IMPLANT MATERIALS AND SURFACE COATINGS ON IMPLANTS

 Definition :
A prosthetic device of alloplastic material(s) implanted into the oral tissues beneath the mucosal and/or periosteal layer, and on/or within the bone to provide retention and support for a fixed or removable prosthesis ; a substance that is placed into and/or upon the jaw bone to support a fixed or removable prosthesis.

A biocompatible material is defined as being harmonious with life and not having toxic or injurious effects on biologic function.

A biomaterial can be defined as any substance other than a drug, that can be used for any period as a part of a system that treats, augments, or replaces any tissue organ or function of the body.

 The body is a harsh chemical environment for foreign materials.  An implanted material can have its properties altered by body fluids.  Degradation mechanisms such as corrosion or leaching can be

accelerated by ion concentrations and pH changes in body fluids.

 The body s response to an implant can range from benign to a

chronic inflammatory reaction, with the degree of biologic response largely dependent on the implanted material.

 The physical, mechanical, chemical and electrical properties of the

basic materials components must always be fully evaluated for any biomaterial application as these properties provide key inputs into the interrelated biomechanical and biologic analyses of function.

HISTORY
o Replacing lost teeth with a bone-anchored device is not a new boneconcept at all.

o Archeological findings showed that the ancient Egyptian and South

American civilizations already experimented with re-implanting lost reteeth with hand-shaped ivory or wood substitutes. hand-

In the 18th century lost teeth were sometimes replaced with extracted teeth of other human donors. donors. The implantation process was probably somewhat crude and the success rates extremely low due to the strong immune reaction of the receiving individual.

Allergy???

500 BC used gold wire to stabilize the periodontally weak teeth

First evidence of use of implants implantation of pieces of shell

In 1809, Maggiolo fabricated a gold implant

In 1887, a physician named Harris attempted the same procedure with a platinum post, instead of a gold post.

o In 1886 Edmunds was the first in the

US to implant a platinum disc into the jawbone, to which a porcelain crown was fixated. Strock placed the first somewhat successful oral implants in 1937 at Harvard University. Strock published a paper on the physiological effects of cobaltcobaltchromiumchromium-molybdenum alloy (vitallium) in bone, and thus placed a series of vitallium implants into test animals and humans.

Modern Historical Developments: The first Subperiosteal Implant was placed in 1948 by Gustav Dahl Implant, The Endosteal Blade Implant, introduced independently in 1967 by Leonard Linkow and Ralph and Harold Roberts

Types of endosseous implants

The quantum leap in Oral Implantology was achieved in 1952 in Sweden by Per Ingvar Branemark He founded the phenomenon of Osseointegration Dr. Branemark's research shifted more towards the use of titanium appliances in human bone, including the use of titanium screws as bone anchors for lost teeth. In 1982, the Toronto Conference on Osseointegration in Clinical Dentistry laid down the first parameters on what is to be considered successful implant treatment within the stringent confines of the scientific community.

BIOLOGIC CLASSIFICATION OF IMPLANT MATERIALS

Biologic classification based on tissue response and systemic toxicity effects of implant

DEGREE OF COMPATIBILITY

CHARACTERISTICS OF REACTIONS OF BONY TISSUE characterized by a thin fibrous tissue interface: distance osteogenesis are characterized by direct bone contact: contact osteogenesis

MATERIALS

biotolerant

Stainless Steel, PMMA, Co-CrCo-Cr-Mo, Co-Cr-MoCo-Cr-Mo-Ni Alumina, Titanium, Tantalum, Carbon

bioinert

bioactive

direct chemical bonding Calcium phosphatephosphateof the implant with the containing glasses, surrounding bone : glassglass-ceramics, ceramics, titanium? bonding osteogenesis

The entire group of possible alloplastic implant materials, regardless of their clinical applications, will fall into one of three categories :

  

Metals and metal alloys. alloys. Ceramics and carbons and Synthetic polymers. polymers.

