Biomaterials:

A biomaterial is any substance that has been engineered to interact with biological systems for a
medical purpose - either a therapeutic (treat, augment, repair or replace a tissue function of the
body) or a diagnostic one. As a science, biomaterials is about fifty years old. The study of
biomaterials is called biomaterials science or biomaterials engineering. It has experienced
steady and strong growth over its history, with many companies investing large amounts of
money into the development of new products. Biomaterials science encompasses elements
of medicine, biology, chemistry, tissue engineering and materials science.
Note that a biomaterial is different from a biological material, such as bone, that is produced by
a biological system.
Biomaterials can be derived either from nature or synthesized in the laboratory using a variety of
chemical approaches utilizing metallic components, polymers, ceramics or composite materials.
They are often used and/or adapted for a medical application, and thus comprises whole or part
of a living structure or biomedical device which performs, augments, or replaces a natural
function.
Biomaterials and the medical devices comprised of them are now commonly used as prostheses
in cardiovascular, orthopedic, dental, ophthalmological, and reconstructive surgery, and in other
interventions such as surgical sutures, bio-adhesives, and controlled drug release devices. The
compelling, human side to biomaterials is that millions of lives have been saved, and the quality
of life improved for millions more, based on devices fabricated from biomaterials. The
biomaterials field has seen accelerating growth since the first medical devices that were based on
accepted medical and scientific principles made their way into human usage in the late 1940s and
early 1950s. And the growth of the field is ensured, with the aging population, the increasing
standard of living in developing countries, and the growing ability to address previously
untreatable medical conditions.

Properties:
 Biocompatibility:
The biocompatibility of a long-term implantable medical device refers to the ability of the
device to perform its intended function, with the desired degree of incorporation in the host,
without eliciting any undesirable local or systemic effects in that host.
 Natural and synthetic biomaterials:
Natural biomaterials are any material taken from plants or animals and used to augment,
replace, or repair body tissues and organs. The use of natural biomaterials is not a new
concept; naturally derived materials have been used by humans for thousands of years.
Naturally derived biomaterial can be classified into many groups including protein-based
biomaterials (collagen, gelatin, silk etc.), polysaccharide-based biomaterials (cellulose,
chitin/chitosan, glucose etc.) and microbial derived biomaterials such as Polyhydroxy butyrate,
polyhydroxy valearate etc.
The success of any implant depends so much on the biomaterial used. Naturally derived
biomaterials have been demonstrated to show several advantages compared to synthetic
biomaterials. These are biocompatibility, biodegradability, remodeling and composition is similar
to native tissues/organs. Therefore, these biomaterials are usually applied in the repair or
replacement of damaged human tissues and organs.
Synthetic biomaterials are classified as: metals, ceramics, non-biodegradable polymers.
 Biodegradable:
“Biodegradable” refers to the ability of things to get disintegrated (decomposed) by the action
of micro-organisms such as bacteria or fungi biological (with or without oxygen) while getting
assimilated into the natural environment.

 Non-immunogenic:
Unwanted immunogenicity is an immune response by an organism against a therapeutic
antigen (ex. recombinant protein, or monoclonal antibody). This reaction leads to production of
antibodies inactivating the therapeutic effects of the treatment and, in rare cases, inducing
adverse effects. Immunogenicity is the ability of a foreign substance, such as an antigen, to
provoke an immune response in the body of a human or other animal. In other words,
immunogenicity is the ability to induce a humoral and/or cell-mediated immune responses.
 Non –toxic:
A biomaterial should be nontoxic. In general, nontoxicity refers to noncarcinogenic,
nonpyrogenic, nonallergenic, blood compatible, and noninflammatory of biomaterial.

