Biomaterials

270 Pages·2002·5.184 MB·English

by  Sujata V Bhat

Biomedical Engineering
Wong
Bronzino
Peterson
BIOMATERIALS
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PRINCIPLES AND PRACTICES
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BIOMATERIALS
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M
Most current applications of biomaterials involve structural functions, even in
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those organs and systems that are not primarily structural in their nature, or PRINCIPLES AND PRACTICES
very simple chemical or electrical functions. Complex chemical functions, such T
as those of the liver, and complex electrical or electrochemical functions, such E
as those of the brain and sense organs, cannot be carried out by biomaterials
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at this time. With these basic concepts in mind, Biomaterials: Principles and
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Practices focuses on biomaterials consisting of metallic, ceramic, polymeric, and
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composite materials. It highlights the impact of recent advances in the area of
nano- and microtechnology on biomaterial design. L
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• Discusses the biocompatibility of metallic implants and corrosion in an

in vivo environment
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• Provides a general overview of the relatively bioinert, bioactive or
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surface-reactive ceramics, and biodegradable or resorbable bioceramics
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• Reviews the basic chemical and physical properties of synthetic N
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polymers, the sterilization of polymeric biomaterials, the importance of
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surface treatments for improving biocompatibility, and the application of P
chemogradient surfaces for the study of cell-to-polymer interactions L
E
• Covers the fundamentals of composite materials and their applications in
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biomaterials
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• Highlights commercially significant and successful biomedical
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biodegradable polymers D
• Examines failure modes of different types of implants based on material,
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location, and function in the body R
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The book discusses the role of biomaterials as governed by the interaction
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between the material and the body, specifically, the effect of the body environment
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on the material and the effect of the material on the body.
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C
E Edited by
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Joyce Y. Wong
Joseph D. Bronzino
K13339
ISBN: 978-1-4398-7251-2
90000 Donald R. Peterson
9 781439 872512
K13339_Cover_final.indd 1 11/1/12 2:27 PM
BIOMATERIALS
PRIncIPLES And PRAcTIcES

BIOMATERIALS
PRIncIPLES And PRAcTIcES
Edited by
Joyce Y. Wong
Joseph d. Bronzino
donald R. Peterson
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
© 2013 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20120823
International Standard Book Number-13: 978-1-4398-7419-6 (eBook - PDF)
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Contents
Introduction ..................................................................................................................................vii
Editors ............................................................................................................................................xv
Contributors ...............................................................................................................................xvii
1 Metallic Biomaterials ...................................................................................................1-1
Joon B. Park and Young Kon Kim
2 Ceramic Biomaterials ..................................................................................................2-1
W.G. Billotte
3 Polymeric Biomaterials ...............................................................................................3-1
Hai Bang Lee, Gilson Khang, and Jin Ho Lee
4 Composite Biomaterials ..............................................................................................4-1
Roderic S. Lakes
5 Biodegradable Polymeric Biomaterials: An Updated Overview ......................5-1
C.C. Chu
6 Biologic Biomaterials: Tissue-Derived Biomaterials (Collagen) .....................6-1
Shu-Tung Li
7 Biologic Biomaterials: Silk ..........................................................................................7-1
Biman Mandal and David L. Kaplan
8 Biofunctional Hydrogels ............................................................................................8-1
Melissa K. McHale and Jennifer L. West
9 Soft Tissue Replacements ...........................................................................................9-1
K.B. Chandran, K.J.L. Burg, and S.W. Shalaby
10 Hard Tissue Replacements .......................................................................................10-1
Sang-Hyun Park, Adolfo Llinás, and Vijay K. Goel
v