Implant Material Metals Titanium Titanium Alloy Stainless Steel Cobalt Chromium Alloy Gold Alloys Tantalum Ceramics Alumina Hydroxyapatite Beta-Tricalcium Phosphate Carbon Carbon-Silicon Bioglass Polymers Polymethylmethacrylate Polytetrafluoroethylene Polyethelene Polysulfone Polyurethane

Common name or abbreviation

cpTi Ti6Al4v SS, 316, L SS Vitallium, Co-Cr-Mo Ta Al2O3, amorphous or single crystal sapphire (Kyocera) HA, Ca10(PO4) (OH)2 B-TCP, Ca3(PO4)2 C, vitreous, low temperature isotropic (LT1), ultra-low temperature isotropic C-Si SiO2 / CaO / Na2O / P2O3 PMMA PTFE PE PSF PU

PHYSICAL, MECHANICAL,AND CHEMICAL REQUIREMENTS for IMPLANT MATERIALS

Forces exerted on the implant material consists of tensile, compressive and shear components.

For most of the implant materials compressive strengths are usually greater than their shear bond tensile counterparts

A recurring problem occurs between the mechanical strength and deformability of the material and the recipient bone

different approach to match more closely the implanted material and hard tissue properties led to the experimentation of polymeric carbonitic and metallic materials because of low modulus of elasticity

The higher the applied load, the higher the mechanical stress and the greater the possibility for exceeding the fatigue limit of the material. In general the fatigue limit of metallic implant materials reaches approximately 50% of their ultimate tensile strength Ceramic materials are weak under shear forces because of the combination of fracture strength and low ductility which can lead to brittle facture. Metals are Modified by the addition of alloying elements or altered by mechanical processing such as drawing , swaging or forging followed by age or dispersion hardening until the strength of material is optimized for the intended application.

A general rule is that constitution of mechanical process hardening procedures result in an increased strength but also invariably correspond to a loss of ductility. This especially is relevant for dental implants. Most of all consensus standards for metal are given by American Society for Testing and Materials (ASTM), International standardization organization (ISO). American dental association (ADA) require a minimum of 8% ductility to minimize brittle fractures.

Material

Nominal Analysis (w/o)

Modulu s of Ultimate Elongati Elasticit tensile on to Surface y strength fracture GN/m2 MN/m2 (ksi) (%) (psix106) 97 (14) 240-550 (2570) 869 896 (125 130) 655 (95) 235 (34) 480 1000 (70 - 145) 690 (100) >8 > 15 Ti oxide Ti oxide Cr oxide Cr oxide Ta oxide

Titanium (T1) Titanium-aluminium vanadium (Ti-Al-V) Cobalt-Chromium molybdenum (casting) (CoCr-Mo) Stainless Steel (316L)

99+Ti 90Ti-6A14V 66Co -27Cr -7Mo 70Fe 18Cr 12 Ni 99+Ta

117 (34)

> 12

193 (28)

> 30

Tantalum (Ta)

11

CORROSION AND BIODEGRADATION

 Corrosion is a special concern for metallic materials in dental implantology because implants must be placed in oral cavity and oxygen compositions differ from that of tissue fluids  In addition the pH can vary significantly in areas below plaque and within the oral cavity.

 The effect of galvanic corrosion is greater in case of dental implants. Galvanic processes depends on the passivity of oxide layers.  The passive layer is usually made of oxides or hydroxides of the metallic elements that have greatest affinity for oxygen.  In reactive group metals such as titanium, niobium, zirconium, tantalum and related alloys, the base materials determine the properties of the passive layer.

 Three types of corrosion are most relevant to

dental implants: implants:
 stress

corrosion galvanic corrosion and

 cracking,  fretting

corrosion.