Types:
 Metals:
A metal (from Greek μέταλλον métallon, "mine, quarry, metal") is a material that, when freshly
prepared, polished, or fractured, shows a lustrous appearance, and conducts electricity and heat
relatively well. Metals are typically malleable (they can be hammered into thin sheets) or ductile
(can be drawn into wires)
  Ceramics:
A ceramic (Ancient Greek: κεραμικός – keramikós, "potter's", from κέραμος – kéramos,
"potter's clay") is a solid material comprising an inorganic
compound of metal or metalloid and non-metal with ionic or covalent bonds. Common examples
are earthenware, porcelain, and brick.
 Biopolymers:
Biopolymers are natural polymers produced by the cells of living organisms. Biopolymers
consist of monomeric units that are covalently bonded to form larger molecules. There are three
main classes of biopolymers, classified according to the monomers used and the structure of the
biopolymer formed: polynucleotides, polypeptides, and polysaccharides. Polynucleotides, such
as RNA and DNA, are long polymers composed of 13 or
more nucleotide monomers. Polypeptides and proteins, are polymers of amino acids and some
major examples include collagen, actin, and fibrin. Polysaccharides are linear or branched
polymeric carbohydrates and examples include starch, cellulose and alginate. Other examples of
biopolymers include natural rubbers (polymers
of isoprene), suberin and lignin (complex polyphenolic polymers), cutin and cutan (complex
polymers of long-chain fatty acids) and melanin.

Types Elements Use

Metals Ti-Al alloy Bone replacement, high load

bearing skeletal system
Stainless steel

Co-Cr

Platinum Electrical stimulation of heart,

muscles and nerve tissue
Pt-iridium

Ni-Ti alloy Orthodontics

(Nitinol)

Ceramics Alumina Joint replacement

Natural polymers
Protein Collagen

Fibroin

Muco- Hyaluronic acid

polysaccharide

Polysaccharide Cellulose

Pectin

Alginate

Dextran

Polydextrose

Chitin and chitosan

Polyesters Polyhydroxybutyrate (PHB)

Polyhydroxyvalerate (PHV)

Polycaprolactone (PCL)

 Collagen is the most abundant protein in the human body, found in the bones, muscles,
skin, and tendons. It is the substance that holds the body together. Collagen forms a
scaffold to provide strength and structure.
 Fibroin is an insoluble protein present in silk produced by numerous insects, such as the
larvae of Bombyx mori,
 Mucopolysaccharides are long chains of sugar molecules that are found throughout the
body, often in mucus and in fluid around the joints. They are more commonly called
glycosaminoglycans. Mucus is a normal, slippery and stringy fluid substance produced by
many lining tissues in the body. It is essential for body function and acts as a protective
and moisturizing layer to keep critical organs from drying out. Mucus also acts as a trap for
irritants like dust, smoke, or bacteria. It contains antibodies and bacteria-killing enzymes
to help fight off infections.
  Pectin is a structural acidic heteropolysaccharide contained in the primary and middle
lamella cell walls of terrestrial plants. Its main component is galacturonic acid, a sugar
acid derived from galactose.
 Alginate, also called Alginic acid is a compound found within the cell walls of brown algae.
 Dextran, cellulose-polymers of glucose
 Chitinₙ, a long-chain polymer of N-acetylglucosamine, is a derivative of glucose. It is a
primary component of cell walls in fungi, the exoskeletons of arthropods, such as
crustaceans and insects, the radulae of molluscs, cephalopod beaks, and the scales of fish
and lissamphibians
 Chitosan is a linear polysaccharide composed of randomly distributed β--linked D-
glucosamine and N-acetyl-D-glucosamine. It is made by treating the chitin shells of shrimp
and other crustaceans with an alkaline substance, such as sodium hydroxide. Chitosan has
a number of commercial and possible biomedical uses. Crustaceans include crabs,
lobsters, crayfish.

