week 5 Flashcards
Ceramic definition
inorganic/non-metallic compositions.
few ceramic compositions have achieved clinical success:
Example of implantable inert bioceramics:
Al2O3, ZrO2,( clinical success) TiO2.
Ceramics are (treatment response)
refractory (resistant to treatment) polycrystalline compounds
Ceramics properties
- Usually inorganic
- Highly inert
- Hard and brittle
- High compressive strength
- Generally good electric and thermal insulators
- Good aesthetic appearance
- Good tribological properties (wear, friction)
Tissue composition
Tissue = organic polymer fibers + mineral + living cells
ceramic classification based on crystallinity
Type of bond
- amorphous ceramics that are generally referred to as ‘glasses’
- Crystalline ceramics, which may be single phase materials like alumina
- Semi-Crystalline:
Ionic bonds
Mineral component (ceramic) bone:
- hydroxyapatite (HA); Ca5(PO4)3OH
- Mineralization under biological conditions: - many elemental substitutions
- protein directed crystallization
- unique characteristics: crystal morphology and solubility
Types of bioceramics (3):
- Bioinert: Alumina (Al2O3), Zirconia (ZrO3), Pyrolytic carbon.
- Bioactive: Bioglass (Na2OCaOP2O3-SiO), Hydroxyapatite (Ca10(PO4)6(OH)2) (sintered at high temperature)
- Resrobable or biodegradable: Hydroxyapatite (sintered at low temperature) Tricalcium phosphate.
Biocompatibility vs bioactivity vs biodegradability:
- Biocompatibility: Minimize inflammatory responses and toxic effects. (eg. head of articulations)
- Bioactivity: Characteristic that allows the material to form a bond with living tissue (Hench 1971).
- Ability of a material to stimulate healing and trick the tissue system into responding as if it were a natural tissue (Hench 2002).
- Advantages: bone-tissue-implant interface, enhanced healing* response, *extended implant life.
- Biodegradability: Breakdown of implant due to chemical or cellular actions, enzymes.
- If timed to rate of tissue healing transforms implant to scaffold for tissue regeneration.
- Mitigates issues of **stress shielding, implant loosening, long term stability. (eg. Low bearing appliacations) **
Types of bioceramics (4)
- Type 1: bioinert == Fully dense and inert: zirconia/alumina
- Type 2: porous inert == Porous/inert: porous alumina/zirconia
- Type 3: surface reactive == Fully dense and bioactive: hydroxyapatite
- Type 4: resorbable materials == Porous/bioactive/resorbable: scaffolds for tissue engineering
Are there materials implanted in the body tha are completely inert?
no type of material implanted in the body is completely inert because **they will elicit a response from living tissues. **
The success of ceramic/bioglass-based implantation depends on:
- Achieving a stable attachment to connective tissue when used as a bulk implant.
- Stimulating repair and regeneration of bone when used as particulates for bone grafting.
Types of implant-Tissue Response
1) If the material is toxic, the surrounding tissue dies.
2) If the material is nontoxic and biologically inactive (nearly inert), a fibrous tissue of variable thickness forms.
3) If the material is nontoxic and biologically active (bioactive), an interfacial bond forrns.
4) If the material is nontoxic and dissolves, the **surrounding tissue replaces it. **
Types of bioceramics Tissue attachments
-
Dense, nonporous nearly inert cerarnics attach by bone growth into surface irregularities by cementing the device into the tissues. or by press-fitting into a defect. flermed Morphoiogicai Fiation)
- AI2O3, (Single Ctystal and Polycrystalline)
-
For porous inert implants bone ingrowth occurs, which mechanicaliy attaches the bone to the material. (termed Biological Fixation)
- Al203 (Porous Polycrystalline) Hydroxylapatilecoated Porous Metals
- _Dense, nonporous surface-reactive cerarnics, glasses, and glass-cerarnics _attach directly by chemical bonding with the bone. (Termed Bioactive Fixation)
- Bioactive glasses Bioactive glass-cerarnics Hydroxylapatite
-
Dense, nonporous (or porous) resorbable cerarnics are designed to be slowly replace by bone.
- Calciurn Sulphate (Plaster of Paris) TricalciurnPhosphate Calciurn-Phosphate Salts
Ceramic Type 1: Bioinert
Describe means of attachment.
- Interface is not chemically or biologically bonded.
- o Relative movement. –> **deformation due to fibrous layer formation that reduces flexibility. –> modular and encapsulation **
- o Progressive development of** fibrous capsule in soft and hard tissues **
Type 2: Porous inert:
Describe means of attachment.
- Tissue ingrowth
- o Biological fixation
- o Increased interfacial area tissue-implant
- o Reduced movement- withstands more complex **stresses **
Type 3: Surface reactive:
Describe means of attachment.
- Attach by chemical bonds with tissue
- o Slow rate of degradation if any
- o Induce bone formation
- o Intermediate between bioinert and resorbable.
Type 4: Resorbable materials
Describe means of attachment
- Degrade gradually over a period of time to be replaced by tissue
- o Leads to a thin, if any, interfacial layer
- o Optimal solution if requirements of strength and short-term performance can be met. Problems??? need screws and inmobilization in order to give enough time to bone to grow.
Problems with each of the 4 types of bioceramics
- Type one: Fibrous layers formation that goes away but if too thick will interfere with movement
- Type 2: Pore size needs to be ideal at least 50 um potential removal of implant is a problem.
- Type 3: behaves more like a bioinert; also pore size is important for vascularization. Mechanical properties are an issue.
- Type 4: degrades too quickly
processing of bioceramics result in 5 different microstructures:
- Glass
- Cast or plasma-sprayed polycrystalline ceramic
- Liquid-phase sintered (vitrified ceramic)
- solid-state sintered ceramic
- Polycrystalline glass- ceramic
Strengthening mechanisms:
- ** Ion exchange:** to get compressive strength – introduction of bigger cations within structure.