STRESS CORROSION CRACKING

The combination of high magnitudes of applied mechanical stress plus simultaneous exposure to a corrosive environment can result in the failure of metallic materials by cracking Most traditional implant body designs under three dimensional finite element stress analysis show a concentration of stresses at the crest of the bone support and cervical one third of the implant. This tends to support potential stress corrosion at the implant interface areas

 GALVANIC CORROSION
Galvanic corrosion occurs when two dissimilar metallic materials are in contact and are within an electrolyte resulting in current to flow between the two.

 FRETTING CORROSION
Fretting corrosion occurs when there is a micromotion and rubbing contact within a corrosive environment Fretting corrosion has been shown to occur along implant abutment superstructure interfaces.

CLINICAL SIGNIFICANCE of CORROSION

passive oxide layers on metallic substrates dissolves at much slower rates more critical problem is irreversible local perforation of the passive layer that is often caused by chloride ions which may result in localized pitting corrosion. This is observed for iron chromium nickel molybdenum (Fe-Cr-NiMo) steels ceramic oxide materials are not fully degradation resistant. corrosion resistance of synthetic polymers on the other hand, depends not only on their composition and structural from but also on the degree of polymerization. polymers are not only dissolved but also penetrated by water and substance from biologic environment.

TOXICITY CONSIDERATIONS
Toxicity is related to primary biodegradation product

Factors to be considered include :

1. 2. 3. The amount dissolved by biodegradation per time unit The amount of material removed by metabolic activity in the same time unit Quantities of solid particles and ions deposited in the tissue

The transformation of harmful primary products is dependent on their level of solubility and transfer. electrochemical behaviour of implanted materials has been instrumental in assessing their biocompatibility

 Charge transfer appear to be a significant factor specific to the

biocompatibility of metallic biomaterials.

 passive layers along the surfaces of niobium, titanium, zirconium

and tantalum increase resistance to charge transfer processes by isolating the substrate from the electrolyte in addition to providing a higher resistance to ion transfers.

 On the other hand, metals of iron, nickel or cobalt are not as

resistant to transfer through the oxide the passive surface zones.

Commonly used biomaterials for dental implants are

Commercially pure (CP) titanium and titanium aluminium vanadium (Ti-6Al-4V) alloy are most often used for endosseous (Ti-6Alimplants whereas cobalt chromium molybedenum (Co-Cr-Mo) alloy is most (Co-Croften used for subperiosteal implants. Calcium phosphate ceramics, particularly hydroxyapatite (HA), have been used in monolithic form as augmentation material for alveolar ridges and as coating on metal devices for endosseous implantation.

TITANIUM AND TITANIUM 6 ALUMINIUM -4 VANDIUM (Ti 6Al 4V)

Titanium appears on the periodic table as element, 22, a fourth row transition metal with an atomic weight of 47.88. An extremely reactive metal, titanium forms a tenacious oxide layer that contributes to its electrochemical passivity. The element was discovered by Wilheim Gregor, a clergyman who found the metal in a black magnetic sand in cornwall in 1791. Klaproth has named titanium after the Greek Titans. In 1930 s Krol developed commercially extraction procedures that are still used today.

Commercially pure (CP) (CP) titanium and titanium-based alloys titaniumare low density metals that have chemical properties suitable for implant applications Titanium has a high corrosion resistance Titanium oxidizes or passivates upon contact with room temperature air and normal tissue fluids. This activity is favourable for dental implant devices in the absence of interfacial motion or adverse environmental conditions. This passivated surface condition minimizes biocorrosion phenomena.

