Bioceramics: From Concept to Clinic

Ceramics used for the repair and reconstruction of diseased or damaged parts of the musculo-skeletal system, termed bioceramics, may be bioinert (alumina, zirconia), resorbable (tricalcium phosphate), bioactive (hydroxyapatite, bioactive glasses, and glass-ceramics), or porous for tissue ingrowth (hydroxyapatite-coated metals, alumina). Applications include replacements for hips, knees, teeth, tendons, and ligaments and repair for periodontal disease, maxillofacial reconstruction, augmentation and stabilization of the jaw bone, spinal fusion, and bone fillers after tumor surgery. Carbon coatings are thromboresistant and are used for prosthetic heart valves. The mechanisms of tissue bonding to bioactive ceramics are beginning to be understood, which can result in the molecular design of bioceramics for interfacial bonding with hard and soft tissues. Composites are being developed with high toughness and elastic modulus match with bone. Therapeutic treatment of cancer has been achieved by localized delivery of radioactive isotopes via glass beads. Development of standard test methods for prediction of long-term (20-year) mechanical reliability under load is still needed.