The selection and application of synthetic materials for surgical impl
ants has been directly dependent upon the biocompatibility profiles of
specific prosthetic devices. The early rationale for ceramic biomater
ials was based upon the chemical and biochemical inertness (minimal bi
oreactivity) of elemental compounds constituted into structural forms
(materials). Subsequently, mildly reactive (bioactive), and partially
and fully degradable ceramics were identified for clinical uses. Struc
tural forms have included bulk solids or particulates with and without
porosities for tissue ingrowth, and more recently, coatings onto othe
r types of biomaterial substrates. The physical shapes selected were a
pplication dependent, with advantages and disadvantages determined by:
(1) the basic material and design properties of the device construct;
and (2) the patient-based functional considerations. Most of the cera
mics (bioceramics) selected in the 1960s and 1970s have continued over
the long-term, and the science and technology for thick and thin coat
ings have evolved significantly over the past decade. Applications of
ceramic biomaterials range from bulk (100%) ceramic structures as join
t and bone replacements to fully or partially biodegradable substrates
for the controlled delivery of pharmaceutical drugs, growth factors,
and morphogenetically inductive substances. Because of the relatively
unique properties of bioceramics, expanded uses as structural composit
es with other biomaterials and macromolecular biologically-derived sub
stances are anticipated in the future.