Biomedical Engineering Reference
In-Depth Information
TABLE 9.2
Uses of Ceramics, Glass, and Comp
osites in Body
ClinicalApplication/Location
Ceramics,Glass,andCompositeMaterialUsed
Head
Cranial repair
Bioactive glasses
Keratoprosthesis
Alumina
Otolaryngological implants
Alumina, HA, bioactive glasses, bioactive glass-ceramics, bioactive
composites
Maxillofacial reconstruction
Alumina, HA, HA-PLA composite, bioactive glasses
Dental implants
Alumina, HA, HA coating, bioactive glasses, bioactive glass-ceramics
Alveolar ride augmentation
Alumina, HA, TCP; HA-autogenous bone composite, HA-PLA
composite, bioactive glasses
Periodontal pocket obliteration
HA, HA-PLA composite, calcium phosphate salts, bioactive glasses
Torsoandupperlimbs
Percutaneous access devices
Bioactive glasses, bioactive glass-ceramics, bioactive composites, HA,
pyrolitic carbon coating
Artificial heart valves
Pyrolitic carbon coating
Spinal surgery
Bioactive glass-ceramics, HA
Iliac crest repair
Bioactive glass-ceramics
Bone space fillers
TCP, calcium phosphate salts, bioactive glasses, bioactive
glass-ceramics
Lowerlimbs
Orthopedic load-bearing applications
Alumina, zirconia, PE-HA composite, HA coating on metal, bioactive
glass, and glass-ceramic coatings on metal
Orthopedic fixation devices
PLA carbon fiber composite, PLS calcium phosphate composite
Artificial tendons
Carbon-fiber composites
Joints
HA
acetabular cups, respectively). Their use continues today in these types of devices. In the
past 40 years of research and clinical applications, many types of biomedical materials
(ranging from metals, polymers, ceramics, and glasses) have been developed, tested in the
laboratory, and used clinically. These first-generation biomaterials all have a fundamental,
inherent material-driven design specification—to reduce to a minimum the host tissues'
immune response to a foreign body while being mechanically and physically stable.
Tissues are “living” things and as such they respond and adapt to their local biochemical
and biomechanical environment. First-generation materials cannot respond to changes in
the host tissue environment and as such their useful lifetime is severely limited. Eventually
secondary surgery is needed to replace the loosened (e.g., detachment of implant from
host tissue and material/tissue interface) or damaged implant (e.g., fracture of the mate-
rial). Numerous strategies have been employed to enhance the useful lifetime of bioma-
terials. For total-bone-joint replacement devices, these include altering textural properties
of the implant/tissue interface to include voids and other anchor points to encourage tis-
sue ingrowth and attachment and cement fixation at the implant/tissue interface. Their
success is limited and survival times (useful lifetime once implanted) are approximately
19 years. Other factors such as infection, host tissue immunological response, and implant
fracture can reduce survival times to 5 years or less.
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