Titanium and its alloys have been used extensively in a wide variety of implant applications, such as artificial heart pumps, pacemaker cases, heart valve parts, and load-bearing bone or hip joint replacements or bone splints. This article discusses the properties of titanium and its alloys and presents titanium-base biomaterials in a table. Titanium components are produced in wrought, cast, and powder metallurgy (PM) form. The article describes forging, casting, and heat treating of titanium alloys for producing titanium components. Typical mechanical properties of titanium biomedical implant alloys are listed in a tabular form. The article presents an overview of surface-modification methods for titanium and its alloys implants. It concludes with a section on biocompatibility and in vivo corrosion of titanium alloys.

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

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 various applications of biomaterials, including orthopedic, cardiovascular, ophthalmic, and dental applications. The article describes the 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 information on examples of biomaterials applications, including endovascular devices, knee implants, and neurostimulation.

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 focuses on the use of noble and precious metals for biomedical applications. The noble metals include gold, platinum, palladium, ruthenium, rhodium, iridium, and osmium. The physical and mechanical properties of the noble and precious metals are presented in tables. A brief discussion on the ancient history of noble and precious metal use in dentistry is provided. The article discusses the use of direct gold dental filling materials, direct silver dental filling materials, traditional amalgam alloys, high-copper amalgam alloys, and gallium alloys in biomedical applications. Modern stents were developed as a result of balloon catheterization research. The article describes gold coatings and iridium oxide coatings for stents.

The interaction of an implant with the human body environment may result in degradation of the implant, called corrosion. This article discusses the corrosion testing of metallic implants and implant materials. The corrosion environments for medical implants are the extracellular human body fluids, very complex solutions containing electrolytes and nonelectrolytes, inorganic and organic constituents, and gases. The article describes the fundamentals of electrochemical corrosion testing and provides a brief discussion on various types of corrosion tests. It illustrates corrosion current density determination by Tafel extrapolation, potentiodynamic measurement of the polarization resistance, electrochemical impedance measurement, and potentiostatic deaeration. Tests combining corrosion and mechanical forces, such as fretting corrosion tests, environment-assisted cracking tests, and ion-leaching tests are also discussed.

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

This article reviews the applications of traditional glasses in architecture, transportation, construction, houseware, containers, and fibers. It also describes uses of specialty glasses for aerospace and military applications, biomedical and dental applications, chemical-resistant applications, lighting, information display, electronic processing and electronic devices, optical and ophthalmic products, and communications equipment.

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

This article describes some of the mechanical/ electrochemical phenomena related to the in vivo degradation of metals used for biomedical applications. It discusses the properties and failure of these materials as they relate to stress-corrosion cracking (SCC) and corrosion fatigue (CF). The article presents the factors related to the use of surgical implants and their deterioration in the body environment, including biomedical aspects, chemical environment, and electrochemical fundamentals needed for characterizing CF and SCC. It provides a discussion on the use of metallic biomaterials in surgical implant applications, such as orthopedic, cardiovascular surgery, and dentistry. It addresses the key issues related to simulation of the in vivo environment, service conditions, and data interpretation. Theses include frequency of dynamic loading, electrolyte chemistry, applicable loading modes, cracking mode superposition, and surface area effects. The article describes the fundamentals of CF and SCC, testing methodology, and test findings from laboratory, in vivo, and retrieval studies.

Stainless steels are used for medical implants and surgical tools due to the excellent combination of properties, such as cost, strength, corrosion resistance, and ease of cleaning. This article describes the classifications of stainless steels, such as austenitic stainless steels, martensitic stainless steels, ferritic stainless steels, precipitation-hardening stainless steels, and duplex stainless steels. It contains a table lists common medical device applications for stainless steels. The article discusses the physical metallurgy, and physical and mechanical properties of the stainless steels. Medical device considerations for stainless steels, such as fatigue strength, corrosion resistance, and passivation techniques, are reviewed. The article describes the process features of the implant-grade stainless steels, including type 316L, type 316LVM, nitrogen-strengthened, ASTM F1314, ASTM F1586, ASTM F2229, and ASTM F2581 stainless steels.

