FAQ's on BioCeramics and Bioactive Coatings

Bio Ceramics - Meaning and properties

Ceramics used for the repair and reconstruction of diseased or damaged musculo-skeletal tissues are termed as bio-ceramics, which may be further classified according to their reactivity as bio-inert (e.g. alumina and zirconia), resorbable (e.g. tricalcium phosphate), bioactive e.g. hydroxyapatite, bioactive glasses, and glass-ceramics), or porous for tissue ingrowth (e.g. bioactive glass or hydroxyapatite porous bone fillers and scaffolds).

Bio-ceramics - Usage of

Bio-ceramics are used in replacements of hips, knees, teeth, fingers, tendons, ligaments and repair for periodontal disease, maxillofacial reconstruction, augmentation and stabilization of the jaw-bone, spinal fusion, and bone repair after tumor surgery.

Metallic Implants - Benefit of Bioactive Coatings thereon.

Metallic implants (stainless steel, titanium and its alloy (Ti6Al4V) are widely used as load bearing orthopaedic, dental implants and plastic surgery. However, being bio-inert, they suffer from unfavourable bioactive fixation with the surrounding hard tissues which limits their effective service life. Therefore, they are often coated with bioactive materials such as hydroxyapatite (HAp), bioactive glass, etc by various techniques to enable cementless fixation and to improve their integration to the adjacent hard or soft tissues.

What are the generally available Bioactive Coating materials.

Metallic load bearing implants are often coated with bioactive materials such as hydroxyapatite (HAp), bioactive glass and other bioactive coatings by various techniques to improve their surface bioactivity and adherence to the adjacent hard tissues and to enable cementless fixation.

Affects of inadequate nutrition in case of elderly people

Eating well is important at any age. Whether it’s because of physical limitations or financial hardship, many elderly persons don’t eat as well as they should. Hence food they do eat must be as nutritious as possible. But health issues and physical limitations sometimes make it difficult for the elderly, to get the nutrients they need for a balanced diet.

Symptoms of malnutrition (weight loss, disorientation, lightheadedness, lethargy and loss of apetite) are sometimes mistaken for illness or disease. Although there are no authentic data to substantiate the extent of malnutrition among the elderly in India, it is said that a large majority of the elderly consume fewer than 1000 calories a day, which is insufficient to maintain adequate nutrition. There are many reasons why an older person may skip a meal, from forgetfulness to financial burden, depression to dental problems, and loneliness to frailty. Older persons, handicapped by their dentition and a consequent reduction in masticatory efficiency, suffer impaired intakes of fruit and vegetables and some key nutrients. This affects their oral health and as a result a fall in their general health.

The dental health problems commonly associated with the elderly people are:

· Gum disease
· Dental Decay
· Inflammation of the mucous membrane (Stomatitis)
· Inflammation of the tongue (Glossitis)
· Tooth wear and excessive staining
· Dry mouth
· Loss or alteration in taste
· Missing teeth, ill fitting dentures or dentures getting repeatedly loose etc
· Facial pain
· Tooth loss and limited oral functioning
· Poor oral hygiene

As a person grows in age, the teeth show signs of wear, gums recede, soft moist oral mucous membrane (i.e. tissues lining the oral cavity), sometimes looks more rough, dry and at times fibrous. There are several changes that may occur as the person grows old. These may relate to clinical changes like wearing of teeth, root decay, gum diseases, discolouration of teeth etc. Apart from clinical changes, there may be cellular changes that may have their impact on the teeth. Old age may also bring about changes in drug metabolism they may have its oral side effects such as dry mouth, changes in taste, oral ulcerations, gingival bleeding, etc. Oral tissues also undergo considerable change as a result of advancing age. Reactions of common diseases such as diabetes, cardiovascular and liver diseases, gastrointestinal diseases etc to name only a few, have their effect in oral cavity.

What is Dry Mouth, What are its Symptoms etc

Dry mouth is the feeling that there is not enough saliva or spit in the mouth, to keep the mouth wet. Everyone has a dry mouth once in a while – if they are nervous, upset or under stress. But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to serious health problems. It can also be a sign of certain diseases and conditions.

What are the symptoms ?
Dry mouth is rarely a solitary symptom. When present for long periods of time, it induces the formation of many other oral symptoms and clinical signs. Besides the decreased amount of saliva, the tongue may also become sore, fissured and the cheeks dry, pale and dull. Not only mastication becomes difficult, it creates persistent denture problems. One may also experience difficulties in taste and swallowing, besides sensitivity to acidic, salty and spicy food. Dry mouth causes extensive, sometimes rampant, dental decay, even affecting areas not usually prone to decay i.e. the lower incisor teeth. These symptoms thus manifest in :

· a sticky, dry feeling in the mouth
· an altered sense of taste
· difficulty in chewing, swallowing, or speaking
· a burning feeling in the mouth
· a dry feeling in the throat
· cracked lips
· an infection in the mouth, sore throat
· bad breath (halitosis)
· tooth decay and gum disease
· a dry tongue
· mouth sores

What is the treatment of dry mouth ?
Treatment of dry mouth is dependent on knowing the cause of the condition in the first place. Your doctor may change your medication if it is suspected to be the cause. Alternatively, medications may be prescribed to increase the production of saliva to help relieve your problem. There are ways to relieve dry mouth such as :

· Sipping water throughout the day and consuming 8 to 10 glasses of water daily to prevent dehydration.
· Drinking water or sugar-free beverages with each meal to keep food particles from becoming trapped in your mouth.
· Sugar-free gum and candy, especially one that has a sour taste, may increase saliva production.
· Avoid beverages such as tea, coffee, and alcohol as they may cause a decrease in saliva production.
· Avoid smoking as it is a major cause of dry mouth.

The following steps are generally advised:

1. To keep Your Mouth Moist

2. Stimulate the flow of your saliva
3. To protect the Hard and Soft Tissues of your Mouth
Ask your dentist to teach you how to properly brush your teeth, and brush them after every meal. Use a dental floss daily. Use a fluoride toothpaste daily. In some cases, your dentist may prescribe the fabrication of a “mouth-guard”, like what the athletes wear. A fluoride gel is placed in these trays and they are worn for several minutes every night. Chew your food slowly and thoroughly, and sip water with it before swallowing. Salivary substitutes (Artificial Saliva) or a mouth-gel can be used to lubricate your tissues. They sometimes make your feel less dry. See your dentist at least 3 times a year and have him/her routinely check you for evidence of early decay.

4. The Use of Drugs to Increase the Flow of Saliva