The ability of a material to elicit an appropriate biological response in a given application in the body

Whether a material is biocompatible is dependent on the physical function the biological response desired

Toxicity
Inflammation Allergy Mutagenicity

Materials

Dose related potential of a material to cause cell death

Substances released Adequate amount

Toxicity

Activation of host immune system to ward of threat Features of inflammation

Acute or chronic

Body recognizes material as foreign & reacts disproportionately to amount of material present
Type l & lV Hypersensitivity reactions

Affect the DNA Mutagenicity Vs Carcinogenicity

Local effects
Pulp Periodontium

Root apex

Gingival inflammation

Oral tissues- buccal mucosa/tongue

Depends on
Ability to distribute to these sites Concentration Exposure time

Systemic effects
Access through

Ingestion & absorption in gut Inhaled vapor Release at tooth apex Absorption through oral mucosa

Principle

Small alterations in cells of immune system by materials can have significant biological consequences

Monocytes
Material

Secretes substances

Chronic inflammation

Usage test

Animal In vitro

Outside living organism Test tube Cell culture

Material/extract contact cell, enzyme or other isolated biological system Contact- direct or indirect

Types
Measure cell growth/death Determine cellular function of some kind Evaluate integrity of genetic material

Advantages Fast Cheap Easy to standardize

Disadvantage Poor relevance to use of material in living

Material intact organism

Mice, rats, sheep, monkeys Expose animal to material without regard to materials final use

Types

Long/short term systemic toxicity test Exposure to intact/abraded membrane Bone response

Advantage Allows material to interact with several biological systems in animal- more complete bio response
Disadvantage Expensive, time taking, difficult to control Ethical issues Relevance to human species questionable

Material place in environment clinically relevant to use of material in practice Humans - clinical trials
Disadvantage Complex, long, expensive, difficult to control & interpret Ethical committee approval Legal liabilities

Three phases
Primary Secondary Usage

In vitro tests Animal test for systemic toxicity

E.g- testing alloy for crown

In vitro cyto & mutagenicity test Animal test

Animals - Allergy, inflammation, sublethal & chronic responses

In animal or
In humans

Usage

Usage

Secondary

Primary
Secondary Primary

Latex Gloves, rubber dam

Rubber dam

Eczema

Wheezing

Angioneurotic edema

Nickel Alloys for crown, dentures, ortho appliances Most allergenic metal used Nickel allergy- women Cross reactivity Ni & Pd allergy Ni2+: mutagenesis (no CA) Inflammatory reactions

Dental resins
Composites- Bis-phenol A act on estrogenic receptors- estrogenicity 1000 times less potent as natural estrogen

MMA- Contact dermatitis