Among these two general groups, however, are six distinct materials defined by the American Society for Testing and Materials (ASTM). All six of these materials, which include four grades of CP titanium and two titanium alloys, are commercially available. The mechanical and physical properties of these materials differs significantly. The two alloys are Ti-6Al Ti(ELI). 4V and Ti-6Al- 4V extra low interstitial Ti-6Al-

The commercially pure titanium materials are 1. 2. 3. 4. commercially pure grade I titanium, commercially pure grade II titanium commercially pure grade III titanium and commercially pure grade IV titanium

Titanium

Fe

Al

Ti

Cp Grade I Cp Grade II Cp Grade III Cp Grade IV Ti-6AL-4V alloy Ti-6AL-4V-ELI alloy

0.03 0.03 0.03 0.03 0.05 0.05

0.10 0.10 0.10 0.10 0.08 0.08

0.015 0.02 0.18 0.015 0.03 0.25 0.015 0.03 0.35 0.015 0.05 0.40 -

Bal. Bal. Bal. Bal. Bal. Bal.

0.015 0.30 0.20 5.50-6.7 3.50-4.50 0.012 0.10 0.13 3.50-4.50

Cp Ti is available in different grades which vary mostly in the oxygen content Grade 4 cp Ti has the most oxygen at 0.40%. Iron is added for corrosion resistance Aluminium increases the strength of the alloy and decreases its density. Vanadium acts to inhibit corrosion by acting as an aluminium scavenger. Vanadium stabilizes the beta phase of Ti-6Al-4V alloys Ti-6AlThis combination of phases gives the alloy strength

Extra low interstitial describes the low levels of oxygen dissolved in interstitial sites in the metal.

With lower amounts of oxygen and iron residuals in the ELI alloy, ductility is improved slightly.

Mechanical Properties of CP Titanium and Alloys

Material

Ultimate Yield Modulus Tensile Strength (Gpa) Strength MPa) (MPa) 102 102 102 104 113 113 240 200 18 18.3 84 240 345 450 550 860 930 700 965 140 52 10 170 275 380 483 795 860 450 690 n/a n/a n/a

Elongation (%)

Density (G / cc)

Cp grade I Ti Cp grade II Ti Cp grade III Ti Cp grade IV Ti Ti-6Al-4V ELI Ti-6Al-4V Co-Cr-Mo 316L steel Cortical Bone Dentin Enamel

24 20 18 15 10 10 8 20 1 0 0

4.5 4.5 4.5 4.5 4.4 4.4 8.5 7.9 0.7 2.2 3

Strength is beneficial because materials better resist occlusal forces without fracture or failure.

Lower modulus is desirable because the implant biomaterial better transmits forces to the bone.

The addition of aluminium and vanadium, which make up 10% of titanium alloys, raises the modulus about 10%.

Surface Properties
The surface properties of implants are important to the biological response that the material will elicit from the body. Thus, the surface oxide which forms on the titanium alloys is of paramount importance to its favorable biological properties. In air, the oxide begins to form in nanoseconds and reaches 2020-100A thickness by 1 sec The oxide thickness of Ti alloy (83 A) has been reported to be thicker than that of cp Ti (32 A) The composition of oxide is primarily TiO2, but also contains TiO and Ti2O3 among other oxide , depending on the position of the oxide within the oxide layer. The surface oxide layer protects against corrosion, it cannot completely prevent release of elements into the body.

Biological Response
Evidence suggests that the oxide layer is first hydrated then covered by molecular layers of water. The molecules which occur are probably the proteins and carbohydrates of the ground substance of bone.

in the osseointegrated implant, the layer is probably only 20 50 A thick. The final layer before the mineralized tissue is that of collagen fibrils in the ground substance which are continuous with the organic phase of the bone itself. The favourable biological response to Ti materials is most likely to the limited release of ions from the material, the stability of complexes which form when release does occur, and the limited biological effects of the ions

 The interface of titanium implants with the gingival tissue is also important
because in the natural tooth the junctional epithelium creates a barrier to chemical, mechanical and biological penetration.

 The connective tissue fibers below the epithelium form a tight cuff around
the implant which may act as a seal. It prevent the apical migration of the epithelium and subsequent bone loss.

 The Titanium alloy is approximately 6 times stronger than compact bone

and thus affords more opportunities for design with thinner sections.

