Historical Overview - in vivo Applications

One of the earliest applications of carbon as an implant material was in restorative dentistry. The first devices were bulky posts fabricated from glassy carbon that were implanted in the maxilla or mandible to serve as artificial tooth roots. Because of the inherent lack of strength of glassy carbon, they were bulky and poorly accepted. As a further complication, the stainless steel post on which a crown was cemented formed a galvanic couple in vivo leading to comphcations caused by accelerated corrosion of the stainless steel. 

In another attempt, artificial tooth roots in the form of blades were fabricated from pyrolytic carbon. Although they were less bulky than the glassy carbon implants, they were difficult to place. Improper seating of the blade caused micromotion after implantation that ultimately caused the prosthesis to fail. The success rate of 60% after 5 years was judged inadequate. Metal blades coated with carbon fared a similar fate. 

Metallic mandibular reconstruction trays coated with a vapor deposited film of carbon generally performed well. The application was complicated by the fact that the trays were custom and many times fashioned directly in the operating room, making the logistics of coating with carbon unacceptable. 

Graft prostheses 6mm diameter are generally considered to work well and improvements in performance as a result of modifying the biochemical nature of the graft lumen with carbon coatings are difficult to quantify and 

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