Calcium Orthophosphates as Bioceramics - Calcium Orthophosphates: Applications in Nature, Biology and Medicine - page 334

4.3 Bioceramics of Calcium Orthophosphates

4.3.1 History

The performance of living tissues is the result of millions years of
evolution, while the performance of acceptable artificial substitutions
those humankind has designed to repair damaged tissues are only
a few decades old. However, man's attempts to repair the human
body with the use of implant materials are recorded in the early
medical writings of the Hindu, Egyptian and Greek civilizations. The
earliest successful implants were in the skeletal system. Historically,
a selection of the materials was based on their availability and an
ingenuity of the individual making and applying the prosthetic [59].
Archaeological findings exhibited in museums showed that materials
used to replace missing human bones and teeth included animal or
human (from corpses) bones and teeth, shells, corals, ivory (elephant
tusk), wood, as well as some metals (gold or silver). For instance,
the Etruscans learned to substitute missing teeth with bridges
made from artificial teeth carved from the bones of oxen, while in
ancient Phoenicia loose teeth were bound together with gold wires
for tying artificial ones to neighboring teeth. In the seventeenth
century, a piece of dog skull was successfully transplanted into the
damaged skull of a Dutch duke. The Chinese recorded the first use
of dental amalgam to repair decayed teeth in the year 659 AD, while
pre-Columbian civilizations used gold sheets to heal cranial cavities
following trepanation [60]. Furthermore, in 1970, Amadeo Bobbio
discovered Mayan skulls, some of them more than ~4000 years old,
in which missing teeth had been replaced by nacre substitutes [61].
Unfortunately, due to the practice of cremation in many societies,
little is known about prehistoric materials used to replace bone lost
to accident or disease.
Historically, plaster of paris was the first widely tested artificial
bioceramics. However, in the past, many implantations failed due
to infections, which tended to be exacerbated in the presence of
implants, since they provided a region inaccessible to the body's
immunologically competent cells. Thus, the use of biomaterials
did not become practical until the advent of an aseptic surgical
technique developed by Dr. J. Lister in the 1860s. Furthermore, there
was a lack of knowledge about a toxicity of the selected materials.