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Du X, Zhou Y, Schümperlin D, Laganenka L, Lee SS, Blugan G, Hardt WD, Persson C, Ferguson SJ. Fabrication and characterization of sodium alginate-silicon nitride-PVA composite biomaterials with damping properties. J Mech Behav Biomed Mater 2024; 155:106579. [PMID: 38749266 DOI: 10.1016/j.jmbbm.2024.106579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/22/2024] [Accepted: 05/08/2024] [Indexed: 05/28/2024]
Abstract
Silicon nitride is utilized clinically as a bioceramic for spinal fusion cages, owing to its high strength, osteoconductivity, and antibacterial effects. Nevertheless, silicon nitride exhibits suboptimal damping properties, a critical factor in mitigating traumatic bone injuries and fractures. In fact, there is a scarcity of spinal implants that simultaneously demonstrate proficient damping performance and support osteogenesis. In our study, we fabricated a novel sodium alginate-silicon nitride/poly(vinyl alcohol) (SA-SiN/PVA) composite scaffold, enabling enhanced energy absorption and rapid elastic recovery under quasi-static and impact loading scenarios. Furthermore, the study demonstrated that the incorporation of physical and chemical cross-linking significantly improved stiffness and recoverable energy dissipation. Concerning the interaction between cells and materials, our findings suggest that the addition of silicon nitride stimulated osteogenic differentiation while inhibiting Staphylococcus aureus growth. Collectively, the amalgamation of ceramics and tough hydrogels facilitates the development of advanced composites for spinal implants, manifesting superior damping, osteogenic potential, and antibacterial properties. This approach holds broader implications for applications in bone tissue engineering.
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Affiliation(s)
- Xiaoyu Du
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
| | - Yijun Zhou
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden
| | | | - Leanid Laganenka
- Institute of Microbiology, Department of Biology, ETH Zurich, Zurich, Switzerland
| | - Seunghun S Lee
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, Dongguk University-Seoul, Seoul, South Korea
| | - Gurdial Blugan
- Laboratory for High Performance Ceramics, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dubendorf, Switzerland
| | - Wolf-Dietrich Hardt
- Institute of Microbiology, Department of Biology, ETH Zurich, Zurich, Switzerland
| | - Cecilia Persson
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden
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2
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He J, Liu Y, Zeng X, Tong Y, Liu R, Wang K, Shangguan X, Qiu G, Sipaut CS. Silicon Nitride Bioceramics Sintered by Microwave Exhibit Excellent Mechanical Properties, Cytocompatibility In Vitro, and Anti-Bacterial Properties. J Funct Biomater 2023; 14:552. [PMID: 37998121 PMCID: PMC10671902 DOI: 10.3390/jfb14110552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
Silicon nitride is a bioceramic with great potential, and multiple studies have demonstrated its biocompatibility and antibacterial properties. In this study, silicon nitride was prepared by a microwave sintering technique that was different from common production methods. SEM and pore distribution analysis revealed the microstructure of microwave-sintered silicon nitride with obvious pores. Mechanical performance analysis shows that microwave sintering can improve the mechanical properties of silicon nitride. The CCK-8 method was used to demonstrate that microwave-sintered silicon nitride has no cytotoxicity and good cytocompatibility. From SEM and CLSM observations, it was observed that there was good adhesion and cross-linking of cells during microwave-sintered silicon nitride, and the morphology of the cytoskeleton was good. Microwave-sintered silicon nitride has been proven to be non-cytotoxic. In addition, the antibacterial ability of microwave-sintered silicon nitride against Staphylococcus aureus and Escherichia coli was tested, proving that it has a good antibacterial ability similar to the silicon nitride prepared by commonly used processes. Compared with silicon nitride prepared by gas pressure sintering technology, microwave-sintered silicon nitride has excellent performance in mechanical properties, cell compatibility, and antibacterial properties. This indicates its enormous potential as a substitute material for manufacturing bone implants.