 Any residues of surface changes must be removed before implantation to

ensure mechanically and chemically cleaned conditions.

COBALT CHROMIUM MOLYBDENUM BASED ALLOY

 The cobalt based alloys are most often used in as cast or cast and annealed metallurgic dentition.  The elemental composition of this alloy includes cobalt , Chromium and molybdenum as major elements.  Cobalt provide the continuous phase for basic properties  Chromium provides corrosion resistance through the oxide surface.  While molybdenum provides strength and bulk corrosion resistance.  Minor concentrations of nickel, manganese and carbon are also included in this alloy.

 Nickel has been identified as biocorrosion products.  The carbon content must be precisely controlled to maintain mechanical properties such as ductility.

 In general the cast cobalt alloys are the least ductile alloy systems used for dental surgical implants.  Thus bending of the finished implants should be avoided.

 when properly fabricated implant from this alloy groups have shown excellent biocompatibility profiles.

IRON CHROMIUM NICKEL BASED ALLOYS

This alloy, as with titanium systems is used most often in a wrought and heat treated metallic condition which results in a high strength ductility alloy. The ramus blade ,ramus frame stabilizer pins (old) and some mucosal insert systems have been made from the iron based alloys. OF the implant alloys this alloy is most subject to crevice and pitting biocorrosion. So care must be taken to use and retain the passivated surface condition. This alloy contains nickel as a major element. Hence its use in patients allergic or hypersensitive to nickel should be avoided

The iron based alloys have galvanic potentials and corrosion characteristics that cause concern about galvanic coupling and biocorrosion if interconnected with titanium, cobalt, zirconium or carbon implant biomaterials If used independently, where the alloys are not in contact or not electrically interconnected, the galvanic couple would not exist, and each device would function independently

OTHER METALS AND ALLOYS

palladium and alloys of these metals.

 Early spiral and cages included tantalum, platinum, iridium, gold,  More recently devices made from zirconium, hafnium and tungsten.

 These are still in the experimental

stage

 Gold, platinum and palladium are metals of relatively low strength.  Also cost per unit weight and the weight per unit volume (density)
of the device along the upper arch have been suggested as possible limitations for gold and platinum.

CERAMICS :

Ceramics are inorganic, non metallic, non polymeric material manufactured by compacting and sintering at elevated temperatures . Oxide ceramics were introduced for surgical implant devices because of their inertness to biodegradation, high strength, physical characteristics such as colour and minimal thermal and electrical conductivity and wide range of material specific elastic properties. Ceramics may be used in bulk forms and more recently as coatings on metals and alloys

ALUMINIUM TITANIUM AND ZIRCONIUM OXIDES:

High ceramics form aluminium , titanium and zirconium oxides have been used for root form, endosteal plate form and pin type dental implant. The compressive, tensile, and bending strengths exceed the strength of compact bone by 3 to 5 times. These properties combined with a high modulus of elasticity and with high fracture and fatigue strengths have resulted in specialized design requirements for these classes of biomaterials. Minimal thermal and electrical conductivity, minimum biodegradation and minimal reactions with bone, soft tissue and the oral environment also recognized as beneficial when compared with other types of synthetic biomaterials. Ceramics have exhibited direct interfaces similar to an osseointegrated condition with titanium.

care must be taken in the handling and placement of these biomaterials. Exposure to steam sterilization results in a measurable decrease in strength for some ceramics Scratches or notches many introduce fracture initiation sites, chemical solutions may leave residues Dry heat sterilization within a clear and dry atmosphere is recommended for most ceramics

GLASS CERAMICS
Glass ceramics such as bioglass and polycrystalline ceramics produced by the controlled crystallization of glasses Glass ceramic made up of crystalline oxyapatite and flourapatite & wollastonite (Si O2 CaO) in MgO CaO SiO2 glassy matrix Bio glass is synthesis of several glasses containing mix of silica, phosphates, calcia and soda Glass ceramics have poor mechanical properties for load carrying applications because they are extremely brittle. A calcium phosphate layer forms on the surface. The ability of bioglass to bond depends on this layer. this surface layer develops on the bioglass when its silica contents is greater than 60 mol%.

