Problem 9.

1:

The rigid design for non-athletes allows for greater stability and ease of use. It also tends to make the
limb less heavy. Athletes require a greater range of motion from the ankle.
Problem 9.2:

Advantages of dental composites over amalgams:

- Composites bond with the tooth enamel and are less likely to fracture;
- Composites look more like the natural tooth
- Composites do not contain mercury
- Composites do not expand with age, so the tooth does not crack

Advantages of amalgams over dental composites:

- Amalgams are cheaper

- Amalgams last longer
Problem 9.3:

The primary function of structural biomaterials is to provide physical support. Functional biomaterials
have a primary function of doing something other than providing support.
Problem 9.4:

Caged-ball valves involve a series of metal struts that keep a floating ball in place. During flow, the ball is
pushed to the end of the cage which allows one dimensional flow. As the pressure is reduced, the ball
descends from the cage and plugs the orifice which present back flow.

Tilting disk valves have a single circular disk that regulates the flow. Four titanium struts position a
carbon-coated disk that can tilt up to 75 degree. Pressure from flow causes the disk to tilt allowing the
liquid to pass. As the pressure subsides, the disk returns to the closed position.

Bileaflet valves contain two distinct leaflets that open when pressurized flow pushes against them. The
result is three distinct regions of flow that far more closely approximates normal valve operation.
Problem 9.5:

Biocompatibility is the ability of a material to function within a host organism without triggering an
immune response. However, biocompatibility may vary considerably from person-to-person and even
based on location and operation of the material within a single person. As such, biocompatibility may be
person-dependent and location-dependent and cannot be determined by a single global test.
Problem 9.6:

The three mechanisms for controlled-release of pharmaceuticals are:

1. Diffusion systems in which the polymer is suspended in a polymer matrix and gradually
diffuses out

2. Solvent-activated systems in which a dry implant absorbs water causing the matrix or
membrane to swell, resulting in osmotic pressure forcing the pharmaceutical into the body
at a controlled rate.

3. Polymer degradation systems in which the active ingredient is housed in a polymer storage
system that gradually degrades allowing the active ingredient to escape.
Problem 9.7:

Osteoblasts are located near the surface of the bone and produce osteoid, a blend of structural proteins
containing collagen and hormones that regulate bone growth. Osteoclasts migrate to areas on the
surface of the bone and release chemicals that dissolve the bone matrix and allow the calcium to be
reabsorbed by the body.
Problem 9.8:

Titanium possesses a blend of strength, chemical resistance, light weight, and biocompatibility that make
it an almost ideal choice for many biomaterial applications.
Problem 9.9:

Pyrolytic carbon adds a greater level of biocompatibility to most metals (especially when in contact with
blood). The use of pyrolytic carbon coating in artificial valves has reduced the rate of thrombosis.
Problem 9.10:

The direct injection of hemoglobin into the bloodstream has been shown to cause capillaries to collapse,
thereby shutting off blood flow to the cells. The hemoglobin bonds with nitric oxide molecules that are
essential in keeping capillaries open.
Problem 9.11:

Artificial blood is used in emergency situations to transport oxygen to the cells of the body. It does not
perform the immune response functions of white blood cells nor the clotting functions of platelets.
These functions are more complex and are not usually of immediate priority in live-saving situations.
Transfusions of real blood remain the best long term solution.
Problem 9.12:

The biocompatible lattice provides a framework for the growth of new skin cells and reduces the scarring
associated with the natural collagen lattices made by the body.
Problem 9.13:

The outer layer (the epidermis) contains no blood vessels and consists primarily of structural
keratinocytes. The primary purposes of the epidermis are to provide structural support and serve as a
moisture barrier. Epidermal cells continuously dry and fall off, making room for the next layer. The inner
layer (the dermis) contains a diverse variety of cells including blood vessels, nerve cells, sweat glands, oil
glands, hair follicles, and muscles. Damage to the dermis is traumatic and requires the development of a
collagen matrix across the wound site and results in a scar. Hair follicles and sweat glands do not grow
back.
Problem 9.14:

The keel is the long bar in the center of transtibial prostheses that experience the compressive load
during standing or walking. As such, the material must have high a compressive strength. At the same
time, the material must have enough rigidity to maintain its shape and provide support, yet flex enough
to prevent transmission of force to the residual limb during walking or running. As such, tensile modulus
is another key factor.
Problem 9.15:

The right atrium receives the oxygen depleted blood from the body and moves it into the right ventricle.