Applications:
 Heart valves
In the United States, 49% of the 250,000 valve replacement procedures performed annually
involve a mechanical valve implant. The most widely used valve is a bileaflet disc heart valve, or
St. Jude valve. The mechanics involve two semicircular discs moving back and forth, with both
allowing the flow of blood as well as the ability to form a seal against backflow. The valve is
coated with pyrolytic carbon, and secured to the surrounding tissue with a mesh of woven fabric
called Dacron (du Pont's trade name for polyethylene terephthalate). The mesh allows for the
body's tissue to grow while incorporating the valve.
Pyrolytic carbon is a material similar to graphite, but with some covalent bonding between its
graphene sheets as a result of imperfections in its production. Pyrolytic carbon is man-made
and is not thought to be found in nature.
Polyethylene terephthalate (sometimes written poly(ethylene terephthalate)), commonly
abbreviated PET, PETE, or the obsolete PETP or PET-P, is the most
common thermoplastic polymer resin of the polyester family and is used in fibres for
clothing, containers for liquids and foods, thermoforming for manufacturing, and in combination
with glass fibre for engineering resins.
It may also be referred to by the brand names Terylene in the UK, Lavsan in Russia and the
former Soviet Union, and Dacron in the US.
  Total Hip Replacement Prostheses:
The human hip joint is subjected to high levels of mechanical stress, and receives considerable
abuse in the course of normal and extraordinary activity. It is not surprising that after 50 or more
years of cyclic mechanical stress or because of degenerative or rheumatoid disease, the natural
joint wears out, leading to loss of mobility and sometimes confinement to a wheelchair. Hip joint
prostheses are fabricated from a variety of materials, including titanium, stainless steel, special
high-strength alloys, ceramics, composites, and ultrahigh molecular weight polyethylene
(UHMWPE).

 Teeth Implant:
The first step in the dental implant process is the development of an individualized treatment plan.
The plan addresses your specific needs and is prepared by a team of professionals who are specially
trained and experienced in oral surgery and restorative dentistry. This team approach provides
coordinated care based on the implant option that is best for you.
Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of
the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it
securely in the jaw. The healing process can take from six to 12 weeks.
Once the implant has bonded to the jawbone, a small connector post -- called an abutment -- is
attached to the post to securely hold the new tooth. To make the new tooth or teeth, the dentist
makes impressions of the patient’s teeth, and creates a model of the bite (which captures all of your
teeth, their type, and arrangement). The new tooth or teeth is based on this model. A replacement
tooth, called a crown, is then attached to the abutment.
The dentist also will match the color of the new teeth to your natural teeth. Because the implant is
secured within the jawbone, the replacement teeth look, feel, and function just like your own natural
teeth.
Crowns are typically made from gold, silver or other metal alloys, PFM, and ceramic compounds
such as zirconia and porcelain for restoring teeth. Crowns are also made to a lesser extent from
resin based materials.
 Skin Implants:
Normal skin, which provides an essential water-, electrolyte-, and bacteria-proof barrier to the
outside world. When this function is lost through burns or chronic nonhealing ulcers, then
patients are susceptible to bacterial infection. In burns patients with extensive skin loss, bacterial
sepsis can be fatal. Collagen is used for skin grafting.
  Cardiac pacemaker:
A cardiac pacemaker, is a medical device that generates electrical impulses delivered by
electrodes to cause the heart muscle chambers to contract and therefore pump blood; by doing so
this device replaces and/or regulates the function of the electrical conduction system of the
heart. These electrodes are made up of platinum or platinum-iridium.

 Nitinol in braces:
Orthodontics is a specialty of dentistry that deals with the diagnosis, prevention and correction
of malpositioned teeth and jaws.
What is Nitinol?
Commonly known as nickel titanium, Nitinol is a type of metal alloy that is associated with
superelasticity, also known as ‘“shape memory”. What this means is that the metal is able to
remember and return to its original shape when heated. It is also able to withstand extreme
stress without changing its shape due to its elastic properties.
What is Nitinol used for?
Nitinol has several uses, but is widely renowned for its use in orthodontic and endodontic
practices. Nitinol is used for the wiring and brackets that connect teeth. It’s the perfect choice for
braces because the alloy is able to bend and shape itself to the requirements of the patient’s tooth
formation.
In endodontics, Nitinol is used during root canals, specifically for cleaning and helping to shape
the root canal.
Why is Nitinol used in braces?

