A Biomaterial can be natural or artificial material that encompasses entire or

part of a living structure or biomedical device which performs, supplements, or

substitutes a natural process. Biomaterials can be defined as inorganic or
organic materials that are biocompatible and can be fixed in the human body to
substitute or repair deteriorating tissue. Biomaterials may be polymers, metals,
or ceramics. Biomaterials must be well-matched with the body so that the body
does not refuse them. Conversely, in some cases, biomaterials like organ
transplants may cause rejection, which can be tackled with anti-rejection drugs.
Overall, Biomaterials are materials that can act as a whole or part of a device
to treat help, repair, or replace any tissue, organ, or function of the body. The
Society for Biomaterials is a professional society which promotes development
in all stages of materials research and development by support of helpful
educational programs, medical applications, and professional standards in the
biomaterials field.

What are biomaterials?

1.1. Introduction to biomaterials
Biomaterials are commonly characterized as materials used to construct artificial organs,
rehabilitation devices, or implants to replace natural body tissues. More specific, biomaterials
are materials that are used in close or direct contact with the body to augment or replace
faulty materials.In general biomaterials can be classified into living or once living materials,
which fit into the division of for example tissue engineering, and materials that are of a
synthetic origin [1]. Such biomaterials can be defined as inorganic or organic materials that
are biocompatible and can be implanted in the human body to replace or repair failing tissue.
The concept extends to the materials used in drugdelivery systems, biosensors or devices
operating outside the body but in communication with it for example artificial heart systems
[2]. In recent years, progress in many different fields has paved the way to creating nnovative
biomaterials to improve existing treatments and develop new ones for a higher quality of life.
In 1986 the European Society for Biomaterials compiled a set of Definitions in
biomaterials. Some

definitions for biomaterials and most important terms in the field are listed in Table 1.
Especially materials known from the field of implantology that are used for the fixation or the
replacement of diseased hard tissue have run through numerous inventions. Particularly, as
this class
of biomaterials includes certain materials systems such as metals, ceramics and polymers,
which are
used for example in reconstructing bones, joints or for teeth replacement, the diversity of
inventions
and modifications on bulk as well as surface properties, has reached an enormous quantity.
To successfully apply implants in the human body, an adequate level of tolerance of the
material
used with the living organism is required, in other words a high grade of biocompatibility [1].
Biocompatibility has been defined as the ability of a material to perform with an appropriate
host
response in a specific application [3,4]. This means that the material or any leachable
products from it
do not cause cell death, chronic inflammation or other impairment of cellular or tissue
functions. Implants
not only have to be biosafe and biostable in terms of cytotoxicity and degradation, they also
have to match with the biological requirements of any structural biocompatibility. In other
words,
shape, inner structure and design of an implant need to be adapted to the characteristics of the
tissue
to be replaced [5]. Besides these bulk requirements, the biocompatibility of surfaces plays a
crucial
role as the surface is directly exposed to the living organism. Therefore it is necessary to
tailor exposed
surfaces in view of their chemical, physical, biological and morphological features [5]. Goal
of implant
Table 1
Definitions for Biomaterials [3,5].
Biomaterial A non-viable material, used in a medical device, intended to interact with
biological systems
Implant Any medical device made from one or more materials that is intentionally placed
within the body,
either totally or partially buried beneath an epithelial surface
Prosthesis A device that replaces a limb, organ or tissue of the body
Artificial organ A medical device that replaces, in part or in whole, the function of one of the
organs of the body
Table 2
Classification of interactions of implants with hard tissue [5,7].
Incompatible Release of substances in toxic concentrations that lead to inharmonious effects
with the living organism
that may result in a rejection of the implant
Biotolerant Release of substances but not in toxic concentrations that may lead to an
encapsulation within connective
tissue
Bioinert No release of toxic substances
Bioactive Positive interaction with differentiation of tissue that leads to a close adhesion and
interconnection along

the interface of implant and tissue

S. Bauer et al. / Progress in Materials Science 58 (2013) 261326 263
surface engineering is not only to fit the demands of avoiding negative effects of implanted
materials
on the surrounding tissue but even more to enhance the interplay between the designed
technical
material and the living matter [6]. Possible interactions of implants with hard tissue are listed
below
(Table 2 [5,7]).
In best case the physical and chemical properties of the chosen implant material should be in
accord
with the replaced tissue. One of the most challenging tasks is that living tissue has the ability
to
renew itself continuously, whereas implant materials typically lack this ability [5]. To reach a
maximum
in implant success it is necessary to combine the synergistic effects of various biomedical
material
systems.

Requirements of a biomaterial
The design and selection of biomaterials depend on the intended medical application. Development of new biomaterials is
an interdisciplinary effort and it often requires a collaborative effort between material scientists and engineers, biomedical
engineers, pathologists and clinicians. In order to serve for longer period without rejection an implant should possess the
following attributes:
2.1. Mechanical properties
The mechanical properties decide the type of material that will be selected for a specific appli-cation. Some of the properties
that are of prime importance are hardness, tensile strength, modulus and elongation. The response of the material to the
repeated cyclic loads or strains is determined by the fatigue strength of the material and this property determines the long-term
success of the implant subjected to cyclic loading. If an implant fractures due to inadequate strength or mismatch in mechanical
property between the bone and implant, then this is referred to as biomechanical incompatibility. The material replaced for bone
is expected to have a modulus equivalent to that of bone. The bone modulus varies in the magnitude from 4 to 30 Gpa
depending on the type of the bone and the direction of measurement [10,11]. The current implant materials which have higher
stiffness than bone, prevent the needed stress being transferred to adjacent bone, resulting in bone resorption around the
implant and consequently to implant loosening. This biomechanical incompatibility that leads to death of bone cells is called as
stress shielding effect [12]. Thus a material with excellent combination of high strength and low modulus closer to bone has
to be used for implantation to avoid loosening of implants and higher service period to avoid revision surgery.

The first biomaterials used were gold and ivory for replacements of cranial defects. This was
done by Egyptians and Romans. Biological materials such as placenta was used since the
1900s. Celluloid was the first man-made plastic used for cranial defects a polymethyl
methacrylate (PMMA) was one of the first polymers accepted since World War II.
A biomaterial is essentially a material that is used and adapted for a medical application.
Biomaterials can have a benign function, such as being used for a heart valve, or may be
bioactive; used for a more interactive purpose such as hydroxyapatite coated hip implants
(the Furlong Hip, by Joint Replacement Instrumentation Ltd, Sheffield is one such example
such implants are lasting upwards of twenty years). Biomaterials are also used every day in
dental applications, surgery, and drug delivery .While a definition for the term 'biomaterial'
has been difficult to formulate, more widely accepted working definitions include: "A
biomaterial is any material, natural or manmade, that comprises whole or part of a living
structure or biomedical device which performs, augments, or replaces a natural function".