Overview of Biomedical Implants

Tolou Shokuhfar, PhD, is an Associate Professor of Bioengineering at University of Illinois at Chicago. She is a recipient of an NSF CAREER Award that pioneers the visualization of biomineralization, biological materials, nanomaterial/protein interactions and microorganisms in nanoenclosures. She has also received the SFB Ortho SIG Faculty Abstract award, TMS Young Leaders Award, DSL Young Scientist Award, and “INSIGHT Diversity Award for Inspiring Women in STEM”. Dr. Shokuhfar has been the Chair for Orthopedic Biomaterials SIG and Vice Chair of Nanomaterials SIG at the Society for Biomaterials since 2019.

• Preface xiiiAcknowledgments xiv1 Biomaterials for Dental Implants 11.1 Introduction: Dental Implants and Current Materials 11.1.1 The Need for Better Dental Implants 11.1.2 Various Approaches and Biomaterials to Improve Dental Implants 31.1.3 Working at the Nanoscale to Improve Dental Implants 61.2 Ceramic Dental Implants 81.2.1 Zirconia 81.2.1.1 Surface Roughness Optimization of Zirconia-Based Implants 91.2.1.2 Coating Alternatives for Zirconia-Based Implants 91.2.1.3 Using Nanotechnology to Modify Zirconia-Based Implants 101.2.1.4 Disadvantages and Advantages of Zirconia-Based Implants 111.2.2 Hydroxyapatite 121.2.2.1 Antimicrobial Properties of Hydroxyapatite-Containing Materials 121.2.2.2 Combination Dental Materials Using Hydroxyapatite 131.2.2.3 Nano-Hydroxyapatite 141.2.2.4 Disadvantages and Advantages of HA-based Biomaterials 151.3 Polyetheretherketone (PEEK) 151.3.1 PEEK Composites to Improve Mechanical Properties 161.3.2 PEEK Bioactivity 171.3.3 Working at the Nanoscale and With Composites to Enhance PEEK Bioactivity 171.3.4 Disadvantages and Advantages of PEEK 201.4 Peptide Coatings for Dental Implants 201.5 Functionally Graded Dental Implants 221.5.1 Biological Responses to Functionally Graded Dental Implants 241.5.2 Radially Designed FGMs for Dental Implants 251.5.3 Disadvantages and Advantages of FGMs 261.6 Looking to the Future: State-of-the-Art Biomaterials for Dental Implants 261.7 Conclusion 28References 292.1 Biomaterials for Total Hip Implants 352.1.1 Introduction 352.1.2 History of THA Development 362.1.3 Metallic Materials 362.1.3.1 Stainless Steel 362.1.3.2 Cobalt–Chromium Alloys 372.1.3.3 Titanium Alloys 372.1.3.4 Alloy Surface Modifications 372.1.4 Exploited Materials for Bearing Surface 382.1.4.1 Polymers 382.1.4.1.1 Ultrahigh Molecular Weight Polyethylene (UHMWPE) 382.1.4.1.2 High Cross-Linked UHMWPE (XLPE) 382.1.4.1.3 Antioxidant-Doped PE 382.1.4.1.4 Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) 392.1.4.2 Ceramics 392.1.4.2.1 Alumina 392.1.4.2.2 Zirconia 392.1.4.2.3 Alumina–Zirconia Composites 402.1.4.2.4 Silicon Nitride 402.1.4.2.5 Hybrid Design of Oxide Ceramic Layer on Metal (Oxinium™) 402.1.4.2.6 Ultra-Hard Coatings on Metals 412.1.4.2.7 Clinical Aspects of Bearing Surface 412.1.4.3 MoP Articulation 422.1.4.3.1 Advantages 422.1.4.3.2 Disadvantages 422.1.4.3.3 Wear Mechanism 422.1.4.4 MoM Articulation 422.1.4.4.1 Advantages 422.1.4.4.2 Disadvantages 432.1.4.4.3 Wear Mechanism 432.1.4.5 CoC Articulation 432.1.4.5.1 Advantages 432.1.4.5.2 Disadvantages 442.1.4.5.3 Wear Mechanism 452.1.4.6 CoP Articulation 452.1.4.6.1 Advantages 452.1.4.6.2 Disadvantages 452.1.4.6.3 Wear Mechanism 452.1.5 Orthopedic Wear Debris 462.1.6 Conclusion 47References 472.2 Biomaterials for Total Knee Replacement (TKR) and Total Hip Replacement (THR) and Next-Generation Advancements 572.2.1 Introduction 572.2.2 Ultra-High Molecular Weight Polyethylene (UHMWPE) and Polyethylene (PE) 612.2.3 Polyetheretherketone (PEEK) 622.2.4 Polymethylmethacrylate (PMMA) 652.2.5 Metal Implants 682.2.5.1 Metal Implants: Titanium (Ti) Alloys and Cobalt–Chromium (Co–Cr) and Surface Treatments 682.2.5.2 Metal Implants: Stainless Steel and Next Generation Surface Treatments 712.2.5.3 Porous Coatings 732.2.6 Ceramics and New Generation Surface Treatments 762.2.7 Advancements in Biomedicine and Nanotechnology: Titanium, Silver Nanoparticles, and More 782.2.8 Summary and Conclusion 81References 832.3 Biomaterials for Shoulder Implants 912.3.1 Introduction 912.3.2 Titanium Alloys 952.3.3 Cobalt–Chrome Alloys 952.3.4 Ceramics 962.3.5 Pyrolytic Carbon 962.3.6 Comparison of Shoulder Implants with Different Class Materials 972.3.7 Conclusion 97References 983 Biomaterials for Spinal Implants 1033.1 Introduction 1033.2 Overview of Implants and Corresponding Material Design Requirements 1043.2.1 Spinal Cages 1043.2.2 Spinal Rods 1043.2.3 Pedicle Screws 1053.2.4 Plates 1053.2.5 Disc Replacements 1053.3 Metals 1063.3.1 Titanium and its Alloys 1063.3.2 Stainless Steel 1083.3.3 Cobalt–Chromium and its Alloys 1083.3.4 Nitinol 1083.3.5 Tantalum 1093.4 Ceramics 1093.4.1 Silicon Nitride 1093.5 Polymers 1123.5.1 Peek 1123.6 3D-Printed Spinal Implants: Applications and Relevant Materials 1183.7 Degradable Implants 1183.8 Discussion 1193.9 Conclusion 120References 1204 Biomaterials in Cochlear Implants 1234.1 Introduction 1234.2 Biological Requirements 1254.3 Electrical Requirements 1264.4 Mechanical Requirements 1264.5 New Electrode Biomaterials 1274.5.1 Dexamethasone (DEX) 1274.6 Nanoscale Coatings 1294.7 New Potential Implant Materials 1344.8 Drug Delivery 1354.9 Summary and Conclusion 136References 1385 Biomaterials for Cardiovascular Implants 1415.1 Introduction 1415.2 Different Applications 1435.2.1 Stents 1435.2.1.1 Balloon Expandable Stents 1445.2.1.2 Self-Expandable Stents 1465.2.1.3 Drug-Eluting Stents 1485.2.1.4 Biodegradable Stents 1505.2.1.5 Latest Stent Inventions 1525.2.2 Prosthetic Heart Valves 1535.2.2.1 Mechanical Valves 1555.2.2.2 Bioprosthetic Valves 1605.2.2.3 Latest Valves Advancements 1615.3 Summary and Conclusions 162References 1646 Biomaterials for Liver and Kidney Implants 1736.1 Introduction 1736.2 Liver Biomaterials 1756.2.1 General View 1756.2.2 Biomaterials and Structures 1776.2.2.1 Natural Polymers 1786.2.2.2 Synthetic Material 1796.2.2.3 Decellularized Matrix 1816.2.3 Conventional Therapy and Future 1846.3 Kidney Biomaterials 1866.3.1 A General View 1866.3.2 Biomaterials and Structure 1886.3.3 Conventional Therapy and Future 1906.4 Conclusions 193References 1947 Biomaterials for Brain Implants 1997.1 Introduction 1997.2 Brain Implants Classification 2017.2.1 Brain Implants for Recording 2017.2.1.1 Electrocorticography (ECoG) 2017.2.1.2 Multielectrode Arrays (MEAs) 2027.2.2 Brain Stimulator Implants 2027.2.3 Brain Regenerative Medicine 2067.3 Causes of Failure 2077.4 Materials for Neural Electrodes 2107.4.1 Neural Electrodes 2107.4.2 Materials for Microelectrode Fabrication 2117.4.2.1 Conductive Polymers 2127.4.2.2 Carbon Nanotubes 2137.4.2.3 Graphene 2147.4.2.4 Hybrid Nanomaterials 2167.5 Conclusions 217References 2188 Biomaterials for Bionic Implants 2258.1 Introduction 2258.2 Biomaterials in Bionic Eye and Neural Systems 2278.2.1 Implant Package 2278.2.2 Electrodes 2298.2.2.1 Diamond Electrodes 2298.2.2.2 Organic Polymer Electrode Coating 2338.3 Biomaterials in Bionic Limbs 2348.3.1 Upper Limb 2358.3.1.1 Electrodes 2358.3.1.2 Electrode Packaging and Encapsulation 2378.3.1.3 Arms 2388.3.2 Lower Limb 2398.4 Summary Conclusion 241References 2419 Final Remarks 249Index 251