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Affiliation(s)
- Jiayu He
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Yuandong Liu
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Xiaofeng Zeng
- Hengyang Kaixin Special Material Technology Co., Ltd., Hengyang 421200, China;
- Faculty of Engineering, University Malaysia Sabah, Kota Kinabalu 88400, Malaysia;
| | - Yan Tong
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Run Liu
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Kan Wang
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Xiangdong Shangguan
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
| | - Guanzhou Qiu
- Key Laboratory of Biohydrometallurgy of Ministry of Education, School of Minerals Processing and Bioengineering, Central South University, Changsha 410083, China; (J.H.); (Y.T.); (R.L.); (K.W.); (X.S.); (G.Q.)
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3
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Lommen J, Schorn L, Sproll C, Kerkfeld V, Aksu A, Reinauer F, Kübler NR, Budach W, Rana M, Tamaskovics B. Metallic Artifact Reduction in Midfacial CT Scans Using Patient-Specific Polymer Implants Enhances Image Quality. J Pers Med 2023; 13:jpm13020236. [PMID: 36836470 PMCID: PMC9958634 DOI: 10.3390/jpm13020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
Midfacial reconstruction after tumor resection surgery is commonly conducted by using autologous bone grafts or alloplastic implants. Titanium is the most frequently used osteosynthesis material in these cases but causes disturbing metallic artifacts in CT imaging. The purpose of this experimental study was to evaluate whether the use of midfacial polymer implants reduces metallic artifacts in CT imaging to improve image quality. Zygomatic titanium (n = 1) and polymer (n = 12) implants were successively implanted in a human skull specimen. Implants were analyzed for their effect on Hounsfield Unit values (streak artifacts) and virtual growth in CT images (blooming artifacts) as well as image quality. Multi-factorial ANOVA and Bonferroni's post hoc test were used. Titanium (173.7 HU; SD ± 5.1) and hydroxyapatite containing polymers (155.3 HU; SD ± 5.9) were associated with significantly more streak artifacts compared to all other polymer materials. There was no significant difference in blooming artifacts between materials. The metallic artifact reduction algorithm showed no significant difference. Image quality was slightly better for polymer implants compared to titanium. Personalized polymer implants for midfacial reconstruction significantly reduce metallic artifacts in CT imaging which improves image quality. Hence, postoperative radiation therapy planning and radiological tumor aftercare around the implants are facilitated.
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Affiliation(s)
- Julian Lommen
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Lara Schorn
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Correspondence: ; Tel.: +49-21-1811-8189
| | - Christoph Sproll
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Valentin Kerkfeld
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Adem Aksu
- Karl Leibinger Medizintechnik GmbH & Co. KG, Kolbinger Str. 10, 78570 Mühlheim, Germany
| | - Frank Reinauer
- Karl Leibinger Medizintechnik GmbH & Co. KG, Kolbinger Str. 10, 78570 Mühlheim, Germany
| | - Norbert R. Kübler
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Majeed Rana
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Bálint Tamaskovics
- Department of Radiation Oncology, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
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Bioactive Silicon Nitride Implant Surfaces with Maintained Antibacterial Properties. J Funct Biomater 2022; 13:jfb13030129. [PMID: 36135564 PMCID: PMC9500919 DOI: 10.3390/jfb13030129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Silicon nitride (Si3N4) is a promising biomaterial, currently used in spinal fusion implants. Such implants should result in high vertebral union rates without major complications. However, pseudarthrosis remains an important complication that could lead to a need for implant replacement. Making silicon nitride implants more bioactive could lead to higher fusion rates, and reduce the incidence of pseudarthrosis. In this study, it was hypothesized that creating a highly negatively charged Si3N4 surface would enhance its bioactivity without affecting the antibacterial nature of the material. To this end, samples were thermally, chemically, and thermochemically treated. Apatite formation was examined for a 21-day immersion period as an in-vitro estimate of bioactivity. Staphylococcus aureus bacteria were inoculated on the surface of the samples, and their viability was investigated. It was found that the thermochemically and chemically treated samples exhibited enhanced bioactivity, as demonstrated by the increased spontaneous formation of apatite on their surface. All modified samples showed a reduction in the bacterial population; however, no statistically significant differences were noticed between groups. This study successfully demonstrated a simple method to improve the in vitro bioactivity of Si3N4 implants while maintaining the bacteriostatic properties.
