Bioceramic Composites

A special issue of Journal of Composites Science (ISSN 2504-477X). This special issue belongs to the section "Biocomposites".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 39452

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Guest Editor
National Research Council of Italy, Institute of Science and Technology for Ceramics (CNR-ISTEC), Faenza, Italy
Interests: biomaterials; bioceramics; joint replacements; dental implants; zirconia

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Guest Editor
National Research Council, 00185 Rome, Italy
Interests: multifunctional bioceramic materials for regenerative medicine; bioactive calcium phosphates; nanopowders; 3D solid scaffolds; antibacterial ceramics; magnetic bioceramics; bioactive ceramic composites
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Special Issue Information

Dear Colleagues,

Bioceramic composites were introduced into orthopaedic practice around 2002. Zirconia–alumina composites, in particular, have attracted a great deal of attention because of their superior mechanical behaviour in comparison with alumina ceramic, i.e., the former standard ceramic in joint replacements. Today, several manufacturers are proposing different zirconia–alumina composites for use in hip, knee, shoulder joint replacements, while several innovative devices are under study and new classes of materials are under development.

In dentistry, bioceramic composites allow for the innovative design of dental implants as well as restorations.

Moreover, bioceramic composites are intensively investigated for purposes of bone regeneration. Particular emphasis is given to calcium phosphates and silicates, as well as to doping with bioactive ions, aiming to enhance osteogenic ability and bioresorbability. On the other hand, hybrid biopolymer/ceramic materials mimicking the complex composition and multiscale structure of bone tissue are a new class of biomimetic materials that are very promising in regenerative medicine. New approaches enabling the preparation of porous injectable pastes and 3D scaffolds with high bioactivity, osteointegrative ability and mechanical properties are under development.

This Special Issue addressing the state-of-the-art of bioceramic composites is intended to be a reference work for students and scholars in the field of biomaterials science. Last but not the least, it is intended to stimulate the interest of young and experienced researchers in making advances in this field through their work.

Mr. Corrado Piconi
Dr. Simone Sprio
Guest Editors

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Keywords

  • Bioceramics
  • Composites
  • Nanocomposites
  • Zirconia
  • Alumina
  • Calcium phosphates
  • Bioactivity
  • Bone regeneration
  • Osteointegration
  • Osteogenesis
  • Joint replacements
  • Dental implants
  • Bone scaffolds
  • Hybrid materials

Published Papers (11 papers)

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Editorial

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3 pages, 185 KiB  
Editorial
Editorial for the Special Issue on Bioceramic Composites
by Corrado Piconi and Simone Sprio
J. Compos. Sci. 2022, 6(3), 65; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs6030065 - 22 Feb 2022
Cited by 1 | Viewed by 1482
Abstract
This Special Issue on bioceramic composites and its published papers, addressing a number of current topics from industry and academia, are intended to be a reference for students and scholars in the field of biomaterials science, giving an insight into challenges and research [...] Read more.
This Special Issue on bioceramic composites and its published papers, addressing a number of current topics from industry and academia, are intended to be a reference for students and scholars in the field of biomaterials science, giving an insight into challenges and research topics in the field bioceramic composites [...] Full article
(This article belongs to the Special Issue Bioceramic Composites)

