One of the most frequently cited advantages of ceramics in dentistry relates to aesthetics, and the same applies for dental implants. Zirconia has emerged as the material of choice for nonmetal implants. This article introduces the reader to zirconia as an implant material, its properties, manufacturing processes, and the particular surface modifications and treatments that have rendered its surfaces biologically compatible with peri-implant soft and hard tissues.

Ceramics are used widely in a number of different clinical applications in the human body. This article provides a brief history of the bioceramics field and discusses the classification of bioceramics. These include bioinert ceramics, bioactive ceramics, and bioresorbable ceramics. The article describes third-generation bioceramics, classified by Hench and Polak, such as silicate-substituted hydroxyapatite and bone morphogenic protein-carrying calcium phosphate coatings. It reviews several examination methods used to test the biocompatibility of ceramics, namely, biosafety testing, biofunctionality testing, bioactivity testing, and bioresorbability testing.

This article focuses on ceramics, glasses, glass-ceramics, and their derivatives, that is, inorganic-organic hybrids, in the forms of solid or porous bodies, oxide layers/coatings, and particles with sizes ranging from nanometers to micrometers, or even millimetres. These include inert crystalline ceramics, porous ceramics, calcium phosphate ceramics, and bioactive glasses. The article discusses the compositions of ceramics and carbon-base implant materials, and examines their differences in processing and structure. It describes the chemical and microstructural basis for their differences in physical properties, and relates the properties and hard-tissue response to particular clinical applications. The article also provides information on the glass or glass-ceramic particles used in cancer treatments.

Biomaterials are the man-made metallic, ceramic, and polymeric materials used for intracorporeal applications in the human body. This article primarily focuses on metallic materials. It provides information on basic metallurgy, biocompatibility, chemistry, and the orthopedic and dental applications of metallic biomaterials. A table compares the mechanical properties of some common implant materials with those of bone. The article also provides information on coatings, ceramics, polymers, composites, cements, and adhesives, especially where they interact with metallic materials.

This article outlines the selection criteria for choosing an implant material for biomedical devices in orthopedic, dental, soft-tissue, and cardiovascular applications. It details the development of various implants, such as metallic, ceramic, and polymeric implants. The article discusses specific problems associated with implant manufacturing processes and the consequent compromises in the properties of functionally graded implants. It describes the manufacturing of the functionally-graded hip implant by using the LENS process. The article reviews four different types of tissue responses to the biomaterial. It discusses the testing methods of implant failure, such as in vitro and in vivo assessment of tissue compatibility.

Structural applications for advanced ceramics include mineral processing equipment, machine tools, wear components, heat exchangers, automotive products, aerospace components, and medical products. This article begins with an overview of the wear-resistant applications and the parameters affecting wear of ceramics, namely, hardness, thermal conductivity, fracture toughness, and corrosion resistance. The next part of the article addresses temperature-resistant applications of advanced ceramics. Specific applications of ceramic materials addressed include cutting tools, pump and valve components, rolling elements and bearings, paper and wire manufacturing, biomedical implants, heat exchangers, adiabatic diesel engines, advanced gas turbines, and aerospace applications.

Implant debris is known to cause local inflammation, local osteolysis, and, in some cases, local and systemic hypersensitivity. The debris can be stainless steel, cobalt alloy, and titanium alloy, and soluble debris obtained due to wear from all orthopedic implants. This article addresses the biologic aspects of implant debris, both locally and systemically. It describes debris-induced local effects, particle-induced proinflammatory responses, and debris-induced systemic effects. The article concludes with a discussion on the four systemic effects of implant debris, namely, neuropathic effects, hypersensitivity effects, carcinogenicity, and general toxicity.

Total joint replacement in orthopedic surgery can be achieved by excision, interposition, and replacement arthroplasty. This article details the most common materials used in total replacement synovial joints: metals, ceramics, and ultrahigh molecular weight polyethylene (UHMWPE). The principal physical properties and tribological characteristics of these materials are summarized. The article discusses pin-on-disk experiments and pin-on-plate experiments for determining friction and wear characteristics. It explains the use of various types of joint simulators, such as hip joint simulators and knee joint simulators, to evaluate the performance of engineering tribological components in machine simulators. The article concludes with a section on the in vivo assessment of total joint replacement performance.

