BIOCOMPATIBILITY
OF DENTAL
MATERIALS
INTRODUCTION
• BIOCOMPATIBILITY REFERS TO THE STUDY OF INTERACTION OF
VARIOUS MATERIALS WITH HUMAN TISSUES.
• MATERIALS USED IN DENTISTRY COME INTO DIRECT CONTACT WITH
THE HARD TISSUES OF TEETH, THE ORAL MUCOSA, THE PULP & THE
PERIAPICAL TISSUES.
• DUE TO THIS INTIMATE, LONG TERM CONTACT, THE MATERIALS
SHOULD EXHIBIT A HIGH DEGREE OF BIOCOMPATIBILITY.
BIOCOMPATIBILITY IS FORMALLY DEFINED AS
THE ABILITY OF A MATERIAL TO ELICIT AN
APPROPRIATE BIOLOGICAL RESPONSE IN A
GIVEN APPLICATION IN THE BODY.
(CRAIG)
3
BIOCOMPATIBILITY REQUIREMENTS
• They should not sensitize and produce allergic
reactions.
• They should not undergo biodegradations.
• They should not be carcinogenic.
• They should not contain any toxic diffusible
substances which get released and enter into the
circulatory system.
• They should not be harmful to soft & hard tissues
of the oral cavity in particular and the whole
body in general.
McCabe JF, Walls AW, editors. Applied dental materials. John Wiley & Sons; 2013 May 7.
Richard Van Noort, Introduction to dental materials;4 th edition
BIOLOGICAL INTERFACE
4 types of interaction can take place:
1. Between the material and oral cavity.
2. Between the material
and the pulp.
3. Between the material
and periodontium.
4. Between the material
and the periapical bone.
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th.
TOXICITY
ALLERGY
ADVERSE
EFFECTS
INFLAMMATION MUTAGENICITY
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th
TOXICITY
• TOXICITY OF A MATERIAL DESCRIBES THE ABILITY
TO DAMAGE A BIOLOGICAL SYSTEM BY CHEMICAL
MEANS.
Placement of a foreign material in the body carries the
possibility of toxicity
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials.
11th.
IMMUNOTOXICITY
• SUBSTANCES LEACHED FROM MATERIALS CAN ALTER
IMMUNE SYSTEM CELLS, RESULTING IN ENORMOUS
BIOLOGICAL CONSEQUENCES BECAUSE OF THE
AMPLIFYING NATURE OF IMMUNE CELLS.
SYSTEMIC TOXICITY
Here site of application & site of adverse
reactions are different.
According to the time frame:
1. Acute (up to an exposure period of
24 h)
2. Subacute (up to 3 months)
3. Chronic toxicity are differentiated
LOCAL TOXICITY
1. Bacterial accumulation on the surface, at the
margin, or under a material.
2. Mechanical/physical irritation, such as
pressure caused by dentures.
Inflammation of the gingiva in contact
with a porcelain- fused-to-metal
crown
INFLAMMATION
12
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th.
ALLERGY
• DENTAL MATERIALS MAY CAUSE ALLERGIES OF TYPE I (IMMEDIATE
REACTION) AND TYPE IV (DELAYED REACTION).
• McCabe JF, Walls AW, editors. Applied dental materials. John Wiley &
Sons; 2013 May 7.
SUSPECTED ASSOCIATION OF AN ALLERGIC
REACTION WITH TITANIUM DENTAL IMPLANTS: A
CLINICAL REPORT
• • RECENT REPORTS HAVE QUESTIONED WHETHER METAL SENSITIVITY
MAY OCCUR AFTER EXPOSURE TO TITANIUM.
• • THIS CLINICAL REPORT DEMONSTRATES THE EMERGENCE OF FACIAL
ECZEMA IN ASSOCIATION WITH A TITANIUM DENTAL IMPLANT PLACED
FOR A MANDIBULAR OVERDENTURE SUPPORTED BY 2 IMPLANTS.
• • COMPLETE REMISSION WAS ACHIEVED BY THE REMOVAL OF THE
TITANIUM MATERIAL.
• • THIS CLINICAL REPORT RAISES THE POSSIBILITY THAT IN RARE
CIRCUMSTANCES, FOR SOME PATIENTS, THE USE OF TITANIUM DENTAL
IMPLANTS MAY INDUCE AN ALLERGIC REACTION.
J Prosthet Dent 2008;100:344-347
• Mutagenicity
• It is the ability of a Carcinogenicity:
substance to pass genetic It is the ability of a material
damage on the next or substance released from
generation. it to induce malignant
• e.g. – Ni, Cu and Be are tumors.
known mutagens.