Research

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11 pages, 5402 KiB  
Article
Outcomes of Ceramic Composite in Total Hip Replacement Bearings: A Single-Center Series
by Giuseppe Solarino, Antonio Spinarelli, Antonio Virgilio, Filippo Simone, Marco Baglioni and Biagio Moretti
J. Compos. Sci. 2021, 5(12), 320; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5120320 - 08 Dec 2021
Cited by 3 | Viewed by 2732
Abstract
Despite the fact that total hip replacement is one of the most successful surgical procedures for treatment of a variety of end-stage hip diseases, the process of osteolysis and implant loosening remains a significant problem, especially in young and high-demand patients. More than [...] Read more.
Despite the fact that total hip replacement is one of the most successful surgical procedures for treatment of a variety of end-stage hip diseases, the process of osteolysis and implant loosening remains a significant problem, especially in young and high-demand patients. More than 40 years ago, ceramic bearings were introduced due to their mechanical advantage in order to obtain a reduction in wear debris, and due to the conviction that it was possible to minimize friction and wear owing to their mechanical hardness, high chemical stability, surface lubrication by fluids and low friction coefficient. Together with excellent mechanical properties, ceramics have a biological inertness: eventual ceramic debris will lead to a reactive response with a high predominance of fibrocystic cells, rather than macrophagic cells, and absence of giant cells, which is ideal from a biological perspective. As a consequence, they will not trigger the granulomatous reaction necessary to induce periprosthetic osteolysis, and this clearly appears to be of great clinical relevance. In recent years, tribology in manufacturing ceramic components has progressed with significant improvements, owing to the development of the latest generation of ceramic composites that allow for an increased material density and reduced grain size. Currently, ceramic-on-ceramic bearings are considered the attractive counterparts of ceramic- or metal-on-polyethylene ones for patients with a long life expectancy. The aim of this paper is to report the results of total hip replacements performed with a ceramic-on-ceramic articulation made from a ceramic composite in a single center, focusing on its usefulness in specific preoperative diagnosis. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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26 pages, 13542 KiB  
Article
Mechanically Stable β-TCP Structural Hybrid Scaffolds for Potential Bone Replacement
by Matthias Ahlhelm, Sergio H. Latorre, Hermann O. Mayr, Christiane Storch, Christian Freytag, David Werner, Eric Schwarzer-Fischer and Michael Seidenstücker
J. Compos. Sci. 2021, 5(10), 281; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5100281 - 17 Oct 2021
Cited by 14 | Viewed by 2346
Abstract
The authors report on the manufacturing of mechanically stable β-tricalcium phosphate (β-TCP) structural hybrid scaffolds via the combination of additive manufacturing (CerAM VPP) and Freeze Foaming for engineering a potential bone replacement. In the first step, load bearing support structures were designed via [...] Read more.
The authors report on the manufacturing of mechanically stable β-tricalcium phosphate (β-TCP) structural hybrid scaffolds via the combination of additive manufacturing (CerAM VPP) and Freeze Foaming for engineering a potential bone replacement. In the first step, load bearing support structures were designed via FE simulation and 3D printed by CerAM VPP. In the second step, structures were foamed-in with a porous and degradable calcium phosphate (CaP) ceramic that mimics porous spongiosa. For this purpose, Fraunhofer IKTS used a process known as Freeze Foaming, which allows the foaming of any powdery material and the foaming-in into near-net-shape structures. Using a joint heat treatment, both structural components fused to form a structural hybrid. This bone construct had a 25-fold increased compressive strength compared to the pure CaP Freeze Foam and excellent biocompatibility with human osteoblastic MG-63 cells when compared to a bone grafting Curasan material for benchmark. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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15 pages, 3732 KiB  
Article
Is Surface Metastability of Today’s Ceramic Bearings a Clinical Issue?
by Alessandro Alan Porporati, Laurent Gremillard, Jérôme Chevalier, Rocco Pitto and Marco Deluca
J. Compos. Sci. 2021, 5(10), 273; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5100273 - 14 Oct 2021
Cited by 4 | Viewed by 1485
Abstract
Recent studies on zirconia-toughened alumina (ZTA) evidenced that in vivo aged implants display a much higher monoclinic zirconia content than expected from in vitro simulations by autoclaving. At the moment, there is no agreement on the source of this discrepancy: Some research groups [...] Read more.
