Future developments and applications of biomaterials: an overview.

It is recommended that the emphasis of biomaterials research and development for the future should be to achieve improved reliability. Use of increasing numbers of implants per year coupled with decreasing long term (greater than 5 years) success rates are resulting in progressively larger numbers of reparative implant operations. This trend can be altered by emphasizing three areas of R&D: 1) Studies of composite biomaterial systems offering unique combinations of biological surface behavior and substrate mechanical performance; 2) Investigate mechanisms of interfacial reactions so that long term responses of the host-implant can be predicted; 3) Develop long term predictive relationships for biomaterials reliability based upon interfacial reactions, biomechanics, fracture mechanics, fatigue testing, and retrieval analysis. Brief examples of efforts to develop undrestanding in these three areas are described using bioglass coated metal and bioglass coated alumina implants.