Genotoxicity Teratogenicity:
Refers to the ability of It is the ability of certain
substance released from substance to cause
materials to cause malformation during
alterations of the genome. embryonic development
Shahriar Shahi, Mutlu Özcan, Solmaz Maleki Dizaj, Simin Sharifi, Nadin AlHaj Husain,
Aziz Eftekhari & Elham Ahmadian (2019): A review on potential toxicity of dental
material and screening their biocompatibility, Toxicology Mechanisms and Methods .
MEASURING THE BIOCOMPATIBILITY
• In vitro test
• Animal test
• Usage test
• USAGE TEST CAN BE PERFORMED IN ANIMALS OR HUMANS
(CLINICAL TRIAL).
• THESE USAGE TESTS ARE GOLD STANDARD, IN THAT THEY
GIVE THE ULTIMATE ANSWER THAT WHETHER A
MATERI A L IS BIOCOMPATIBLE OR NOT.
1 7
Craig RG. Craig's restorative dental materials/edited by Ronald L. Sakaguchi, John M.
Powers. Philadelphia, PA :Elsevier/Mosby,; 2012.
IN VITRO TEST
• Done outside a living organism.
• Test tube, cell culture dish, flask , or other container
CLASSIFICATION OF IN VITRO TESTS
DIRECT INDIRECT
TEST
MATERIAL CONTACT EXTRACT CONTACT
1. TESTS FOR CYTOTOXICITY
• CELL DEATH
The morphology of the fibroblasts The fibroblasts are rounded19
indicates that they are alive and are not and detached indicating that
suffering from a toxic response they are either dead or dying.
Craig RG. Craig's restorative dental materials/edited by Ronald L. Sakaguchi,
John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012.
MEMBRANE PERMEABILITY
Measures cytotoxicity by the ease with which a dye can
pass through a cell membrane.
• 1. Vital dyes:
• Eg:Neutral red
• 2.Non vital Dye:
• Eg:Trypan Blue,Propidium
• Iodide.
2.TESTS FOR CELL METABOLISM OR
CELL FUNCTION:
•USE BIOSYNTHETIC OR ENZYMATIC ACTIVITY OF CELLS TO
ASSESS
• CYTOTOXIC RESPONSE
•USUALLY ASSESS DNA SYNTHESIS OR PROTEIN
SYNTHESIS TYPES:
•MTT,NBT,XTT,WST
•MTT FORMAZAN COMPOUND
ALAMAR BLUE TEST
21
Craig RG. Craig's restorative dental materials/edited by Ronald L. Sakaguchi,
John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
TESTS THAT USE BARRIERS(INDIRECT TESTS)
1. Agar overlay method,
23
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
MILLIPORE FILTER
ASSAY,
• A cellulose acetate filter having 0.45µm filter is
used
• Cells are grown on one side of the filter and the
test material placed on the opposite side of
filter.
• Any leachable substance from the test material
must diffuse through the pores to exert a
cytotoxic effect on the cells.
DENTIN DISC BARRIER TEST
The material is placed on one
side (A)of the dentin disk (B) in the
device used to hold the dentin
disk.
• Collection fluid (cell culture
medium or saline) is on the
other side of the disk (C).
• Components of the material
maydiffuse through the dentin
and effect of medium on cell
metabolism can be measured.
3.MUTAGENESIS ASSAYS
• 1. AMES
•TEST:
It uses mutant stocks of
Salmonella typhimurium that
require exogenous histidine.
• Native stocks of bacteria do not
require exogenous histidine.
• If the mutant stocks bacteria are
treated with a mutagen there will
be a mutation back to the
normal state and growth in
histidine free medium will
occur.
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
2. STYLES CELL TRANSFORMATION TEST :
Done in mammalian cell.
Assay quantifies the ability of potential carcinogens to
transform standardized cell lines.
Untransformed cell lines wont grow within an agar gel.whereas
genitically mutated cells will grow within an agar gel.
IN VITRO TEST
ADVANTAGES DISADVANTAGES
•Quick to perform •Questionable relevance to the
•Least expensive final in vivo use of the material
•Can be standardized •Lack of inflammatory or other
•Large scale screening tissue protective mechanisms
•Good experimental control in the in vitro environment
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th
ANIMAL
TEST
• USUALLY INVOLVING MAMMALS SUCH AS MICE, RATS,
HAMSTERS, OR GUINEA PIGS, AND ARE DISTINCT
FROM USAGE TESTS IN THAT THE MATERIAL IS NOT
PLACED IN THE ANIMAL WITH REGARD TO ITS FINAL
USE .
