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Overview of Biomaterials By: Dr. Murtaza Najabat Ali (CEng MIMechE P.E.) 1 Biomaterials can be divided into four major classes of materials 2 3 4 • Polymers o Consists of repeating units strung together in long chains o Represent the largest class of biomaterials o Natural o Synthetic o Hydrophobic o Hydrophilic o Water swelling materials (Hydrogels) o Biostable o Biodegradable 5 • Application of Polymers as Biomaterials The hip joint is the largest load bearing joint. A hip joint is lined Polymers used as femoral head and acetabular cup in total hip replacement with a layer of cartilage that reduces friction and acts as a shock absorber. When the bone is exposed to arthritis and injury, this protective layer is damaged, causing extreme pain. 6 • Polymers By using a Polymethylmethacrylate (PMMA) cement to adhere the metal to the bone By using a porous metal surface to create a bone ingrowth interface The acetabulam and the proximal femur ca be also replaced, where the femoral side is completely metal. The acetabular side is composed of the polyethylene bearing surface 7 • Polymers Bonding Time: Cemented Vs. Cementless Cemented •Approximately 10min Cementless •One year or more for good ingrowth Healing Time Cemented Cementless Weight bearing Next day with crutches Next day depending on stability Walk (crutches) 2 day after surgery 2 day after surgery 6-12 weeks depending on surgeon Pain Free 5 days in some cases Depends on stability Normal Walk 2 weeks (6 weeks with crutches is recommended) Couple of months to 1 year depending on ingrowth rate Everything good Around six months for a knee replacement 2 years onward 8 • Polymers PMMA and silicone elastomers are used as Intraocular lenses to treat cataract Hard contact lenses for clear vision 9 • Polymers Polyethylene, Polytetrafluoroethylene (PTFE) and silicone used as medical tubing for drains and catheters Ultra high molecular weight Polyethylene, as Femoral head, acetabular cup or insert 10 • Polymers The healthy human knee joint is also lined with articular cartilage. Arthritis and injury can similarly damage this protective layer of cartilage causing extreme pain Hyaluronic Acid (HA) Injections restores lubrication and fluid in the joint and creates a shock absorber between the bones 11 • Polymers PTFE and Polyurethane used as Vascular and non-vascular grafts Pacemakers leads are insulated by silicone Polyvinylchloride (PVC) and silicone used as Tubing, blood storage bags, in blood transfusion, feeding and dialysis 12 • Metals • Load bearing implants and internal fixation devices; • When processed suitably contribute high tensile, high fatigue and high yield strengths; • Properties depend on the processing method and purity of the metal. • When metallic biomaterials were first used in biomedical applications, the only requirement was to achieve a suitable combination of physical properties to match those of the replaced tissue with a minimal toxic response of the host • Few concepts were gradually introduced with time as requirements for metallic biomaterials in the design of implantable devices, such as Foreign body reaction (particularly due to wear debris) Stress shielding Biocompatibility Bioactivity, and Osteoinduction 13 • Metals Although many metals and alloys are used for medical device applications, the most commonly employed are • Stainless steels • Cobalt-base alloys • Commercially pure Titanium and Titanium alloys • Nickel- Titanium alloys, and some • Noble metals (Au, Pt, Pd) 14 • Metals 15 • Metals 16 • Metals Ti alloy Pacemaker case and metallic leads encapsulated in silicone tubing Metal electrodes In Phrenic stimulator for respiratory control 17 • Metals Tooth metal crown For securing removable denture Ti alloy single teeth replacement Metal wires and braces 18 • Metals 19 • Ceramics • Bone bonds well to them • Exhibit minimum foreign body reaction • High stiffness • Low friction and wear coefficients But • Low fracture toughness Owing to its Brittle nature • Low impact resistance 20 • Ceramics • Alumina (Al2O3) • Zirconia • Several porous ceramics (CaCO3) Calcium Phosphates (CaPs) Bioactive Glasses (BGs) Glass Ceramics • Hydroxyapatite Ca10(PO4)6(OH)2 • A range of suitable CaPs (amorphous CaP (ACP), dicalcium phosphate (DCP), tricalcium phosphate (α-TCP, β-TCP), tetracalcium phosphate (TTCP) e.t.c.) • Several BGs formulations containing e.g. SiO2 as network former and Na2O, CaO and P2O5 as modifying oxides (Bioglass 45S5) 21 • Ceramics Alumina Femoral head and Acetabular liner 22 • Ceramics Zirconia dental crown and bridges Hydroxyapatite coated metallic implants Zirconia artificial tooth root 23 • Ceramics Calcium Phosphate Scaffold All-carbon mono-leaflet mechanical heart valves consist of a rotatable housing ring within