 x 28 x 16 cm.Short Term Systemic Toxicity Test (Oral route)         Penetapan toksisitas material jangka pendek Hewan coban: 40 tikus. 8 minggu. toksik klinik. atau stomach tube (kontrol dgn aquadest) Observasi: 7 hari. jaringan . diet standart Material dibuat serbuk larutan/suspensi atau dicampur dlm makanan (dosis 1 g/kg BB) Cara pemberian materi: dgn alat intragastric needle. amati perub.

BB. bila tak larut extract 4 g dipotong kecil-kecil. toksik klinik. perkandangan spt STSTT oral Materi: dilarutan dlm 0. masukkan dlm 20 ml saline normal.v pada vena cauda dgn dosis 5 ml/100 g BB.9% NaCl.Acute Systemic Toxicity Test (Intravenous route)       Hewan coba. di autoclve 121o C 1 jam. semua extrac disuntikkan Pengamatan: observasi selama 7 hari Euthanasia dgn eter dan necropsy Interprestasi: mati. jaringan . Cara pemberian: suntikan i.

8 ± 0.hemolitik dasar: pelepasan Hb .d) . waterbath. tabung pipa darah Prosedur: .Hemolysis Test     Evaluasi aktivitas hemolitik pada bahan yang kontak lama Rational: .2 ml di hemilisis dalam 10 ml akuades (dibaca pada λ : 545 nm : 0.5 o.hemolitik komponen solubel dan permukaan fisik: total hemoltik Material: centrifuge. spectro-fotometer. test tube.Darah kelinci oksalat : 0.

darah dlm 10 ml saline normal (o.5 mm) dlm 10 ml saline normal dlm waterbath 37oC selam 30 menit ..3) (o.Bahan 5 gr (dipotong 0.o.d < 0.2 ml lar.d kontrol neg)  % hemolisis = -----------------------------------.: 0.2 ml lar.x100% (o. darah dlm 10 ml akuades .d kontrol pos .d kontrol neg)  Uji antar mean statistik  Respon hemolisis > respon kultur jaringan .Kontrol .Kontrol + : 0.d sampel – o.

implan 3 mm (Ǿ) x 10 mm (p) .insisi 0. pertinent changes) .evaluasi pada 48 jam.Subcutaneous implant test    Hewan coba: tikus Rational: Prosedur: . 2 minggu dan 12 minggu. parah . moderat.Kriteria : tidak ada reaksi inflamasi / reaksi ringan. nekrosis. (inflamasi.5 cm kemudian diseksi tumpul + I cm .

ada reaksi ringan pd minggu ke 2 meningkat ke moderat/ parah pada ke 12 b.Bahan diterima : a. tdk ada/reaksi ringan pd minggu 2 dan 12 b. Reaksi moderat pada minggu 2 dan 12 c. reaksi moderat pd minggu ke hilang pada 12 . Reaksi parah pada minggu 2 dan 12 . Ketentuan implan .Bahan ditolak: a.

Biocompatibility of Dental Materials (2)  Reaction of pulp Microleakage: …………………….wear .thermal cycling saliva invasion microorganism inflammation/infection . (nanoleakage) ..contracting during polymerization .

its juxtaposes resin & dentin without barrier b. wettability >> EDTA. Na-hypochloride c. make any microleakage more significant c.removal of smear layer caused: a.bonding to dentin has proven more difficult a. Dental bonding .occurred hybrid layer of resin & collagen . acid are potential source irritation . lower mineral content (in dentin) . organic and inorganic b.

the ability of resin based material to increase plaque formation . act synergis tically .some resin component enhance the growth of oral bacteria .combination HEMA and other resin. Dentin bonding agent cytotoxicity: HEMA 100 X less toxic than bis-GMA .

reaction diminished 5 – 8 weeks and an increase in reparative dentin .be mediated by resin component release .freshly set chemically & light cured resin cause moderate cytotoxicity.light cure < chemically cure (depend on : efficiency of the light and type of resin) . and reduced 24-72 hours (with dentin barrier) . Resin base materials release (Resin composite: organic & inorganic phase) .

hypersensitivity reaction was cause by true latex.6-7% surgical personnel may be allergic to latex .Ni sulfide is a respiratory carcinogen .Ni+ is a mutagenic in human .42% dental personnel: dermatoses of hands & finger . accelerator or antioxidant (in processing) Nickel .CURRENT BIOCOMPATIBILITY ISSUES IN DENTISTRY   Latex .the most allergenic metal (10-20%) .is a known cross-reactivity between Ni and Pd patient who are allergic Ni will be allergic to Pd .

toxic effect is 3 µg/kg  . Beryllium .access to the body via the skin or vapor .Beo & Be + is a carcinogenic .containing particle (dust) that are inhaled cause berylliosis Mercury .Be .acidic environment enhance Be release from Ni-Cr .

resin component have been to transverse the dentin  .have significant toxic effect (invitro test) .the use of glove is not effective in preventing to monomer resins .bisphenol A (BPA & BPAD) is a estrogenic effect .to be allergy because exposure to unpolymerized materials.Estrogenicity . .evidence comes from estrogen receptor-BPA binding  Residual Resin .

form of metal / alloys b. great of chemical reactivity .the rate metal ion release depend on: a.residual stress .mechanical preparation .cleaner surface c. composition alloy & specific environment  .Effect of Metal Ions on Tissues Cytotoxicity / allergenic / carcinogenic .

increased dentin permeability after etching  .marginal microleakage .by corrosion product release (γ2) .fluoride release (cytotoxicity in vitro) .mercury residu Glass ionomer . Amalgam and casting alloys Amalgam: .freshly prepared is mildly cytotoxixity .

pH alkaline (12) extreem cytotoxicity . Varnishes & non resin cement  Liners (CaOH) : .resin component dissolve .containing resin mild to moderate in culture  varnish containing copal & polystyrene .Liners.formation pinpoint holes  Non resin ZnPO4 : low pH and leaching of Zn Zn OE : suppresses nerve transmission and anti inflammatory  Bleach agent .chemically burn the gingiva .peroxide can rapidly traverse the dentin .

roughness surface .direct contact resin composite with fibroblast caused leach out un polymerized component . Reaction of Oral Soft Tissue to Restorative material .hypersensitivity of the acrylic & diacrylic monomers .buffering & protein-bonding to mitigate cytotoxic .product of bacterial plaque & accumulate .

 Reaction bone & soft tissue to implant materials (osseointegration / biointegration) Van der Waals force Mechanical entrapment Compressive force Chemically bond Mechanical entrapment Physiologically reaction (Calcification process) .

Ceramic .Bioactive .

Si Si – O – Si Cation & silica Dissolution network Silanol formation Silica gel forms by condensation of silanols (silane chain) Calcium-phosphate-rich mineral forms H OH H – O – Si Si – O – Si Si – O – Si O O Ca & PO4 CO3 OHF- Ca & PO4 Ca10(PO4)6(OH)F Ca-P mineral crystallizes into a hydroxy. Fluorapatite layer .TISSUE BIOGLASS Na – O . carbonate.

Attachment between metal and tissue        Diffusion oxygen and metals ion into tissue Diffusion hydrogen and oxygen into tissue to form hydroxides Diffusion of mineral or atoms from electrolyte in to the oxides Dissolution of oxide metal ion (corrosion) Adsorption at biomolecular Desorption for replacement of biomolecular Fragmentation of modification of biomolecular .

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