Introduction
I.1 A Brief Note Regarding This Edition
This book has updated chapters from a previous edition and some new chapters added. The content
remains the same, and the following introduction is taken from the previous edition, with minor
changes describing the content of this book. In addition, a number of relevant biomaterials journals
have been added to the list.
Biomaterials are employed to manufacture devices to replace a part or a function of the body in a safe,
reliable, economic, and physiologically acceptable manner (Hench and Erthridge, 1982). A variety of
devices and materials are used in the treatment of disease or injury. Common examples include sutures,
needles, catheters, plates, tooth fillings, and so on. Biomaterials are synthetic materials used to replace part
of a living system or to function in intimate contact with living tissue. The Clemson University Advisory
Board for Biomaterials has formally defined a biomaterial to be “a systemically and pharmacologically
inert substance designed for implantation within or incorporation with living systems.” Black (1992)
defined biomaterials as “nonviable materials used in a medical device, intended to interact with biological
systems.” Others include “materials of synthetic as well as of natural origin in contact with tissue, blood,
and biological fluids, and intended for use for prosthetic, diagnostic, therapeutic, and storage applications
without adversely affecting the living organism and its components” (Bruck, 1980). Another definition
of biomaterials is stated as “any substance (other than drugs) or combination of substances, synthetic
or natural in origin, which can be used for any period of time, as a whole or as a part of a system which
treats, augments, or replaces any tissue, organ, or function of the body” (Williams, 1987) and adds to the
many ways of looking at the same but expressing it in different ways. In contrast, a biological material is
a material, such as skin or artery, produced by a biological system. Artificial materials that simply are in
contact with the skin, such as hearing aids and wearable artificial limbs, are not included in our definition
of biomaterials since the skin acts as a barrier to the external world.
According to these definitions, one must have a vast knowledge or collaborate with different special-
ties in order to develop and use biomaterials in medicine and dentistry as Table I.1 indicates. The uses of
biomaterials, as indicated in Table I.2, include replacement of a body part which has lost its function due
to disease or trauma, to assist in healing, to improve function, and to correct abnormalities. The role of
biomaterials has been influenced considerably by advances in many areas of biotechnology and science.
For example, with the advent of antibiotics, infectious disease is less of a threat than in earlier days so
that degenerative disease assumes a greater importance. Moreover, advances in surgical techniques and
instruments have permitted materials to be used in ways which were not possible previously. This book
is intended to breed familiarity in the reader with the uses of materials in medicine and dentistry and
with some rational basis for these applications.
vii
viii Introduction
TABLE I.1 Fields of Knowledge to Develop Biomaterials
Discipline Examples
Science and engineering Materials sciences: structure–property relationship of synthetic and
biological materials including metals, ceramics, polymers,
composites, tissues (blood and connective tissues), etc.
Biology and physiology Cell and molecular biology, anatomy, animal and human physiology,
histopathology, experimental surgery, immunology, etc.
Clinical sciences All the clinical specialties: dentistry, maxillofacial, neurosurgery,
obstetrics and gynecology, ophthalmology, orthopedics,
otolaryngology, plastic and reconstructive surgery, thoracic and
cardiovascular surgery, veterinary medicine, surgery, etc.
Source: Modified from von Recum, A.F. 1994. Annual Biomaterials Society Meeting. Boston,
MA: Biomaterials Society.
TABLE I.2 Uses of Biomaterials
Problem Area Examples
Replacement of diseased or damaged part Artificial hip joint, kidney dialysis machine
Assist in healing Sutures, bone plates, and screws
Improve function Cardiac pacemaker, intraocular lens
Correct functional abnormality Cardiac pacemaker
Correct cosmetic problem Augmentation mammoplasty, chin augmentation
Aid to diagnosis Probes and catheters
Aid to treatment Catheters, drains
The performance of materials in the body can be classified in many ways. First, biomaterials may
be considered from the point of view of the problem area which is to be solved, as shown in Table I.2.