Craig RG. Craig's restorative dental materials/edited by Ronald L. Sakaguchi, John M. Powers.
Philadelphia, PA :Elsevier/Mosby,; 2012
1.MUCOUS MEMBRANE IRRITATION TEST
• Placing the test materials and positive and negative controls into contact
with
rabbit oral tissue.
• The animals are then sacrificed and biopsy specimens are prepared
for histological evaluation of inflammatory changes.
29
2.SKIN- SENSITIZATION TEST
• The materials are injected
INTRADERMALLY to test for
development of skin hypersensitivity
reactions.
• The injection is followed by
adhesive
patches containing the test substance
3. IMPLANTATION TESTS
• Materials are implanted subcutaneously,
intramuscularly, or in the bone of an
experimental animal .
• Adjacent tissue is investigated
macroscopically and microscopically.
Formation of an abscess at the
interface between material
• After a short implantation time (1–2 and connective tissue
weeks), degrees of inflammation
surrounding the implant will primarily be
assessed.
ANIMAL
TEST
ADVANTAGE DISADVANTAGES
S
•Allows complex systemic •Questionable relevance to the
in vivo use of the material
interactions
final
•Response more •Expensive
•Time consuming
comprehensive than in •Legal/ethical concerns
vitro test •Difficult to control
•More relevant than in •Difficult to interpret and quantify
vitro test
Browne, R. M. (1994). Animal tests for biocompatibility of dental materials—relevance,
advantages and limitations. Journal of Dentistry, 22, S21–S24
IN USAGE TEST
LARGER ANIMALS or IN HUMAN VOLUNTEERS
Requires that material be placed in a situation identical
to its intended clinical use
GOLD STANDARD
• DENTAL PULP IRRITATION TEST
• MUCOSA AND GINGIVAL USAGE TEST
• INTRAOSSEOUS IMPLANT TEST
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
1. DENTAL PULP IRRITATION TEST
TEST MATERIAL PLACED IN CLASS V CAVITY
PREPARED IN INTACT, NON CARIOUS TEETH
TEETH REMOVED, SECTIONED FOR
MICROSCOPIC
EXAMINATION
TISSUE NECROSIS AND INFLAMMATION GRADED
ACCORDING TO INTENSITY
RECENT APPROACH IS TO USE TEETH WITH
INDUCED PULPITIS WHICH ALLOW
EVALUATION OF THE TYPE AND AMOUNT OF
REPARATIVE DENTIN FORMED AS AN
INFLAMMED PULP REACTS DIFFERENTLY TO
RESTORATIVE MATERIALS
2. INTRAOSSEOUS IMPLANT TEST
• Criteria for implant success
• Early implant success 1-3 years
• Intermediate implant success 3-7 years
• Long term implant success >7 years
• Tests used
Passage of periodontal probe along side of the
implant
Mobility of the implant
Radiographic evidence
3.MUCOSA AND GINGIVAL USAGE
TESTS
• Materials are placed in cavity preparations with sub gingival extensions.
• Slight, moderate or severe based on amount of inflammatory cells depending
on the number of mononuclear inflammatory cells (mainly lymphocytes and
neutrophils) in the epithelium and adjacent connective tissues
• Disadvantages:
• Presence of plaque
• Preexisting inflammation in the gingival tissue
• Surface roughness of the restorative material
• Over contouring and under contouring of the restoration.
IN USAGE TEST
DISADVANTAGES
•Very Expensive
ADVANTAGES
•Relevance to the use of •Time consuming
•Major Legal/ethical concerns
material is assured
•Can be Difficult to control
•Difficult to interpret and quantify
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials.
11th
STRATEGIES FOR EVALUATING
BIOCOMPATIBILITY
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
• Disadvantages
• 1. It is seen that the materials that cleared the first two
tests were not entirely harmless at the clinical usage level.
E.G. ZOE when tested in vitro completely kills every cell in
the culture, but in clinical practice, the same cement has
been successfully used for many years with no evidence
of pulp damage.
• 2. It is time consuming since it is performed in a
sequential manner.
42
NEWER SCHEMES FOR THE PROGRESSION
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials.
STANDARDS THAT REGULATE THE MEASUREMENT
OF BIOCOMPATIBILITY
• ANSI/ADA SPECIFICATION 41
• This was approved by the council on scientific affairs in 1972 and was
updated in 1982 to include tests for mutagenicity.