Recent studies on zirconia-toughened alumina (ZTA) evidenced that in vivo aged implants display a much higher monoclinic zirconia content than expected from in vitro simulations by autoclaving. At the moment, there is no agreement on the source of this discrepancy: Some research groups ascribe it to the effect of mechanical impact shocks, which are generally not implemented in standard in vitro aging or hip walking simulators. Others invoke the effect of metal transfer, which should trigger an autocatalytic reaction in the body fluid environment, accelerating the kinetics of tetragonal-to-monoclinic transformation in vivo. Extrapolations of the aging kinetics from high (autoclave) to in vivo temperature are also often disputed. Last, Raman spectroscopy is by far the preferred method to quantify the amount of monoclinically transformed zirconia. There are, however, many sources of errors that may negatively affect Raman results, meaning that the final interpretation might be flawed. In this work, we applied Raman spectroscopy to determine the monoclinic content in as-received and in vitro aged ZTA hip joint implants, and in one long-term retrieval study. We calculated the monoclinic content with the most used equations in the literature and compared it with the results of X-ray diffraction obtained on a similar probe depth. Our results show, contrary to many previous studies, that the long-term surface stability of ZTA ceramics is preserved. This suggests that the Raman technique does not offer consistent and unique results for the analysis of surface degradation. Moreover, we discuss here that tetragonal-to-monoclinic transformation is also necessary to limit contact damage and wear stripe extension. Thus, the surface metastability of zirconia-containing ceramics may be a non-issue. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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15 pages, 9717 KiB  
Article
New Perspectives on Zirconia Composites as Biomaterials
by Giuseppe Magnani, Paride Fabbri, Enrico Leoni, Elena Salernitano and Francesca Mazzanti
J. Compos. Sci. 2021, 5(9), 244; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5090244 - 11 Sep 2021
Cited by 12 | Viewed by 2823
Abstract
Zirconia–alumina composites couple the high toughness of zirconia with the peculiar properties of alumina, i.e., hardness, wear, and chemical resistance, so they are considered promising materials for orthopedic and dental implants. The design of high performance zirconia composites needs to consider different aspects, [...] Read more.
Zirconia–alumina composites couple the high toughness of zirconia with the peculiar properties of alumina, i.e., hardness, wear, and chemical resistance, so they are considered promising materials for orthopedic and dental implants. The design of high performance zirconia composites needs to consider different aspects, such as the type and amount of stabilizer and the sintering process, that affect the mechanics of toughening and, hence, the mechanical properties. In this study, several stabilizers (Y2O3, CuO, Ta2O5, and CeO2) were tested together with different sintering processes to analyze the in situ toughening mechanism induced by the tetragonal–monoclinic (t–m) transformation of zirconia. One of the most important outcomes is the comprehension of the opposite effect played by the grain size and the tetragonality of the zirconia lattice on mechanical properties, such as fracture toughness and bending strength. These results allow for the design of materials with customized properties and open new perspectives for the development of high-performance zirconia composites for orthopedic implants with high hydrothermal resistance. Moreover, a near-net shape forming process based on the additive manufacturing technology of digital light processing (DLP) was also studied to produce ceramic dental implants with a new type of resin–ceramic powder mixture. This represents a new frontier in the development of zirconia composites thanks to the possibility to obtain a customized component with limited consumption of material and reduced machining costs. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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22 pages, 7600 KiB  
Article
Materials and Manufacturing Techniques for Polymeric and Ceramic Scaffolds Used in Implant Dentistry
by Mutlu Özcan, Dachamir Hotza, Márcio Celso Fredel, Ariadne Cruz and Claudia Angela Maziero Volpato
J. Compos. Sci. 2021, 5(3), 78; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5030078 - 11 Mar 2021
Cited by 26 | Viewed by 5265
Abstract
Preventive and regenerative techniques have been suggested to minimize the aesthetic and functional effects caused by intraoral bone defects, enabling the installation of dental implants. Among them, porous three-dimensional structures (scaffolds) composed mainly of bioabsorbable ceramics, such as hydroxyapatite (HAp) and β-tricalcium phosphate [...] Read more.
Preventive and regenerative techniques have been suggested to minimize the aesthetic and functional effects caused by intraoral bone defects, enabling the installation of dental implants. Among them, porous three-dimensional structures (scaffolds) composed mainly of bioabsorbable ceramics, such as hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP) stand out for reducing the use of autogenous, homogeneous, and xenogenous bone grafts and their unwanted effects. In order to stimulate bone formation, biodegradable polymers such as cellulose, collagen, glycosaminoglycans, polylactic acid (PLA), polyvinyl alcohol (PVA), poly-ε-caprolactone (PCL), polyglycolic acid (PGA), polyhydroxylbutyrate (PHB), polypropylenofumarate (PPF), polylactic-co-glycolic acid (PLGA), and poly L-co-D, L lactic acid (PLDLA) have also been studied. More recently, hybrid scaffolds can combine the tunable macro/microporosity and osteoinductive properties of ceramic materials with the chemical/physical properties of biodegradable polymers. Various methods are suggested for the manufacture of scaffolds with adequate porosity, such as conventional and additive manufacturing techniques and, more recently, 3D and 4D printing. The purpose of this manuscript is to review features concerning biomaterials, scaffolds macro and microstructure, fabrication techniques, as well as the potential interaction of the scaffolds with the human body. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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Review