The right ventricle pumps the blood into the lungs.

The oxygenated blood returns into the left atrium and is pumped into the left ventricle.

The left ventricle pumps the blood through the aorta to the entire body.
Problem 9.16:

Stents made from nitinol experience a shape memory effect in which they undergo a diffusionless
transformation. This allows them to be used without the balloon expansion process and has
substantially reduced retinosis (scarring).
Problem 9.17:

Hydroxyapatite is biomemitic because it is physically similar to materials produced by living creatures.

Bone is a biological material because it is produced for use by living creatures.

Seashells used as aggregate in concrete are bio-based materials since they are derived from living tissue
but are not serving a function for the organism

A Nitinol stent is a biomaterial because it was specifically designed for use in a biological application.
Problem 9.18:

The volumetric flow rate of blood must remain unchanges, so

A1v1 = A2v2 and A2 = 0.7A1 so

v2 = 1.43v1

We know from equation 9.4 that

1v12  2 v 22
P2  P1   and in this case there is no density change so
2 2

P2  P1 v12 v 22 v 2 (1.43v1 ) 2 - 1.04 v12

    1  
2 2 2 2
Problem 9.19:

During hemodialysis, blood is extracted from a patient and pumped into a dialysis membrane. Dialysis
fluid flows on the opposite side of the membrane. Impurities diffuse out of the blood, across the
membrane, and into the dialysis fluid. The “cleaned” blood is returned to the patient.
Problem 9.20:

Biomaterials are not reused or recycled for fear of transferring disease or other contamination between
patients. In many cases, the biomaterial was constructed specifically for an individual and would be
poorly suited for other patients.
Problem 9.21:

Silicon gel implants use a silicone rubber pouch filled with a silicon gel. These implants most closely
resemble the form of original breast tissue, but have issues with rupture and potential health effects
associated with extracapsular silicone. These implants were banned in the United States in 1992 with
the exception of replacing existing silicone gel implants.

Saline implants use thicker vulcanized shells that resist rupture. They contain a simple saline solution
that presents little health risk, but does not replicate the natural appearance of silicone gel implants.

Gummy bear implants use a cohesive gel (much like the inner texture of a gummy bear candy) that
substantially reduced the risk of leakage.
Problem 9.22:

VADs help the existing heart pump the blood more efficiently. They are used preferentially to artificial
hearts because the severe complications experienced by artificial heart patients (including clotting within
the device and irreversible damage to blood cells) limits the life expectancy of a patient to a few months.
Problem 9.23:

A pacemaker consists of a titanium casing that houses a microprocessor and long lasting battery. The
pacemaker is placed in the heart and small wires are attached to the right atrium, right ventricle, or both
depending on the specific problem. When the microprocessor senses an irregular heartbeat, it sends an
electrical signal through the wires that causes the heart to restore a normal rhythm. The titanium casing
was selected for its biocompatibility and corrosion resistance.
Problem 9.24:

Material properties that impact the selection for acetabulum replacement include biocompatibility,
hardness (for wear resistance) and ability to adhere to bone cement (PMMA).
Problem 9.25:

Y-TZP femoral heads are gaining in popularity over alumina or titanium because they are stronger, offer
better wear rates, and allow for the use of smaller diameter femoral heads.
Problem 9.26:

Most patients require a single artificial limb that will last for decades. Much of the expense is
customizing the design of the limb for the needs and changing shape of the residual limb of the
amputee. Dialysis membranes are changed repeatedly and a single patient may utilize hundreds of
membranes during their lifetime.
Problem 9.27:

Mechanical heart valves can be mass produced and stored until needed, but are subject to stenosis and
other complications. Natural valves avoid these issues, but each type has advantages and disadvantages.
Homografts (which come from cadavers) are natural heart valves that do not cause clotting. However,
they require immunosuppresants to avoid rejection and the surgical technique is difficult. Autografts
involve reshaping tissue from the patient’s own body, which eliminates the need for
immunosuppresants. However, efficiency tends to be low because the materials used were not designed
to function as valves. Xenografts (which come from other species) also require immunosuppresants and
present ethical and religious dilemmas.
Problem 9.28:

The key non-economic issues in the selection of dialysis membrane are selective permeability (so that
impurities pass through but blood cells do not) and biocompatibility since the blood is returned to the
body after contact with the membrane. For transdermal patches, the membrane must be selected
based on its controlled release properties. The material (in this case a pharmaceutical) not only needs to
pass through the membrane, but it needs to do so at a controlled rate.
Problem 9.29:

The performance index scales flow rate efficiencies to account for the size of the valve so that a single
number can be used to compare performance of valves of different sizes.
Problem 9.30:

The material directly around the cavity in the tooth usually has been weakened by the same attack the
created the cavity. The weakened enamel is removed to provide a solid surrounding for the filling.
Problem 9.31:

Collagen is a structural protein with high tensile strength. These fibers serve as the reinforcing material
in the bone composite with a hydroxyapatite matrix. Collagen fibers are also used to lay down a matrix
for the growth of new dermal cells during skin injury, but the presence of these fibers result in scarring.
Problem 9.32:

Wolf’s law dictates that bone becomes stronger when exposed to high stress levels and weaker when
stress is reduced. The biomaterials used in hip replacements are stronger than the bone that they
replaced and, therefore, handle more of the load. The surrounding bones become weaker as a result
which shortens the lifespan of the replacement.
Problem 9.33:

Controlled release agents offer several key advantages over syringes including a more uniform
concentration profile for the pharmaceutical, compared to the spike and drop off that follow injection.
Additionally, the patient does not need to worry about forgetting to take the injection, injecting the
wrong amount, or risking infection from improperly sterilized needles.
Problem 9.34:

The eye is the most complicated organ in the body (with the exception of the brain). The eye
contains cells (rods and cones) that respond to light, but the images transferred from these cells are
interpreted by the brain in complex fashions that remain poorly understood. Artificial vision has yet to
function appropriately in robots and other in situ forms and it is unlikely that the complexity of the eye-
brain interface that results in vision will be completely understood any time soon.
Problem 9.35:

During keratinization, skin cells advances through the more diverse dermal region and become part of
the epidermis. As they enter the epidermis, they change shape and produce significantly more keratin
until they reach the outer surface. Once there, they dry and fall off after about 30 days to make room for
new cells.
Problem 9.36:

The soft, living tissue in the center of a tooth is called the dental pulp. It is surrounded by cementum, a
bony material whose primary purpose is to provide a point of attachment for the periodontal ligaments.
Beyond the cementum is the dentin, a yellow, porous material comprised of structural proteins (mainly
collagen) surrounded by a calcium phosphate material called dahlite. These layers are surrounded by a
thick layer of enamel – the hardest substance in the body. The enamel also is a composite consisting of
collagen fibers in a hydroxyapatite matrix.
Problem 9.37:

Homografts (which come from cadavers) are natural heart valves that do not cause clotting. However,
they require immunosuppresants to avoid rejection and the surgical technique is difficult. Autografts
involve reshaping tissue from the patient’s own body, which eliminates the need for
immunosuppresants. However, efficiency tends to be low because the materials used were not designed
to function as valves. Xenografts (which come from other species) also require immunosuppresants and
present ethical and religious dilemmas.