BIOACTIVE AND BIODEGRADABLE CERAMICS BASED ON CALCIUM PHOSPHATES

Calcium phosphate ceramics classified as polycrystalline ceramic similar to mineral phase of bone (Ca5[PO4]3OH) Hydroxyapatite commonly called tribasic calcium phosphate is a geologic mineral that closely resembles the natural mineral in vertebrate bone tissue. Hydroxyapatite forms non resorbable form of calcium phosphate Tribasic calcium phosphate should not be confused with other calcium phosphate ceramics especially tricalcium phosphate [(Ca(PO4)2] which is chemically similar to hyroxyapatite but is not a natural bone mineral. -TCP is an non crystalline amorphous material, which is resorbable

Used in wide range of implant types The coatings of metallic surfaces using flame or plasma spraying have increased rapidly for the calcium phosphate ceramics. The coatings have been applied to a wide range of endosteal and subperiosteal dental implant designs with an overall indent of improving implant surface biocompatibility profiles and implant longevities. Mixtures of particulates with collagen, and subsequently with drugs and active organic compounds such as BMP increases the range of applications

ADVANTAGES and DISADVANTAGES OF CALCIUM PHOSPHATE CERAMICS ADVANTAGES

Chemistry mimics normal
biological tissues (Ca,P,O,H)

DISADVANTAGES
Variable chemical and structural
characteristics

Relatively low mechanical, tensile Excellent biocompatibility Attachment between cpc

and hard and soft tissues and shear strength under fatigue loading

Low attachment between coating

and substrate

Minimal thermal and electrical

conductivity

Variable solubility variable mechanical stability of

coatings under load bearing conditions

Moduli of elasticity closer to bone Colour similar to hard tissues

overuse

 classes of bioceramics have low strength, hardness and moduli of

elasticity than the more chemically inert forms.

 The calcium phosphate ceramics have proved to be one of the more

successful high technology based biomaterials that has evolved with the past decades.

 Their advantages properties strongly support the expanding clinical

applications and the enhancement of the biocompatibility profiles for surgical implant uses.

CARBON AND CARBON SILICON COMPOUNDS

Carbon compounds are often classified as ceramics because of their chemical inertness and absence of ductility. They are conductors of heat and electricity. Their excellent biocompatibility and moduli of elasticity close to that of bone have resulted in clinical trials of these compounds in dental prostheses. combination of design, material and application limitations resulted in a significant number of clinical failures and its subsequent withdrawal from clinical use.


1.

The possible limitation are : Those relating to mechanical strength properties along the substrate to coating interface. Biodegradation that could adversely influence tissue stability. Minimal resistance to scratching or scarping procedures, associated with oral hygiene.

2. 3.

4.

Susceptibility to standard handling, sterilizing or placing methodologies.

POLYMER AND COMPOSITES

Fiber reinforced polymers offer advantages in that they can be designed to match tissue properties, and can be coated for attachment to tissues.

STRUCTURAL BIOMEDICAL POLYMERS The more inert polymeric biomaterials include Polytetra fluoroethylene (PTFE) Polyethylene tetraphthalate (PET) Polymethyl methacrylate (PMMA) Ultrahigh molecular weight polyethylene (UHMW-PE) (UHMWPolypropylene (PP) Polysulfone (PSF) and Poly dimethyl siloxane (PDS) or silicone rubber (SR)

In general the polymers have lower strengths and elastic moduli and higher elongations to fracture compared with others. They are thermal and electrical insulators, They are relatively resistant to biodegradation. Compared with bone most polymers have lower elastic moduli with magnitudes closer to soft tissue. Polymers have been fabricated in porous and solid forms for tissue attachment, replacement and augmentation and as coatings for force transfer to soft tissue and hard tissue regions.