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31 pages, 16898 KiB  
Review
Alumina, Zirconia and Their Composite Ceramics with Properties Tailored for Medical Applications
by Wolfgang Burger and Gundula Kiefer
J. Compos. Sci. 2021, 5(11), 306; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5110306 - 22 Nov 2021
Cited by 7 | Viewed by 3896
Abstract
Although in 1977 the first ceramic composite material had been introduced into the market, it was a long time before composite materials were qualified for medical applications. For a long period high purity alumina ceramics have been used as ball-heads and cups. Because [...] Read more.
Although in 1977 the first ceramic composite material had been introduced into the market, it was a long time before composite materials were qualified for medical applications. For a long period high purity alumina ceramics have been used as ball-heads and cups. Because of their brittleness, in 1986 yttria stabilized zirconia has been introduced into this application, because of higher strength and fracture toughness. However, due to its hydrothermal instability this material disappeared in orthopaedic applications in 2000. Meanwhile a composite materials based on an alumina matrix with dispersed metastable tetragonal zirconia particles and in-situ formed hexagonal platelets became the standard material for ceramic ball-heads, because of their excellent mechanical strength, hardness and improved fracture toughness. Especially fracture toughness can be improved further by special material formulations and tailored microstructure. It has been shown that a mixed stabilisation of zirconia by yttria and ceria with dispersed alumina and hexagonal platelets overcomes the hydrothermal instability and excellent materials properties can be achieved. Such materials do have big potential to be used in dental applications. Furthermore, these materials also can be seen as a new generation for ball-heads, because of their enhanced fracture toughness. All materials are described within these articles. In order to achieve the required properties of the materials, special raw materials are required. Therefore, it is quite important to understand and know the raw material manufacturing procedures. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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24 pages, 2953 KiB  
Review
Calcium-Based Biomineralization: A Smart Approach for the Design of Novel Multifunctional Hybrid Materials
by Elisabetta Campodoni, Margherita Montanari, Chiara Artusi, Giada Bassi, Franco Furlani, Monica Montesi, Silvia Panseri, Monica Sandri and Anna Tampieri
J. Compos. Sci. 2021, 5(10), 278; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5100278 - 15 Oct 2021
Cited by 10 | Viewed by 2853
Abstract
Biomineralization consists of a complex cascade of phenomena generating hybrid nano-structured materials based on organic (e.g., polymer) and inorganic (e.g., hydroxyapatite) components. Biomineralization is a biomimetic process useful to produce highly biomimetic and biocompatible materials resembling natural hard tissues such as bones and [...] Read more.
Biomineralization consists of a complex cascade of phenomena generating hybrid nano-structured materials based on organic (e.g., polymer) and inorganic (e.g., hydroxyapatite) components. Biomineralization is a biomimetic process useful to produce highly biomimetic and biocompatible materials resembling natural hard tissues such as bones and teeth. In detail, biomimetic materials, composed of hydroxyapatite nanoparticles (HA) nucleated on an organic matrix, show extremely versatile chemical compositions and physical properties, which can be controlled to address specific challenges. Indeed, different parameters, including (i) the partial substitution of mimetic doping ions within the HA lattice, (ii) the use of different organic matrices, and (iii) the choice of cross-linking processes, can be finely tuned. In the present review, we mainly focused on calcium biomineralization. Besides regenerative medicine, these multifunctional materials have been largely exploited for other applications including 3D printable materials and in vitro three-dimensional (3D) models for cancer studies and for drug testing. Additionally, biomineralized multifunctional nano-particles can be involved in applications ranging from nanomedicine as fully bioresorbable drug delivery systems to the development of innovative and eco-sustainable UV physical filters for skin protection from solar radiations. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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23 pages, 1556 KiB  
Review
Toughening of Bioceramic Composites for Bone Regeneration
by Zahid Abbas, Massimiliano Dapporto, Anna Tampieri and Simone Sprio