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5
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Du X, Lee SS, Blugan G, Ferguson SJ. Silicon Nitride as a Biomedical Material: An Overview. Int J Mol Sci 2022; 23:ijms23126551. [PMID: 35742996 PMCID: PMC9224221 DOI: 10.3390/ijms23126551] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023] Open
Abstract
Silicon nitride possesses a variety of excellent properties that can be specifically designed and manufactured for different medical applications. On the one hand, silicon nitride is known to have good mechanical properties, such as high strength and fracture toughness. On the other hand, the uniqueness of the osteogenic/antibacterial dualism of silicon nitride makes it a favorable bioceramic for implants. The surface of silicon nitride can simultaneously inhibit the proliferation of bacteria while supporting the physiological activities of eukaryotic cells and promoting the healing of bone tissue. There are hardly any biomaterials that possess all these properties concurrently. Although silicon nitride has been intensively studied as a biomedical material for years, there is a paucity of comprehensive data on its properties and medical applications. To provide a comprehensive understanding of this potential cornerstone material of the medical field, this review presents scientific and technical data on silicon nitride, including its mechanical properties, osteogenic behavior, and antibacterial capabilities. In addition, this paper highlights the current and potential medical use of silicon nitride and explains the bottlenecks that need to be addressed, as well as possible solutions.
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Affiliation(s)
- Xiaoyu Du
- Institute for Biomechanics, ETH Zurich, 8093 Zurich, Switzerland; (S.S.L.); (S.J.F.)
- Correspondence:
| | - Seunghun S. Lee
- Institute for Biomechanics, ETH Zurich, 8093 Zurich, Switzerland; (S.S.L.); (S.J.F.)
| | - Gurdial Blugan
- Laboratory for High Performance Ceramics, Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland;
| | - Stephen J. Ferguson
- Institute for Biomechanics, ETH Zurich, 8093 Zurich, Switzerland; (S.S.L.); (S.J.F.)
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6
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Lommen J, Schorn L, Sproll C, Haussmann J, Kübler NR, Budach W, Rana M, Tamaskovics B. Reduction of CT artifacts using polyetheretherketone (PEEK), polyetherketoneketone (PEKK), polyphenylsulfone (PPSU) and polyethylene (PE) reconstruction plates in oral oncology. J Oral Maxillofac Surg 2022; 80:1272-1283. [DOI: 10.1016/j.joms.2022.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/06/2022] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
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Mu J, Zhang L, Zhang C, Xu E, Wang L, Liu X, Chang G, Sun X, Ma C, Yuan H, Zhao F, Gao J. Improved sintering performance of β-SiAlON-Si 3N 4 and its osteogenic differentiation ability by adding β-SiAlON. J Biomater Appl 2022; 36:1652-1663. [PMID: 35139673 DOI: 10.1177/08853282211054323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To improve the sintering performance of silicon nitride bioceramics, we explored the effect of β-SiAlON's Z-value on the physical, chemical, and biological properties of β-SiAlON-Si3N4 composites. Results showed that the phase product was β-Si3N4. As the Z-value increased, the X-ray diffraction peaks gradually shifted to a smaller angle, the material grains were more tightly packed, and the bulk density and compressive strength increased, reaching the highest values (2.71 g/cm3 and 1157 MPa, respectively) at Z = 4. Soaking and ion-release experiments show that in an aqueous environment, a small amount of Al and Si ions were released, and no obvious decomposition occurred on the surface of the material. The biological performance showed that the growth of cultured cells in each group was in good condition, there was no obvious difference in morphology and adhesion, and the materials had good biological performance. An increase in the Z-value promotes the formation of mineralized nodules and osteogenic differentiation of MC3T3-E1 cells, which may be because the release of Si can promote osteogenic differentiation. Therefore, the addition of β-SiAlON could improve the sintering performance of β-Si3N4 without degrading its biological properties. The prepared β-SiAlON-Si3N4 composite ceramic is a latent bioceramic material.