 Extremly tough and fatigue cycle resistant (PP,UHMA-PE,PTFE) (PP,UHMAfor mechanical force transfer within selected implant designs.

 Internal force distribution connectors for osseointegrated implants where the connector is intended to better stimulate biomechanical conditions for normal tooth functions.

 PTFE has a low resistance to contact abrasion and wear phenomena

COMPOSITES :
 Combinations of polymers and other categories of synthetic
biomaterials continues

 Biodegradable polymers such as polyvinyl alcohol (PVA) polylactides

or glycolides, cyanoacrylates or other hydratable forms have been combined with calcium phosphate particulate or fibres.

 polymers and composite of polymers are especially sensitive to

sterilization and handling techniques.

 If intended for implant use most cannot be sterilized by steam or

ethylene oxide

 Extreme care must be taken to maintain quality surface conditions of

the implant.

 Porous polymers can be deformed by elastic deformation , which can

close open regions intended for tissue in growth.

 Cleaning of contaminated porous polymers is not possible without a

laboratory environment .

 Talc or starch on surgical gloves, contact with a towel or gauze pad,

or the touching of any contaminated area must be avoided.

Osseo integration

IT is DEFINED as direct structural and functional contact of ordered living bone to the surface of loaded implant materials this contact helps in direct transfer of forces onto the surrounding bone , prevents mobility of the implant and stimulates the growth of bone Thus reduces the incidence of implant failure is dependent on material biocompatibility implant surface, status of bone, surgical technique, healing conditions, and biting forces.

Metallic oxides dictate type of cellular and protein binding at implant surface Progression of surface from the lowest implant tissue strength to the highest: smooth, textured, screw threaded plasma sprayed and porous coated Surface coatings enhance the bond of bone to the implants Roughness and porosities of the surface conducive to cell attachment Surface roughening can be done by sand blasting Titanium implants may be etched with a solution of nitric acid and hydroflouric acid to chemically alter the surface Alumina grit blasting and glass bead blasting

SURFACE COATINGS

The implant surface may be covered with a porous coating. These may be titanium or ceramics

Plasma spray coating process:

a thermal spraying process in which an arc is utilized as a source of heat that ionizes a gas which melts and propels the coating material to the work piece.

powders are injected into the plasma stream thus melting the material. Powder is carried at the velocity of the gas to the substrate where it is quenched and bonds to the substrate.

both thermal and kinetic energy in the particles bring out the high bond strength Plasma is generated by passing the gas between 2 concentric electrodes (water cooled) where it is heated by sustained high current

Titanium Plasma Sprayed:

Porous or rough titanium surfaces have been fabricated by plasma spraying at high temperatures of 15,000 degree C at very high velocity 600 m/sec The plasma sprayed layer after solidification (fusion) is often provided with a 0.04 to 0.05 mm thickness. These types of surface were first developed by Hahn and Palich rough and porous surfaces showed a three-dimensional threeinterconnected configuration likely to achieve bone-implant boneattachment for stable anchorage

 Porous titanium surface from various fabrication

methods may
     increase the total surface area, produce attachment by osteoformation, enhance attachment by increasing ionic interactions, introduce a dual physical and chemical anchor systems and increase the load bearing capacity 25% to 30%.

o In 1981 Clemow et al showed that the rate and percentage of bone ingrowth into the surface was inversely proportional to the square root of the pore size for sizes greater than 100 Qm o porous surfaces can result in an increase in tensile strength. o Bone forms within the porosities even in the presence of some micromovement during the healing phase. o The basic theory was based on increased area for bone contact.

Hydroxyapatite Coating
dental profession by deGroot.

o Hydroxyapatite coating by plasma spraying was brought to the o HA coating can also lower the corrosion rate of the alloy. o The bone adjacent to this implant shows better organized then with
other implant materials and with a higher degree of mineralization. .

o HA to bone attachment is superior to the HA to implant interface. o Implants of solid sintered hydroxyapatite have been shown to be
susceptible to fatigue failure. This situation can be altered by the use of CPC coatings, along metallic substrate.