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 properties and hard-tissue response to particular clinical applications. The article provides information on glass or glass-ceramic particles for cancer treatments.

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.

Polymers offer a wide range of choices for medical applications because of their versatility in properties and processing. This article provides an overview of polymeric materials and the characteristics that make them a unique class of materials. It describes the ways to classify polymers, including the polymerization method, how the material deforms, or molecular origin or stability. The article contains tables that list common medical polymers used in medical devices. It describes the medical polymer selection criteria and regulatory aspects of materials selection failure analysis and prevention. Failure analysis and prevention processes to determine the root cause of failures that arise at different stages of the product life cycle are reviewed. The article describes the mechanisms of plastic product failure analysis. It discusses the trends in the use of medical polymers, such as high-performance polymers for implants, tissue engineering, and bioresorbable polymers.

This article reviews cleaning and finishing operations that have proven to be effective on titanium, its alloys, and semi-fabricated titanium products. It explains how to remove scale, tarnish films, grease, and other soils and how to achieve required finishes and/or improve wear and oxidation resistance through the use of polishing, buffing, and wire brushing operations. The article also covers a wide range of surface modification and coating processes, including ion implantation, diffusion, chemical and physical vapor deposition, plating, anodizing, and chemical conversion coatings as well as sprayed and sol-gel coatings and laser and electron-beam treatments.

This article reviews some concepts considered important for an understanding of processes used for preparing cobalt-chromium alloy implants, the microstructures resulting from this processing, and the resulting material properties. The review includes the solidification of alloys, diffusionless (martensitic) phase transformation as occurs with face-centered cubic to hexagonal close-packed transformation in cobalt-chromium alloys, stacking faults and twins and their role in this transformation. It also includes strengthening mechanisms that are responsible for the mechanical properties of cast and wrought cobalt alloys. The article contains tables that list the commonly used cobalt alloys and their biomedical applications and chemical compositions. It discusses the mechanical and corrosion properties of cobalt alloys, and provides a description of the microstructure of cobalt alloys.

This article discusses the mechanisms of metal and alloy biocompatibility. It provides information on early testing and experience with metals in medical device applications. The article describes the response to severe corrosion of implant and particulate materials. It provides a description of metal binding and its effects on metabolic processes. The hypersensitive responses to metal ions are also reviewed. The article concludes with a discussion on possible cancer-causing effects of metallic biomaterials.

This article focuses on the analysis of materials and mechanical- (or biomechanical-) based medical device failures. It reviews the failure analysis practices, including evidence receipt, cleaning, nondestructive examination, destructive examination, exemplars analysis, and device redesign. The article examines the common failure modes, such as overload, fatigue, corrosion, hydrogen embrittlement, and fretting, of medical devices. The failure analysis of orthopedic implants, such as permanent prostheses and internal fixation devices, is described. The article reviews the failure mechanisms in some of the more common medical device materials, namely, stainless steels, titanium alloys, cobalt-base alloys, and nitinol. It presents case histories with examples for failure analysis.

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 information on the classification of the different types of bioceramics. These include bioinert ceramics, bioactive ceramics, and bioresorbable ceramics. The article describes the 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 that are used to test the biocompatibility of ceramics, namely, biosafety testing, biofunctionality testing, bioactivity testing, and bioresorbability testing.

This article highlights corrosion resistance and ion release from main transition metallic bearings that are used as medical devices. It discusses the main issues associated with the in vivo presence of ions and their biocompatibility during the exposure of patients to different aspects of ion toxicity. These include ion concentration and accumulation in organisms, reactive oxygen species and oxidative stress, and carcinogenicity stimulated by the corrosion process and toxic ions release.