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Affiliation(s)
- Jinghua Mu
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Liguo Zhang
- Hena Institute of Medical and Pharmaceutical Science, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China.,BGI College, Zhengzhou University, Zhengzhou 450007, China
| | - Can Zhang
- Hena Institute of Medical and Pharmaceutical Science, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China.,BGI College, Zhengzhou University, Zhengzhou 450007, China
| | - Enxia Xu
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Lulu Wang
- BGI College, Zhengzhou University, Zhengzhou 450007, China
| | - Xinhong Liu
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Guanglei Chang
- BGI College, Zhengzhou University, Zhengzhou 450007, China
| | - Xu Sun
- Henan Cancer Hospital, Zhengzhou University, Zhengzhou, No. 127 Dongming Road, Zhengzhou 450008, China
| | - Chengliang Ma
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Huiyu Yuan
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Fei Zhao
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
| | - Jinxing Gao
- 12636School of Material Science and Engineering, Zhengzhou University, Zhengzhou, NO.100 Science Avenue, Zheng Zhou 450001, China.,Henan Key Laboratory of High Temperature Functional Ceramics, Zhengzhou University, 75 Daxue Road, Zhengzhou 450052, China
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Hnatko M, Hičák M, Labudová M, Galusková D, Sedláček J, Lenčéš Z, Šajgalík P. Bioactive silicon nitride by surface thermal treatment. Ann Ital Chir 2020. [DOI: 10.1016/j.jeurceramsoc.2019.12.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Gray ME, Meehan J, Blair EO, Ward C, Langdon SP, Morrison LR, Marland JRK, Tsiamis A, Kunkler IH, Murray A, Argyle D. Biocompatibility of common implantable sensor materials in a tumor xenograft model. J Biomed Mater Res B Appl Biomater 2019; 107:1620-1633. [PMID: 30367816 PMCID: PMC6767110 DOI: 10.1002/jbm.b.34254] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/30/2018] [Accepted: 09/09/2018] [Indexed: 12/22/2022]
Abstract
Real-time monitoring of tumor microenvironment parameters using an implanted biosensor could provide valuable information on the dynamic nature of a tumor's biology and its response to treatment. However, following implantation biosensors may lose functionality due to biofouling caused by the foreign body response (FBR). This study developed a novel tumor xenograft model to evaluate the potential of six biomaterials (silicon dioxide, silicon nitride, Parylene-C, Nafion, biocompatible EPOTEK epoxy resin, and platinum) to trigger a FBR when implanted into a solid tumor. Biomaterials were chosen based on their use in the construction of a novel biosensor, designed to measure spatial and temporal changes in intra-tumoral O2 , and pH. None of the biomaterials had any detrimental effect on tumor growth or body weight of the murine host. Immunohistochemistry showed no significant changes in tumor necrosis, hypoxic cell number, proliferation, apoptosis, immune cell infiltration, or collagen deposition. The absence of biofouling supports the use of these materials in biosensors; future investigations in preclinical cancer models are required, with a view to eventual applications in humans. To our knowledge this is the first documented investigation of the effects of modern biomaterials, used in the production of implantable sensors, on tumor tissue after implantation. © 2018 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1620-1633, 2019.