J. Compos. Sci. 2021, 5(10), 259; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5100259 - 29 Sep 2021
Cited by 20 | Viewed by 5747
Abstract
Bioceramics are widely considered as elective materials for the regeneration of bone tissue, due to their compositional mimicry with bone inorganic components. However, they are intrinsically brittle, which limits their capability to sustain multiple biomechanical loads, especially in the case of load-bearing bone [...] Read more.
Bioceramics are widely considered as elective materials for the regeneration of bone tissue, due to their compositional mimicry with bone inorganic components. However, they are intrinsically brittle, which limits their capability to sustain multiple biomechanical loads, especially in the case of load-bearing bone districts. In the last decades, intense research has been dedicated to combining processes to enhance both the strength and toughness of bioceramics, leading to bioceramic composite scaffolds. This review summarizes the recent approaches to this purpose, particularly those addressed to limiting the propagation of cracks to prevent the sudden mechanical failure of bioceramic composites. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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27 pages, 4310 KiB  
Review
Bioactive Calcium Phosphate-Based Composites for Bone Regeneration
by Marta Tavoni, Massimiliano Dapporto, Anna Tampieri and Simone Sprio
J. Compos. Sci. 2021, 5(9), 227; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5090227 - 27 Aug 2021
Cited by 48 | Viewed by 5571
Abstract
Calcium phosphates (CaPs) are widely accepted biomaterials able to promote the regeneration of bone tissue. However, the regeneration of critical-sized bone defects has been considered challenging, and the development of bioceramics exhibiting enhanced bioactivity, bioresorbability and mechanical performance is highly demanded. In this [...] Read more.
Calcium phosphates (CaPs) are widely accepted biomaterials able to promote the regeneration of bone tissue. However, the regeneration of critical-sized bone defects has been considered challenging, and the development of bioceramics exhibiting enhanced bioactivity, bioresorbability and mechanical performance is highly demanded. In this respect, the tuning of their chemical composition, crystal size and morphology have been the matter of intense research in the last decades, including the preparation of composites. The development of effective bioceramic composite scaffolds relies on effective manufacturing techniques able to control the final multi-scale porosity of the devices, relevant to ensure osteointegration and bio-competent mechanical performance. In this context, the present work provides an overview about the reported strategies to develop and optimize bioceramics, while also highlighting future perspectives in the development of bioactive ceramic composites for bone tissue regeneration. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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13 pages, 1657 KiB  
Review
Oxide Bioceramic Composites in Orthopedics and Dentistry
by Corrado Piconi and Simone Sprio
J. Compos. Sci. 2021, 5(8), 206; https://0-doi-org.brum.beds.ac.uk/10.3390/jcs5080206 - 03 Aug 2021
Cited by 21 | Viewed by 3365
Abstract
Ceramic composites based on alumina and zirconia have found a wide field of application in the present century in orthopedic joint replacements, and their use in dentistry is spreading. The development of this class of bioceramic composites was started in the 1980s, but [...] Read more.
Ceramic composites based on alumina and zirconia have found a wide field of application in the present century in orthopedic joint replacements, and their use in dentistry is spreading. The development of this class of bioceramic composites was started in the 1980s, but the first clinical applications of the total hip replacement joint were introduced in the market only in the early 2000s. Since then, several composite systems were introduced in joint replacements. These materials are classified as Zirconia-Toughened Alumina if alumina is the main component or as Alumina-Toughened Zirconia when zirconia is the main component. In addition, some of them may contain a third phase based on strontium exa-aluminate. The flexibility in device design due to the excellent mechanical behavior of this class of bioceramics results in a number of innovative devices for joint replacements in the hip, the knee, and the shoulder, as well in dental implants. This paper gives an overview of the different materials available and on orthopedic and dental devices made out of oxide bioceramic composites today on the market or under development. Full article
(This article belongs to the Special Issue Bioceramic Composites)
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