A braces’ main function is to gently shift and position teeth into their new positions. This is done
using wires and brackets that exert just enough force to slowly and gently push and pull the teeth
into their new formations. Nitinol wire is perfect for performing this task as it has a high
recoverable strain modulus – meaning the wire will continuously attempt to return to its original
form and in turn, moving the teeth into position. Once the force is too low to move the teeth, the
braces are removed and that part of the treatment is complete.
The advantages of Nitinol for braces over traditional wiring
As the Nitinol is able to remember its former shape, it becomes the perfect material for braces.
Traditional stainless steel wires are likely to lose tension as time passes, meaning you will have
to return to your orthodontist to get the wire adjusted. With nitinol wire, your orthodontist will
mold the wire to fit the current formation of your teeth. The heat from your mouth will begin to
affect the nitinol wire and eventually return to its original shape. This means that as the nitinol
wire “straightens out”, it is in turn, shifting your teeth into their new positions.
The biggest advantage of nitinol is less frequent trips to your orthodontist thanks to the alloy
being able to “remember” and eventually return to its original form.
What is shape memory?
Shape memory is a term often applied to materials that are able to “remember” and return to
their original form. In the context of braces, nitinol is the preferred material to perform such a
task.

How does shape memory work?

The easiest way to describe memory shape is to liken it to an elastic band. When you stretch an
elastic band, the molecules inside it tear apart but do not break. When you stop stretching it, the
molecules return to their original form (pulling back together again).
Shape memory works differently to elasticity, it relies on heat to return to its original form. For
example, let’s say you bend an object made from a shape memory alloy (nitinol) it will remain
that way because you have deformed its crystalline structure. It will not return to its original
form unless heat is applied. When this happens, the crystalline structure reactivates and works to
transition itself back to its original form.
Why is stainless steel used for braces?
Stainless steel has long remained the most trusted material for creating archwires since the early
1900s. Steel was preferred over noble metals because it was cheaper and offered better
formability – essentially meaning it is easier to shape and mould to the patient’s mouths.
Stainless steel archwires main advantages are that they are corrosion-resistant and offer
fantastic formability.
  Alumina [Ceramics] for Joint replacement
Ceramic-on-ceramic
Ceramic-on-ceramic seems to be the golden child for hip replacement devices for the fast few
years. There have been numerous studies released that tout the lack of issues within all-ceramic
hip replacement devices. They do not have any biological adverse effects or allergic responses,
for example. Patients that had an all-ceramic device implanted had lower rates of revision
surgery, bone deterioration, and the loosening and/or dislocation of the device.
 Wound healing by Hyaluronic acid:
HA is also involved in various signaling pathways that are activated in the wound bed during the
healing process. Hydrogel-based dressings for skin wounds provide a barrier between the wound
and the external environment, thus preventing infection and absorbing exudates (such as water,
plasma, and red blood cells). Similarly, biomaterials used for internal wounds should repel or
damage microbes and other infectious agents, be hydrophilic and sufficiently porous to absorb
exuded liquids, and/or have a large enough swelling factor to fill any voids within the damaged
tissue. In order to prevent an inflammatory response to the hydrogel itself, the material should
be biologic and degradable on a time scale comparable to the wound healing process (on the
order of days). In addition, hydrogels can serve as delivery vehicles for drugs and other wound
healing compounds and can be manipulated to allow for controlled release of these components
in both space and time

 Drug delivery by Collasome: Collagen shield

Collagen is regarded as one of the most useful biomaterials. The excellent biocompatibility
and safety due to its biological characteristics such as biodegradability and weak
antigenecity made collagen the primary resource in medical applications. Collasomes show
promise among drug delivery systems to the human eye. They are first fabricated from
porcine scleral tissue, which bears a collagen composition similar to that of the human
cornea. The shields are hydrated before they are placed on the eye, having been stored in a
dehydrated state. Typically the drug is loaded into the drug solution for a period of time
prior to application. Collagen shields are designed to be inserted in a physician’s office;
they often produce some discomfort and interfere with vision. Shields are not individually
fit for each patient, as are soft contact lenses and therefore, comfort may be problematic
and expulsion of the shield may occur. Kaufman et al have developed a new drug delivery
system- collasomes. They combined collagen pieces or particles and a viscous vehicle that
could be instilled beneath the eyelid, thereby simplifying application and reducing the
blurring of vision. Collasomes were well tolerated; and because the collagen particles are
suspended in carrier vehicles, they could be instilled safely and effectively by patients in
much the same fashion as drops or ointments.