Second, we may consider the body on a tissue level, an organ level (Table I.3), or a system level (Table I.4).
Third, we may consider the classification of materials as polymers, metals, ceramics, and composites,
as shown in Table I.5. In this, the role of such materials as biomaterials is governed by the interaction
between the material and the body, specifically, the effect of the body environment on the material and
the effect of the material on body (Williams and Roaf, 1973; Bruck, 1980; Hench and Erthridge, 1982;
von Recum, 1986; Black, 1992; Park and Lakes, 1992; Greco, 1994).
It should be evident from these perspectives that most current applications of biomaterials involve
structural functions, even in those organs and systems which are not primarily structural in their
nature, or very simple chemical or electrical functions. Complex chemical functions such as those of the
liver and complex electrical or electrochemical functions such as those of the brain and sense organs
cannot be carried out by biomaterials at this time.
TABLE I.3 Biomaterials in Organs
Organ Examples
Heart Cardiac pacemaker, artificial heart valve, total artificial heart
Lung Oxygenator machine
Eye Contact lens, intraocular lens
Ear Artificial stapes, cochlea implant
Bone Bone plate, intramedullary rod
Kidney Kidney dialysis machine
Bladder Catheter and stent
Introduction ix
TABLE I.4 Biomaterials in Body Systems
System Examples
Skeletal Bone plate, total joint replacements
Muscular Sutures, muscle stimulator
Circulatory Artificial heart valves, blood vessels
Respiratory Oxygenator machine
Integumentary Sutures, burn dressings, artificial skin
Urinary Catheters, stent, kidney dialysis machine
Nervous Hydrocephalus drain, cardiac pacemaker, nerve stimulator
Endocrine Microencapsulated pancreatic islet cells
Reproductive Augmentation mammoplasty, other cosmetic replacements
TABLE I.5 Materials for Use in the Body
Materials Advantages Disadvantages Examples
Polymers (nylon, silicone Resilient Not strong Sutures, blood vessels, hip socket,
rubber, polyester, Easy to fabricate Deforms with time ear, nose, other soft tissues, sutures
polytetrafluoroethylene, etc.) May degrade
Metals (Ti and its alloys, Co–Cr alloys, Strong, tough, May corrode Joint replacements, bone plates and
stainless steels, Au, Ag, Pt, etc.) ductile Dense screws, dental root implants, pacer
Difficult to make and suture wires
Ceramics (aluminum oxide, calcium Very biocompatible, Brittle Dental, femoral head of hip
phosphates including inert, strong in Not resilient replacement, coating of dental
hydroxyapatite, carbon) compression Difficult to make and orthopedic implants
Composites (carbon–carbon, wire, or Strong, tailor-made Difficult to make Joint implants, heart valves
fiber-reinforced bone cement)
I.2 Historical Background
The use of biomaterials did not become practical until the advent of an aseptic surgical technique
developed by Dr. J. Lister in the 1860s. Earlier, surgical procedures, whether they involved biomaterials
or not, were generally unsuccessful as a result of infection. Problems of infection tend to be exacerbated
in the presence of biomaterials, since the implant can provide a region inaccessible to immunologically
competent cells of the body. The earliest successful implants, as well as a large fraction of modern ones,
were in the skeletal system. Bone plates were introduced in the early 1900s to aid in the fixation of long-
bone fractures. Many of these early plates broke as a result of unsophisticated mechanical design; they
were too thin and had stress-concentrating corners. Also, materials such as vanadium steel that was
chosen for its good mechanical properties corroded rapidly in the body and caused adverse effects on
the healing processes. Better designs and materials soon followed. Following the introduction of stain-
less steels and cobalt chromium alloys in the 1930s, greater success was achieved in fracture fixation,
and the first joint-replacement surgeries were performed. As for polymers, it was found that warplane
pilots in World War II who were injured by fragments of plastic polymethyl methacrylate (PMMA) air-
craft canopies did not suffer adverse chronic reactions from the presence of the fragments in the body.
PMMA became widely used after that time for corneal replacement and for replacements of sections of
damaged skull bones. Following further advances in materials and in surgical technique, blood vessel
replacements were tried in the 1950s and heart valve replacements and cemented joint replacements
in the 1960s. Table I.6 lists notable developments relating to implants. Recent years have seen many
further advances.