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Affiliation(s)
- Mark E. Gray
- The Royal (Dick) School of Veterinary Studies and Roslin InstituteUniversity of EdinburghEdinburghEH25 9RGUK
- Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghEH4 2XUUK
| | - James Meehan
- Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghEH4 2XUUK
- Institute of Sensors, Signals and Systems, School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| | - Ewen O. Blair
- School of Engineering, Faraday BuildingEdinburghEH9 3JLUK
| | - Carol Ward
- The Royal (Dick) School of Veterinary Studies and Roslin InstituteUniversity of EdinburghEdinburghEH25 9RGUK
- Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghEH4 2XUUK
| | - Simon P. Langdon
- Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghEH4 2XUUK
| | - Linda R. Morrison
- The Royal (Dick) School of Veterinary Studies and Roslin InstituteUniversity of EdinburghEdinburghEH25 9RGUK
| | | | | | - Ian H. Kunkler
- Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghEH4 2XUUK
| | - Alan Murray
- School of Engineering, Faraday BuildingEdinburghEH9 3JLUK
| | - David Argyle
- The Royal (Dick) School of Veterinary Studies and Roslin InstituteUniversity of EdinburghEdinburghEH25 9RGUK
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10
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Mobbs RJ, Rao PJ, Phan K, Hardcastle P, Choy WJ, McCartney ER, Druitt RK, Mouatt CAL, Sorrell CC. Anterior Lumbar Interbody Fusion Using Reaction Bonded Silicon Nitride Implants: Long-Term Case Series of the First Synthetic Anterior Lumbar Interbody Fusion Spacer Implanted in Humans. World Neurosurg 2018; 120:256-264. [PMID: 30205211 DOI: 10.1016/j.wneu.2018.08.237] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, a historical case series is reported of reaction bonded silicon nitride (Si3N4) implants for anterior lumbar interbody fusion (ALIF) for a patient population of 30 and surgery levels L3/4, L4/5, and/or L5/S1. Before the study, the only work on Si3N4 as a biomedical material was associated preliminary work, which involved animal trials using a rabbit model. The objective was to undertake the first use of Si3N4 as a biomedical material for humans, as an implant for ALIF. METHODS The Si3N4 implants were prepared by die-pressing silicon powder and reaction bonding in 95 N2/5 H2 at ∼1400°C for ∼50 hours. The surgeries involved a retroperitoneal approach for L3/4 and L4/5 levels and a transperitoneal approach for L5/S1 level. The patient follow-up involved assessment of radiologic fusion up to 30 years and clinical outcomes to 10 years. RESULTS The reaction bonded Si3N4 implants were found to be biologically safe and to show high fusion rates with minimal subsidence, no abnormal reaction, and no other complications. The primary outcome measure, visual analog scale back pain, improved from a preoperative mean of 8.4 (range, 6-10) to a mean of 3.7 (range, 0-9) at 5 years and a mean of 4.9 (range, 0-9) at 10 years. The Oswestry Disability Index improved from a preoperative mean of 48 (range, 26-84) to a mean of 35 (range, 4-76) at 10 years. CONCLUSIONS This study confirms that Si3N4 is biologically safe in the long-term, with capacity for excellent radiologic osseointegration.
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Affiliation(s)
- Ralph J Mobbs
- NeuroSpine Surgery Research Group (NSURG), Sydney, New South Wales, Australia; Prince of Wales Private Hospital, Sydney, New South Wales, Australia; University of New South Wales Sydney, Sydney, New South Wales, Australia.
| | - Prashanth J Rao
- NeuroSpine Surgery Research Group (NSURG), Sydney, New South Wales, Australia; Prince of Wales Private Hospital, Sydney, New South Wales, Australia; University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Kevin Phan
- NeuroSpine Surgery Research Group (NSURG), Sydney, New South Wales, Australia; Prince of Wales Private Hospital, Sydney, New South Wales, Australia; University of New South Wales Sydney, Sydney, New South Wales, Australia
| | | | - Wen Jie Choy
- NeuroSpine Surgery Research Group (NSURG), Sydney, New South Wales, Australia; University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Eric R McCartney
- University of New South Wales Sydney, Sydney, New South Wales, Australia; Deceased
| | - Ross K Druitt
- Sialon Ceramics Pty. Ltd., Doyalson North, New South Wales, Australia
| | - Christopher A L Mouatt
- Sialon Ceramics Pty. Ltd., Doyalson North, New South Wales, Australia; Currently BC&M Advisory Pty. Ltd., Lindfield, New South Wales, Australia
| | - Charles C Sorrell
- University of New South Wales Sydney, Sydney, New South Wales, Australia; School of Materials Science and Engineering, University of New South Wales Sydney, Sydney, New South Wales, Australia
