Chapter 6: Biological Interactions with Materials

Appropriate biological interactions are critical to the success of biomaterials in their surgical applications. This chapter covers this topic in detail. It begins with a consideration of biocompatibility, noting that it is not a material property, but depends on the biological location, as well as the state of division and the surface roughness of the material. Toxicity including cytotoxicity is covered, as are the biological problems of hypersensitivity and carcinogenicity. Reactions that can aid biological acceptance, such as inflammation, are described, as are interactions with blood, including blood and plasma proteins. The chapter goes on to consider cell adhesion and osseointegration and fibrous capsule formation in bone-contact applications. It ends with an account of the current situation with safety testing, with emphasis on present-day regulations.