- Quenching of glass: glass transformation temperature.
heating —> expansion —-> cooling (upon cooling surface is put into compression
ceramics Fractures easily under tension.
- In ceramics strengthening means to prevent fracture or inhibit crack propagation.
- To improve strength:
- polishing: etch (**electropolishing) or fire polish. **
Surface residual stresses:
o Early crack nucleation and propagation can occur if a ceramic specimen is put under tension.
Failure is probabilistic in ceramics it depends on:
- o It depends on flaw distribution.
- o It depends on **crystal size. **
- It depends on **porosity: 3% porosity will result in 10x decrease in strength of ceramics. **
Stress = k (d-1/3) —> d = diameter of crystals
Nearly inert crystalline ceramic: Aluminum oxides (Alumina)
Advantages:
Disadvantages:
Applications:
- Combination of attractive properties.
- Bioinertness – low immune response.
- Alumina-on-alumina implants have been cleared by the FDA.
- Implantations, since 1987, have been successful.
- Small grain size and porosity – higher strength.
- Stress shielding may be a problem.
- High hardness, low wear.
Disadvantages:
- Minimal bone ingrowth.
- Interfacial failure and loss of implant may be a problem.
Applications:
- Orthopedics: Femoral heads, bone screws and plates, porous coatings for femoral stems, porous spacers (revision), knee prosthesis.
- Dental crowns and bridges.
Porous ceramics
- Inertness combined with the mechanical stability of a highly convoluted interface that develops when bone grows into the pores of the ceramic.
- Implant serve as a structural bridge or scaffold for bone formation (>50 - 150 microns pore size).
How to decrease fractures in ceramics
- Make small grains
- Use sintering agent + MO (Molibdenium oxide) but this changes the purity of the ceramic
- Eliminate flaws = inclusions –> reduction of [stress] [] by polishing reduction of flaws
- Electromechanical —> electrochemical
- Etching
- Temperature treatment (annealing decreases the stress resigual
- Ion Exchange
Bioactive glasses and glass-ceramics:
- Bioactive: direct chemical bonding with the host biological tissue
- Some compositions will bond to soft tissues as well as to bone = formation of carbonated HA layer.
Glass:
- An inorganic melt cooled to solid form without crystallization.
- ** An amorphous solid.**
- Possesses short range atomic order – it is brittle.
Glass-ceramic:
- Polycrystalline solid prepared by controlled crystallization of glass.
- Stimulatory effects on bone building cells.
Calcium-phosphate ceramics:
Factors that influence rate of resorption of an implant are: o physical factors
- Naturally occurring in the body.
- Composition of bone.
- The main crystalline component of the mineral phase of bone is a calcium deficient carbonate HA.
- Speed of hydrolysis increase with a decreasing Ca/P ratio.
_ Factors that influence rate of resorption of an implant are:_
- o chemical factors
- o biological factors
- o physical factors
Calcium-phosphate ceramics applications:
- bone grafting applications.
- porous component to **non-major load bearing parts of the skeleton. **
The most employed method for ceramic coating is
plasma spraying.
- Mechanical mismatch between the coating and the substrate can lead to high levels of **residual interfacial stress. **
Calcium-phosphate ceramics mechanical behavior :
- Poor mechanical behavior of calcium phosphate ceramics greatly restrict its use as implants.
- Tensile, compressive strength and fatigue resistance depend on the total volume of porosity.
- Low reliability under tensile loads, consequently in clinical practice, calcium phosphate bioceramics should be used as:
- powders
- in small, unloaded implants
- with reinforcing metal posts
- coatings
- fillers (composites)
- in porous implants where bone
- growth acts as the reinforcing phase
Resorbable calcium-phosphate:
Calcium-phosphate bone cements:
Resorbable calcium-phosphate:
- Biodegradation caused by three factors: physiochemical dissolution, physical disintegration, and biological factors.
- Degradation or resorption of calcium phosphate in vivo occurs by a combination of phagocytosis of particles and the production of acids.
- All calcium phosphate ceramics biodegrade to varying degrees.
** Calcium-phosphate bone cements:**
- Requirements are injectability and moldability.
- Different combinations of calcium compounds (alpha-TCP, dicalcium phosphate).
- Considerable interest in the potential use of these materials for drug delivery.
Hydroxyapatites ceramics bioactivity, application
- Bioactive + osteoconductive.
- Broadly used as coating or orthopedic implants.
- Successful clinical application in polymer composites.
- Approaches were developed to produce bioactive and either** bioresorbable or biodurable composites**.
- _Substitution of hydroxyl and/or phosphate groups by carbonate increases apatite solubility. _
Calcium - phosphate ceramics depend on the ratio of
Give examples:
Calcium to phosphate
- If ratio Ca-P = 1 —-> ceramic degrades too fast
- If ratio Ca-P = 2 —-> ceramic degrade very slowly
- If ratio Ca-P = 1.43 —-> ceramic degrades in 3 months (slow but not too slow)
- Ceramics Type 3 and 4 have a ratio of Ca-P close to 1.
- Ceramics Type 1 and 2 have a ratio of Ca-P close to 2.
4 strengthening methods used for ceramics.
- Ion exchange : provides **compressive strength **
- polishing : to make surface smooth –> to **eliminate flaws or cracking **
- Quenching of glass heating and cooling: giving compressive strength. When it is cooled the surface is put under compressive stress.
- **Annealing: make small grains **controlled heating rates –> need phase diagram to achieve ideal temperature and cooling rates to achieve small grains
calcium-phosphate ceramics. What state of matter are they used?
Pastes for bone augmentation and powders for sintering