Principle of Biocompatibility

One of the most important requirements of bioceramics is their biocompa ability. This term encompasses not only the biological safety of a material as assessed by the ISO 10993 norm (2003, 2009, 2010) but also the mechanical and chemical characteristics, the design, sterilisation procedures and packaging of a medical device. 

Bioceramic Coatings for Medical Implants Trends and Techniques, First Edition. 

The definition of a biomaterial that has been arrived at by consensus is A biomaterial is one which possesses the ability to perform with an appropriate host response in a specific application (Williams, 1999). As subsequently stressed by Hench (2014), this definition emphasises that the term biocompatibility does not just mean absence of cytotoxicity but provides for the requirement that a material performs appropriately. This also means that different applications of a particular material enforces different conditions. As a consequence, a material, be it a metal, a ceramics or a polymer may or may not be biocompatible in different applications. 

Moreover, according to the degree of their interaction with living tissue, biomaterials are divided into three classes bioinert, biotolerant and bioactive (osseo-conductive) (Table 2.1 see also Heimann, 2011). 

Bioinert materials are materials that display minimal, if any, interaction with surrounding tissues examples of these are titanium and its alloys, alumina, partially stabilised zirconia, carbon and possibly ultrahigh molecular weight polyethylene (UHMWPE). In the case of bioinert materials bone remodelling occurs by a shape-mediated contact osteogenesis. 

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Wataha J C (2001) Principles of biocompatibility for dental practitioners. J Prosthet Dent, 86, 203-209. 

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