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Hingsammer L, Grillenberger M, Schagerl M, Malek M, Hunger S. Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation. J Mech Behav Biomed Mater 2018; 77:34-39. [DOI: 10.1016/j.jmbbm.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
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12
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Ghalme S, Mankar A, Bhalerao Y. Integrated Taguchi-simulated annealing (SA) approach for analyzing wear behaviour of silicon nitride. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jart.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Ishikawa M, de Mesy Bentley KL, McEntire BJ, Bal BS, Schwarz EM, Xie C. Surface topography of silicon nitride affects antimicrobial and osseointegrative properties of tibial implants in a murine model. J Biomed Mater Res A 2017; 105:3413-3421. [PMID: 28865177 DOI: 10.1002/jbm.a.36189] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/10/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022]
Abstract
While silicon nitride (Si3 N4 ) is an antimicrobial and osseointegrative orthopaedic biomaterial, the contribution of surface topography to these properties is unknown. Using a methicillin-resistant strain of Staphylococcus aureus (MRSA), this study evaluated Si3 N4 implants in vitro utilizing scanning electron microscopy (SEM) with colony forming unit (CFU) assays, and later in an established in vivo murine tibia model of implant-associated osteomyelitis. In vitro, the "as-fired" Si3 N4 implants displayed significant reductions in adherent bacteria versus machined Si3 N4 (2.6 × 104 vs. 8.7 × 104 CFU, respectively; p < 0.0002). Moreover, SEM imaging demonstrated that MRSA cannot directly adhere to native as-fired Si3 N4 . Subsequently, a cross-sectional study was completed in which sterile or MRSA contaminated as-fired and machined Si3 N4 implants were inserted into the tibiae of 8-week old female Balb/c mice, and harvested on day 1, 3, 5, 7, 10, or 14 post-operatively for SEM. The findings demonstrated that the antimicrobial activity of the as-fired implants resulted from macrophage clearance of the bacteria during biofilm formation on day 1, followed by osseointegration through the apparent recruitment of mesenchymal stem cells on days 3-5, which differentiated into osteoblasts on days 7-14. In contrast, the antimicrobial behavior of the machined Si3 N4 was due to repulsion of the bacteria, a phenomenon that also limited osteogenesis, as host cells were also unable to adhere to the machined surface. Taken together, these results suggest that the in vivo biological behavior of Si3 N4 orthopaedic implants is driven by critical features of their surface nanotopography. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3413-3421, 2017.
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Affiliation(s)
- Masahiro Ishikawa
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Karen L de Mesy Bentley
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - B Sonny Bal
- Amedica Corporation, Salt Lake City, Utah, USA.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, USA
| | - Edward M Schwarz
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Chao Xie
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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14
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Badran Z, Struillou X, Hughes FJ, Soueidan A, Hoornaert A, Ide M. Silicon Nitride (Si3N4) Implants: The Future of Dental Implantology? J ORAL IMPLANTOL 2017; 43:240-244. [DOI: 10.1563/aaid-joi-d-16-00146] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
For decades titanium has been the preferred material for dental implant fabrication, with mechanical and biological performance resulting in high clinical success rates. These have been further enhanced by incremental development of surface modifications aimed at improving speed and degree of osseointegration and resulting in enhanced clinical treatment options and outcomes. However, increasing demand for metal-free dental restorations has also led to the development of ceramic-based dental implants, such as zirconia. In orthopedics, alternative biomaterials, such as polyetheretherketone or silicon nitride, have been used for implant applications. The latter is potentially of particular interest for oral use as it has been shown to have antibacterial properties. In this article we aim to shed light on this particular biomaterial as a future promising candidate for dental implantology applications, addressing basic specifications required for any dental implant material. In view of available preclinical data, silicon nitride seems to have the essential characteristics to be a candidate for dental implants material. This novel ceramic has a surface with potentially antimicrobial properties, and if this is confirmed in future research, it could be of great interest for oral use.
