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Tissue Response to Biomaterials (Biocompatibility (Affected by (Material…
Tissue Response
to Biomaterials
Tissue Response
Surgical Trauma
Response to the biomaterial
Protein adsorption
Bioinert implant
Recognised as foreign
Macrophages
attempt to engulf
If too large
Further macrophage recruitment
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If material cannot
be digested
Permanent
residual body
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Digestion of material
Inflammatory stimuli stopped
High aspect ratio
e.g. asbestos fibre
Macrophage 'feels' small dimension
and attempts to engulf
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Results in tissue death
Other effects
Biomaterial is affected by tissue
Loss of components and contaminants
General attack/solubilisation
Chemical changes at the surface
Physical property changes
Structural changes
Hydration
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Plastic deformation, viscoelastic properties
Systemic effects
Particular ions may be
concentrated in specific tissues
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Auto-immune response
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Stress shielding of tissues
Vascularisation (pore size)
Bioactive implant
Intimate contact with implant
Prevents bacterial penetration
Secures implant in place
Determines subsequent events
Protein deposition
Removal, adsorption of proteins
Response to an inscision
Sealing of blood vessels via clotting
Acute inflammatory response
Arrival of Macrophages
Digest and remove damaged tissue
via phagocytosis
Respond to
first signal
from neutrophils
Formation of fibrous scar tissue
around inscision
Macrophages and fibroblasts
Consists of collagen fibres
Response to the
second signal
Arrival of neutrophils
Biocompatibility
(nearly) Bioinert
Required for some applications
(open mouth, eye)
e.g.
Ti alloys
Precious metal alloys
Alumina
Zirconia
Porcelain
Silicone
PMMA
Designed or intended not to
elicit any response with host tissue
Bioactive
Designed to elicit or modulate a
beneficial biological action resulting
in the formation of a bond between
tissue and material.
Bioresorbable
Designed to degrade in the
body to give normal metabolites
Affected by
Tissue
Age
Sex
Genetics
Diet
Material properties
Chemistry
Degradability
Solubility
Size
Surface Texture
Consider systemic effects