This article provides a summary of the biocompatibility or biological response of metals, ceramics, and polymers used in medical implants, along with their clinical issues. The polymers include ultrahigh-molecular-weight polyethylene, nonresorbable polymer, and resorbable polymers.

The human internal environment plays a vital role in the friction and wear of implants and prosthetic devices. This article describes the tribological/wear behavior of implants. It discusses the classification of active tribological pairs, namely, amphiarthosis joints and diarthosis joints. The article details the classification of total knee replacement, depending on the type of mechanical stability, including nonconstrained knee replacement, semiconstrained knee replacement, and constrained knee replacement. It also discusses the classifications of passive tribological pairs, namely, total disc replacement in the spine, dental implants, and temporomandibular joint. It describes the various testing methods for characterizing the implant materials used in hip, knee, spine, and dental applications. The article also describes the typical standards used for testing wear behavior of tribological pairs, namely, hip-wear simulation standards, knee-wear simulation standards, and spinal disc-wear simulation standards.

This article provides an overview of how thermal spray technology has adapted to meet the needs of the orthopaedic industry. It includes the challenges facing the development of artificial joints, substrate material selection criteria, thermal spray solutions, and clinical outcomes of thermal spray coatings. The article focuses on plasma thermal spray, which is the technique most often used to make porous titanium and hydroxyapatite (HA) coatings, such as thermal spray titanium, thermal spray HA, solution-precipitated HA, thermal spray chromium oxide, and thermal spray chromium carbide cermet coatings.

The classes of tool materials for machining operations are high-speed tool steels, carbides, cermets, ceramics, polycrystalline cubic boron nitrides, and polycrystalline diamonds. This article discusses the expanding role of surface engineering in increasing the manufacturing productivity of carbide, cermet, and ceramic cutting tool materials used in machining operations. The useful life of cutting tools may be limited by a variety of wear processes, such as crater wear, flank wear or abrasive wear, builtup edge, depth-of-cut notching, and thermal cracks. The article provides information on the applicable methods for surface engineering of cutting tools, namely, chemical vapor deposited (CVD) coatings, physical vapor deposited coatings, plasma-assisted CVD coatings, diamond coatings, and ion implantation.

Ion implantation involves the bombardment of a solid material with medium-to-high-energy ionized atoms and offers the ability to alloy virtually any elemental species into the near-surface region of any substrate. This article describes the fundamentals of the ion implantation process and discusses the advantages, limitations, and applications of ion implantation. It also reviews a typical medium current semiconductor implanter adapted for implantation of metals with the aid of illustrations.

Although stainless steel is naturally passivated by exposure to air and other oxidizers, additional surface treatments are needed to prevent corrosion. Passivation, pickling, electropolishing, and mechanical cleaning are important surface treatments for the successful performance of stainless steel. This article describes the surface treatment of stainless steels including abrasive blast cleaning, acid pickling, salt bath descaling, passivation treatments, electropolishing, and the necessary coating processes involved. It also describes the surface treatment of heat-resistant alloys including metallic contaminant removal, tarnish removal, oxide and scale removal, finishing, and coating processes.

Powder-bed fusion (PBF) is a group of additive manufacturing (AM) processes that includes selective laser sintering, selective laser melting, and electron beam melting. This article explains the processes and parameters of PBF systems that are used for biomedical applications. It also presents the desirable properties of biomedical devices and the advantages of using PBF systems for biomedical applications.

The biocompatibility of a material relates to its immunological response, toxicity profile, and ability to integrate with surrounding tissue without undesirable local or systemic effects on a patient. This article underscores the transformation of the medical device design ecosystem engaged as an integral part of the device ecosystem. It discusses the applications of biomaterials, including orthopedic, cardiovascular, ophthalmic, and dental applications. The article describes four major categories of biomaterials such as metals, polymers, glass and ceramics, and composites. A discussion on natural materials, nanomaterials, and stem cells is also provided. The article concludes with examples of biomaterials applications, such as endovascular devices, knee implants, and neurostimulation.