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Affiliation(s)
- Zahi Badran
- Department of Periodontology, Rmes Inserm U1229/UIC11, Faculty of Dental Surgery, Nantes, France
- Department of Oral Implantology, CHU-Faculty of Dental Surgery, Nantes, France
- Unit of Periodontology, Dental Institute, King's College, London, UK
| | - Xavier Struillou
- Department of Periodontology, Rmes Inserm U1229/UIC11, Faculty of Dental Surgery, Nantes, France
- Department of Oral Implantology, CHU-Faculty of Dental Surgery, Nantes, France
| | - Francis J Hughes
- Unit of Periodontology, Dental Institute, King's College, London, UK
| | - Assem Soueidan
- Department of Periodontology, Rmes Inserm U1229/UIC11, Faculty of Dental Surgery, Nantes, France
| | - Alain Hoornaert
- Department of Periodontology, Rmes Inserm U1229/UIC11, Faculty of Dental Surgery, Nantes, France
- Department of Oral Implantology, CHU-Faculty of Dental Surgery, Nantes, France
| | - Mark Ide
- Unit of Periodontology, Dental Institute, King's College, London, UK
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15
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Caridi F, Picciotto A, Vanzetti L, Iacob E, Scolaro C. Surface wet-ability modification of thin PECVD silicon nitride layers by 40 keV argon ion treatments. Radiat Phys Chem Oxf Engl 1993 2015. [DOI: 10.1016/j.radphyschem.2015.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Olofsson J, Grehk TM, Berlind T, Persson C, Jacobson S, Engqvist H. Evaluation of silicon nitride as a wear resistant and resorbable alternative for total hip joint replacement. BIOMATTER 2014; 2:94-102. [PMID: 23507807 PMCID: PMC3549862 DOI: 10.4161/biom.20710] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Many of the failures of total joint replacements are related to tribology, i.e., wear of the cup, head and liner. Accumulation of wear particles at the implants can be linked to osteolysis which leads to bone loss and in the end aseptic implant loosening. Therefore it is highly desirable to reduce the generation of wear particles from the implant surfaces. Silicon nitride (Si(3)N(4)) has shown to be biocompatible and have a low wear rate when sliding against itself and is therefore a good candidate as a hip joint material. Furthermore, wear particles of Si(3)N(4) are predicted to slowly dissolve in polar liquids and they therefore have the potential to be resorbed in vivo, potentially reducing the risk for aseptic loosening. In this study, it was shown that α-Si(3)N(4)-powder dissolves in PBS. Adsorption of blood plasma indicated a good acceptance of Si(3)N(4) in the body with relatively low immune response. Si(3)N(4) sliding against Si(3)N(4) showed low wear rates both in bovine serum and PBS compared with the other tested wear couples. Tribofilms were built up on the Si(3)N(4) surfaces both in PBS and in bovine serum, controlling the friction and wear characteristics.
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17
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Webster TJ, Patel AA, Rahaman MN, Sonny Bal B. Anti-infective and osteointegration properties of silicon nitride, poly(ether ether ketone), and titanium implants. Acta Biomater 2012; 8:4447-54. [PMID: 22863905 DOI: 10.1016/j.actbio.2012.07.038] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 07/19/2012] [Accepted: 07/25/2012] [Indexed: 11/17/2022]
Abstract
Silicon nitride (Si(3)N(4)) is an industrial ceramic used in spinal fusion and maxillofacial reconstruction. Maximizing bone formation and minimizing bacterial infection are desirable attributes in orthopedic implants designed to adhere to living bone. This study has compared these attributes of Si(3)N(4) implants with implants made from two other orthopedic biomaterials, i.e. poly(ether ether ketone) (PEEK) and titanium (Ti). Dense implants made of Si(3)N(4), PEEK, or Ti were surgically implanted into matching rat calvarial defects. Bacterial infection was induced with an injection of 1×10(4)Staphylococcus epidermidis. Control animals received saline only. On 3, 7, and 14days, and 3months post-surgery four rats per time period and material were killed, and calvariae were examined to quantify new bone formation and the presence or absence of bacteria. Quantitative evaluation of osteointegration to adjacent bone was done by measuring the resistance to implant push-out (n=8 rats each for Ti and PEEK, and n=16 rats for Si(3)N(4)). Three months after surgery in the absence of bacterial injection new bone formation around Si(3)N(4) was ∼69%, compared with 24% and 36% for PEEK and Ti, respectively. In the presence of bacteria new bone formation for Si(3)N(4), Ti, and PEEK was 41%, 26%, and 21%, respectively. Live bacteria were identified around PEEK (88%) and Ti (21%) implants, whereas none were present adjacent to Si(3)N(4). Push-out strength testing demonstrated statistically superior bone growth onto Si(3)N(4) compared with Ti and PEEK. Si(3)N(4) bioceramic implants demonstrated superior new bone formation and resistance to bacterial infection compared with Ti and PEEK.