• This specification uses the linear paradigm for materials screening and
divides testing into initial, secondary, and usage test.
.
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials.
• ISO 10993-
• It is the international standards for testing the biocompatibility of dental materials.
• Unlike ANSI/ADA document no. 41, the IS0 10993 standard is not restricted to dental
materials. The standard divides tests into initial and supplementary tests to assess the
biological reaction to materials
• Published in 1992.
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th
BIOCOMPATIBILITY OF
VARIOUS DENTAL
MATERIALS
45
BONDING
AGENTS
• May penetrate upto 0.5 mm in dentin and cause
supression of cellular metabolism for upto 4
weeks
• HEMA 100 times less cytotoxic than Bis-GMA
• The application of an MMP inhibitor, such as
chlorhexidine, has been shown to minimize this
effect.
Craig RG. Craig's restorative dental materials/edited by Ronald L. Sakaguchi,
John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
RESIN BASED COMPOSITES
• Moderate cytotoxic reactions in cultured cells over 24 to 72
hours
of exposure
• Light-cured resins are less cytotoxic than chemically cured
systems.
• With a protective liner or a bonding agent, the reaction of the
pulp to resin composite materials is minimal.
Dent Res J (Isfahan). 2011 Dec; 8(Suppl1): S21–S29.
Gingivitis after cervical resin
composites
A after contact with resin-
l based composites
Richard Van Noort, Introduction toldental materials;4 th edition
e
r
Chemical burn after
inadvertent contact of
phosphoric acid with gingiva
G
i
n
g
i
DENTAL CASTING ALLOYS
The biological response to an alloy depends on the biological effects of
released elements, the quantities released, the duration of tissue
exposure to these elements.
Shahriar Shahi, Mutlu Özcan, Solmaz Maleki Dizaj, Simin Sharifi, Nadin AlHaj
Husain, Aziz Eftekhari & Elham Ahmadian (2019): A review on potential toxicity of
dental material and screening their biocompatibility, Toxicology Mechanisms and
Methods
SYSTEMI The number of elements
C released from the dental alloys
TOXICITY is far below the dietary intake;
for e.g. the amount of zinc
released (< 0.1µg
/day ) is far below the daily
dietary intake (14,250µg /day).
No studies have demonstrated
systemic toxicity due to cast
alloys
LOCAL TOXICITY When there is a release of
elements from the alloys, and if it
is present in more conc. in the
sulcus than in saliva, then
epithelial cells of the sulcus will
be more prone to cytotoxicity.
Ni, Cr, Co - Cytotoxic.
Gold coating of nickel-based
and cobalt-based alloys.
Pronounced redness of the
palate beneath the denture base.
A prosthesis was made of a base metal on the titanium abutment using
three types of Ni-Cr alloys with different components and
compositions.
• The amount of metal ions released was increased by galvanic
corrosion in all of the groups in which Ni-Cr alloys were in contact
with titanium. • Cytotoxicity was significantly increased in all of the
groups in which Ni-Cr alloys containing Beryllium were in contact
with titanium.
• Conclusion: The release of metal ions was increased by galvanic
corrosion due to contact between base metal and titanium, and it can
cause adverse effects on the tissue around the implant by inducing
cytotoxicity. OF EFFECT OF GALVANIC CORROSION BETWEEN NICKEL-
EVALUATION
CHROMIUM METAL AND TITANIUM ON ION RELEASE AND CELL TOXICITY.
THE JOURNAL OF ADVANCED PROSTHODONTICS. 2015;7(2):172. .
Perioral allergic reaction after
insertion of nickel-containing
orthodontic wires (CuNiTi)
Lichenoid reaction of
the mucosa contacting an alloy
Richard Van Noort, Introduction to dental materials;4 th edition
Pronounced gingivitis after
seating of ceramic crowns, despite
good oral hygiene
Dental lab –Inhaled beryllium –
berylliosis.
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th
GLASS IONOMER CEMENTS
Freshly prepared ionomer is mildly cytotoxic
Resin modified GIC is more cytotoxic
Large size of molecules of Polyacrylic Acid
unable to diffuse through dentinal tubules
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
LINERS, VARNISHES, AND
NONRESIN
CEMENTS
• CALCIUM HYDROXIDE
• ZINC PHOSPHATE
• ZINC POLYCARBOXYLATE CEMENT
• ZOE CEMENT
ALCIUM HYDROXIDE CEMENT
Systemic No reported systemic reaction
toxicity
Local toxicity Indirect pulp capping material:
1.Exerts antibacterial effect.