The bond between CPC and metal should be dense, more tenacious and thinner

this minimize the problem of poor shear strength and fatigue at the coating substrate interface. CPC coatings may resorb in infected or chronic inflammation areas. One advantage of CPC coatings is that they can act as a protective shield to reduce potential slow ion release from the Ti-6AI-4V Ti-6AIsubstrate

BIOCOMPATIBILITY OF PLASMA SPRAYED BIOMEDICAL COATINGS Osteoblasts grows better on hydroxyapatite and wollastonite coating than on zirconium dioxide coatings and alumina oxide coatings Biocompatibility of bio active ceramic coatings is better than of bio inert ceramic coatings. Bone like apatite can form on bio active coatings Plasma spray Al2O3 coatings is harmful because of existence of alumina in the coating alumina forms when stable Al2O3 is plasma sprayed The compatibility of wollastonite is similar to that of bio active glass. it forms tight bond to Ti alloy substrate as its T.E is close to Ti alloys

Hyroxyapatite - thin film coating

Adhesive strength of coating to implant surface are maximized by:

 incorporation of bio compatible bond coats such as titanium  use of radio frequency sputtering technique for the deposition of HA thin
film coatings These coatings can be applied on complex shapes and provide complete coverage. This deposition forms graded micro structure for selective dissolution of coating i.e. sub layer with high crystallanity (low dissolution rate) and amorphous layer on top

The drawback of Ti 6- Al- 4V is its poor strength 6- AlHA coated Ti 6- Al- 4V of the corrosion of underlying material 6- AlHA coatings have tendency of cracking or peeling off under the influence of bending or shearing forces These drawbacks have led to the invention of HA and Ti 6- Al- 4V 6- Alcomposite powder and its deposition by plasma spraying. The composite powder improves bonding between HA and underlying substrate and prevents oxidation and corrosion of Ti 66Al- 4V Al-

Other Surface Modifications:

Surface modification methods include controlled chemical reactions with nitrogen or other elements or surface ion implantation procedures. The reaction of nitrogen with titanium alloys at elevated temperatures results in titanium nitride compounds being formed along the surface. These nitride surface compounds are biochemically inert and alter the surface mechanical properties to increase hardness and abrasion resistance. The element most commonly used is nitrogen. electrochemically, the titanium nitrides are similar to the oxides (TiO2) and no adverse electrochemical behaviour has been noted if the nitride is lost regionally. the titanium substrate reoxidizes when the surface layer of nitride is removed.

 The local treatment of sol gel derived coatings with CO2 laser is a
promising technique for implants with varying properties to interface different tissues both hard and soft tissues

 CHITOSAN is a biopolymer that exhibits osteoconductive, enhanced

wound healing and antimicrobial properties which make it attractive for use as a bioactive coating to improve osseointegration of orthopaedic and craniofacial implant devices. Coatings made from 91.2% de-acetylated chitosan were chemically debonded to titanium coupons via silane-glutaraldehyde molecules silanethe bond strengths were not affected by gas sterilization.

 CHEMICAL-MADE APATITE LAYER CHEMICALCommercially pure titanium plates were heated and chemically treated to deposit crystalline apatite on their surface. dense bone-like apatite layer was formed on the surface of the bonetitanium by a simple chemical method This chemical apatite layer also bonded tighter to the titanium than the plasma-sprayed apatite. This chemically made apatite coating is plasmaexpected to provide a long-term implant-bone fixation. longimplant-

 PLASM- Pulsed Laser Assisted Surface Modification PLASMUltra fine layers of polymers are deposited through non aqueous, non solvent techniques near atmospheric pressure Advantages: control of both thickness and uniformity of polymer coating on any surface

thank you