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Affiliation(s)
- T J Webster
- School of Engineering and Department of Orthopaedics, Brown University, Providence, RI 02917, USA
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18
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Bal BS, Rahaman MN. Orthopedic applications of silicon nitride ceramics. Acta Biomater 2012; 8:2889-98. [PMID: 22542731 DOI: 10.1016/j.actbio.2012.04.031] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 04/18/2012] [Accepted: 04/19/2012] [Indexed: 11/29/2022]
Abstract
Silicon nitride (Si(3)N(4)) is a ceramic material developed for industrial applications that demand high strength and fracture resistance under extreme operating conditions. Recently, Si(3)N(4) has been used as an orthopedic biomaterial, to promote bone fusion in spinal surgery and to develop bearings that can improve the wear and longevity of prosthetic hip and knee joints. Si(3)N(4) has been implanted in human patients for over 3 years now, and clinical trials with Si(3)N(4) femoral heads in prosthetic hip replacement are contemplated. This review will provide background information and data relating to Si(3)N(4) ceramics that will be of interest to engineering and medical professionals.
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Affiliation(s)
- B S Bal
- Department of Orthopaedic Surgery, School of Medicine, University of Missouri, Columbia, MO 65211, USA.
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19
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Neumann A, Kevenhoerster K. Biomaterials for craniofacial reconstruction. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 8:Doc08. [PMID: 22073101 PMCID: PMC3199817 DOI: 10.3205/cto000060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region. For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products) when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull. The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc.) does not exist. The different material types are (autogenic) bone and many alloplastics such as metals (mainly titanium), ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.
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20
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Abstract
Achieving solid skeletal attachment is a requirement for the clinical success of orthopedic implants. Porous or roughened surfaces and coatings have been developed and used with mixed success to achieve attachment due to bone ingrowth. Silicon nitride is a high performance ceramic whose strength, imaging properties, and biocompatibility make it a candidate material for orthopedic implants. A porous form of silicon nitride, cancellous-structured ceramic (CSC), has been developed. CSC is a nonresorbable, partially radiolucent porous structure that can be bonded to orthopedic implants made of silicon nitride to facilitate skeletal attachment. The purpose of this study was to quantify the extent and rate of bone ingrowth into CSC in a large animal model. Cylindrical implants were placed bilaterally using staged surgeries in the medial femoral condyle of six sheep. Condyles were retrieved after 3 and 6 months in situ and prepared for examination of bone growth under SEM. Bone grew into CSC to extents and at rates similar to those reported for other titanium porous surfaces in studies involving large animals and postmortem retrievals in humans. Bone ingrowth was observed at depths of penetration greater than 3 mm in some implants after only 12 weeks in situ. Bone ingrowth into CSC is a viable method for achieving skeletal attachment.
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Affiliation(s)
- M C Anderson
- Amedica Corporation, Salt Lake City, Utah 84108, USA.
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21
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Mazzocchi M, Bellosi A. On the possibility of silicon nitride as a ceramic for structural orthopaedic implants. Part I: processing, microstructure, mechanical properties, cytotoxicity. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:2881-2887. [PMID: 18347952 DOI: 10.1007/s10856-008-3417-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 02/26/2008] [Indexed: 05/26/2023]
Abstract
Notwithstanding the good combination of mechanical and tribological properties, the suitability of silicon nitride for application as prosthesis in bone reconstruction or in articular joints replacements is still controversial. This study aims to design and produce three different silicon nitride-based ceramics and to test the materials. In this Part I the microstructure and mechanical properties evidence outstanding characteristics and the cytotoxicity studies confirm that all the materials are extremely inert and biocompatible. In Part II, the wear performance and the wettability and chemical stability against different aqueous media and physiological solutions are investigated and discussed.
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Affiliation(s)
- Mauro Mazzocchi
- Institute for Sciences and Technology for Ceramics, National Research Council, Via Granarolo, n.64, Faenza, Ravenna 48018, Italy.
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