a compliant suture ring HA scaffold (light purple colour) with bone (yellow colour) that has grown in the scaffold 24 Example 6 : Which of the following classes of biomaterials would be most appropriate for use to fabricate an artificial tendon, a tissue that must sustain substantial deformation at low forces and return rapidly to its original dimensions upon release of the stress ? WHY ? (a) Metals (b) Ceramics (c) Polymers 25 The selection of the biomaterial and selection of the appropriate processing techniques for a given application is determined primarily by • Surface • Bulk, and • Degradative properties of the material 26 What constitutes a surface? An interface is the boundary region between two adjacent layers We recognize (S/G), (S/L), and (L/V) as surfaces L G S L S S V L L S L = Liquid G = Gas S = Solid V = Vapor 27 Biomaterial surface Protein adsorption Proteins (red) adsorb differently to the different materials and are depicted as elongated on metal and globular on polymer. Cells (blue) interact with the materials via the adsorbed proteins and conformation of the adsorbed proteins dictates how the cells will respond (adhere, proliferate, differentiate, etc.). The effect of protein size on interaction with a surface. Notice that the larger protein composed of more amino acids is capable of making more interactions 28 The surface of a material is defined to be the few atomic layers on the exterior of the object Surface properties can be different from the bulk properties Surface properties include both chemical and physical characteristics 29 Surface Chemical Property Contact Angle The contact angle is the angle at which a liquid-vapor interface meets the solid-liquid interface • The contact angle is determined by the resultant between Adhesive and Cohesive forces • As the tendency of a drop to spread out over a flat solid surface increases, the contact angle decreases Wetting A shows a fluid with very little wetting, while C shows a fluid with more wetting. A has a large contact angle, and C has a small contact angle. Wetting is the ability of a liquid to maintain contact with a solid surface, resulting from intermolecular interactions when the two are brought together Thus, the Contact angle provides an inverse measure of Wettability Water bead on a fabric that has been made hydrophobic 30 Surface Tension • Surface tension is a measurement of the cohesive energy present at an interface • This forms a surface “Film” which makes it more difficult to move an object through the surface Hydrophilicity • If the liquid is very strongly attracted to the solid surface • The droplet will completely spread out on the solid surface Hydrophobicity • If the solid surface is hydrophobic, the contact angle will be larger than 900C 31 Surface Physical Property Surface Roughness 32 Example 2.1: Would a hydrophobic or hydrophilic polymer be a more appropriate choice for a Contact lens application? WHY ? Would a melting temperature (Tm) of the polymer above 37oC or below 370C be more appropriate for this application ? WHY ? Example 2.2: A 1ml droplet of distilled water is dropped onto each material “A” and “B” as shown below. Which material is more hydrophilic ? Justify your answer. Example 2.3: Why do atoms at the surface of a crystalline material generally possess higher energy than those inside of the crystal and what is the term for this heightened energy ? 33 Most important parameter They may play a less significant role in initial biological interaction/response, but they have a large long-term impact They can be altered to allow the biomaterial to mimic the physicochemical properties of the biological system Bulk characteristic of biomaterials include • Mechanical Properties • Physical Properties • Chemical composition 34 Mechanical Properties Such as, • Strength • Stiffness • Anisotropy • Fatigue properties/strength Mechanical properties of materials are highly affected by their physical and chemical characteristics 35 Physical Properties Such as, • Crystallinity • Thermal Transition Points Melting Point (Tm) Glass Transition Point (Tg) Chemical Composition • It varies when chemicals are added or subtracted, and when the ratio of substances changes • It determines the (bulk) properties of the substance • It also dictates other properties such as chemistry at the surface SEM Micrograph of steel showing grain boundaries 36 Factors that affect biomaterials’ degradation in vivo The size and shape of the implant Its location in the body Chemical, physical and mechanical (both bulk and surface) properties Although the temperature and pH of body environment/fluids are relatively mild, BUT ! • Degradation can be undesired or desired • The biocompatibility of degradation by-products is as important as the biocompatibility of the intact material 37