2.Tertiary dentin formation.
3.Decreases the permeability of dentin.
NOTE: Tertiary dentin will be
triggered only if the remaining
dentin thickness(RDT) is 5 to 10 µm.
Direct pulp capping material:
When in direct contact with the
pulp, produces superficial
coagulation necrosis.
This acts like a stimulus for the
differentiation of secondary
odontoblasts that lay down tertiary
dentin.
Richard Van Noort, Introduction to dental materials;4 th edition
ZINC PHOSPHATE CEMENT
Systemic toxicity No reported systemic reaction
Local Toxicity The acidity of the cement initially after mixing is
very high due to presence of phosphoric acid (pH is
around
3.5 during application).
Subsequently, it increases towards neutrality
within 24-48 hours.
Precautions to be taken are as follows:
1. The powder/liquid ratio should never be
reduced to increase the working time, as this
increases the acid content.
2. The placement of a protective layer of a
dentin bonding agent, ZOE, varnish, or
calcium hydroxide is needed.
Allergic Reaction No reported allergic reaction
Other reaction No evidence of mutagenic or carcinogenic reaction
Zinc phosphate cement that
was left in the sulcus after
cementation results in
periodontal destruction and
bone loss
62
ZINC POLYCARBOXYLATE CEMENT
• Polyacrylate cements evoke a pulpal response similar
to that caused by ZOE, with a slight-to-moderate
response after 3 days and only mild, chronic
inflammation after 5 weeks.
• Reparative dentin formation is minimal with these
cements, and thus they are recommended only in
cavities with intact dentin in the floo rs of the
s.
cavity preparation
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
ZINC OXIDE EUGENOL CEMENT
Systemi No reported systemic
c
toxicity reaction
Local Toxicity Pulp reaction
1. The cement can
produce a cytotoxic
reaction when directly
applied to the pulp.
2. If there is a complete
dentin layer between
the pulp and the
cement, no • Reaction of the gingiva
inflammatory reaction after temporary
will occur. cementation of a crown
with a zinc oxide and
[LEAST IRRITATING OF ALL eugenol cement.
THE CEMENTS : pH 6.6 - 8
PRECAUTIONS DURING CEMENTATION
Apply petroleum jelly to the surrounding soft tissues
Clean the excess cement after luting the prosthesis
Any residues of cement left in the gingival sulcus will lead to
inflammation
IMPRESSION MATERIALS
Addition Silicone
NONTOXIC
Hydrocolloids
Polysulphides - contain lead peroxide, among others,
which can cause acute and severe systemic toxic
effects when swallowed or inhaled
Polyether ALLERGIC REACTIONS
ZnoE
least biocompatibility applies to
condensation silicones
68
POLY-METHYLMETHACRYLATE RESINS
Monomer is the main cause for
hyper sensitization
Hypersensitivity has been
documented to the acrylic and
diacrylic monomers, certain curing
agents, antioxidants, amines, and
formaldehyde.
Allergic acrylic stomatitis – diffuse
erythema, edema & occasionally
small vesicles and erosions.Heat
polymerized is better than
Autopolymerized resin.
Gautam R, Singh RD, Sharma VP, Siddhartha R, Chand P, Kumar R. 2012. Biocompatibility o
polymethylmethacrylate resins used in dentistry. J Biomed Mater Res Part B 2012
DENTIST SUFFERING FROM AN
ALLERGY TO METHYL
METHACRYLATE CONTACT
DERMATITIS
PRONOUNCED INFLAMMATION
OF THE PALATAL MUCOSA
BENEATH A POLYMETHYL
METHACRYLATE DENTURE WITH
PAPILLARY HYPERPLASIA
Richard Van Noort, Introduction to dental materials;4 th edition
SOFT DENTURE LINERS & ADHESIVES
Release of plasticizers
Extremely cytotoxic
Denture adhesives show severe cytotoxic
reactions in-vitro
Large amount of formaldehyde
Allowed significant microbial
growth
73
REACTION OF BONE & SOFT
TISSUES TO IMPLANT
MATERIAL
) REACTION TO CERAMIC IMPLANT MATERIAL
VERY LOW TOXIC EFFECTS.
OXIDIZED STATE CORROSION RESISTANT
MINIMALLY TOXIC
NONIMMUNOGENIC & NONCARCINOGENIC.
