Composite biomaterials: From lab to clinics

Abstract

Although metals, ceramics, and particulate filler resin composites have successfully been used as dental and also medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements and the present understanding of the importance of minimally invasive dentistry. For instance, preparation of large amounts of tooth substance is needed, the high-strength materials lack property to be shaped in situ, and metal objects may interfere with some medical imaging systems (computer tomography, magnetic resonance imaging). There has been a lot of development in the field of composite biomaterials, which has focused to a large extent on biodegradable composites. Less focus has been paid to biostable composites although they could provide lots of benefits over the existing biomaterials. This chapter reviews the rationale of using biostable glass fiber-reinforced composites (FRCs) in several dental and surgical applications from restorative and prosthetic dentistry to cranial surgery. Biostability of dental restorations and implantable medical devices is still important to ensure success of the treatment in short and long term. Materials mechanical properties, biocompatibility, and possibility to add bioactive components to dental and surgical implants alongside with the clinical experience suggest that FRC materials are a relevant new group of biomaterials for clinical medicine and dentistry. FRCs with continuous or discontinuous glass fibers in biostable thermoset resin matrix provide high-strength and high-toughness nonmetallic biomaterial. By adding bioceramics, such as bioactive glass, to the FRC construct, the material combination supports osteogenesis and vascularization and provides antimicrobial properties, for example, to the implant. Material combination of FRC and bioactive glass is used clinically in cranioplasty and cranio-maxillofacial implants, and they have been investigated also as oral and orthopedic implants. This is a journey from lab to clinics.