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
C) REACTION TO PURE METALS & ALLOYS
‘Metal’ oldest type of oral implant material
Initially selected on the basis of the ‘ease of
fabrication’
Stainless steel, chromium-cobalt-
molybdenum, titanium and its alloys
Most commonly used is titanium(Ti-
6Al-4V)
Titanium’s biocompatibility is associated
with its fast oxidizing capacity.
Corrosion resistant & allows osseointegration 75
SOFT TISSUE :
In recent years, Titanium
allergy has been noted at
a low prevalence rate of
0.6% and presents
with urticaria, eczema,
redness of the mucosa.
76
BARRIER MATERIALS
Latex :
Latex products can produce either:
1.Type 1 immediate
atopic/anaphylactic reaction - due to
proteins present in natural latex.
2.Type 1V delayed
hypersensitivity reaction
(allergic contact dermatitis):
due to accelerators and
antioxidants used in latex
manufacturing.
Richard Van Noort, Introduction to dental materials;4 th edition
Kenneth AJ, Shen C, Rawls HR. Philips' Science of Dental Materials. 11th
PRECAUTION TO BE TAKEN ARE AS
FOLLOWS:
Non latex synthetic materials such as nitrile and ethylene
butadiene styrene should be used.
Polyethylene or polyvinyl chloride rubber dams can be used
instead of latex.
•Contact urticaria following
occupational exposure to latex
proteins in disposable gloves
Craig RG. Craig's restorative dental materials/edited by Ronald L.
Sakaguchi, John M. Powers. Philadelphia, PA :Elsevier/Mosby,; 2012
CONCLUSION
• DUE TO RISE IN NUMBER OF PATIENTS WITH ALLERGIES FROM
DIFFERENT MATERIALS, THE PRACTICING DENTISTS SHOULD
BE AWARE ABOUT THE ALLERGIES DOCUMENTED TO KNOWN
MATERIALS
• FOR ESTABLISHING DIAGNOSIS, IT IS ESSENTIAL TO
OBTAIN PROPER HISTORY RELATED TO ALLERGY,
CLINICAL EXAMINATION AND CONFIRMATORY TESTS.
• IT IS MANDATORY FOR THE CLINICIAN TO KNOW AND
UNDERSTAND THE BIOCOMPATIBILITY OF THE DENTAL
MATERIALS, SO AS TO PROVIDE MAXIMUM ADVANTAGE
& MINIMUM RISK TO THE PATIENT.
REFERENCES:
CRAIG RG. CRAIG'S RESTORATIVE DENTAL MATERIALS/EDITED
BY RONALD L. SAKAGUCHI, JOHN M. POWERS. PHILADELPHIA,
PA :ELSEVIER/MOSBY,; 2012
RICHARD VAN NOORT, INTRODUCTION TO DENTAL
MATERIALS;4TH EDITION
MCCABE JF, WALLS AW, EDITORS. APPLIED DENTAL
MATERIALS. JOHN WILEY & SONS; 2013 MAY 7.
KENNETH AJ, SHEN C, RAWLS HR. PHILIPS' SCIENCE OF DENTAL
MATERIALS. 11TH
COMBE EC, COMBE EC. NOTES ON DENTAL MATERIALS.
EDINBURGH: CHURCHILL LIVINGSTONE; 1986.
Browne, R. M. (1994). Animal tests for biocompatibility of dental materials—
relevance, advantages and limitations. Journal of Dentistry, 22, S21–S24
Dent Res J (Isfahan). 2011 Dec; 8(Suppl1): S21–S29
Shahriar Shahi, Mutlu Özcan, Solmaz Maleki Dizaj, Simin Sharifi,
Nadin AlHaj Husain, Aziz Eftekhari & Elham Ahmadian (2019): A
review on potential toxicity of dental material and screening their
biocompatibility, Toxicology Mechanisms and Methods
Gautam R, Singh RD, Sharma VP, Siddhartha R, Chand P, Kumar R. 2012.
Biocompatibility of polymethylmethacrylate resins used in dentistry. J
Biomed Mater Res Part B 2012:00B:000–000
EVALUATION OF EFFECT OF GALVANIC CORROSION BETWEEN
NICKEL-CHROMIUM METAL AND TITANIUM ON ION RELEASE
AND CELL TOXICITY. THE JOURNAL OF ADVANCED
PROSTHODONTICS. 2015;7(2):172. .
Suspected association of an allergic reaction with titanium dental implants: A
clinical report -Hiroshi Egusa J Prosthet Dent 2008;100:344-347
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