1 Biomaterial Application On Fiber Reinforced Polymer: A review Abstract This paper glances through the application of Fibre Reinforced Polymer (FRP) in the biomedical industry. It covers development, application and future prospect of FRP in medical world in a very simple yet informative way. The study touches on various aspect of FRP such as its biocompatibility, advantages and as well critical analysis. The study also describes various latest technologies available in the market to test property of FRP and its suitability as a bio medical material in a very lay man term. It also scrutinizes the challenges and critical issues of its application in various purposes. Keywords: Biomaterial, Fibre Reinforced Polymer (FRP) , Composite, Medical Application. 1.0 Introduction FRP based material has been in used for many decades in various industries. FRP in bio engineering was introduced to address the problems facing by medical practitioners. Usage of metals such as stainless and titanium widely used in bone repairing for its bio compatibility properties, however it causes un necessary pain and inconveniences as several surgeries required to remove these metals over time[4]. This journal also pointed out other consequences of using metal plates for bone repairing which could lead to uneven cells growth around the metals plates a eventually causes porosis. Another disadvantage of this material in bone repairing is the possibility of re-fracture of the bone where differential in stiffness between bones and metals effects after the plate has been removed. Bio engineering defined as application of concepts and methods of the physical science and mathematics in an engineering approach towards solving problem in repair and reconstructions of damaged, lost or deceased tissues. Any material that is used for this purpose falls in to biomaterial class[6]. Biomaterial has long history date back to ancient civilization, 2 where Chinese and Indians used wax, glues and tissues in reconstructing missing or defective parts[5]. On the other hand, Polymer also known as plastic is made from petroleum based resins. Petroleum based polymer however is not ideal for certain application such as in bone repairing, because of its bio incompatibility. In biomaterial development polymer alone may not give the desired/required mechanical properties, one way of overcoming this problem is to reinforce it with fibres. By introducing fibres into (resins) polymers, it enhance the mechanical properties of the polymer particularly its strength and modulus[20] . Just like in the construction of building columns and beams, where steel rods have been used to enhance the strength of concretes Fibre in general can be divided in to 2 major groups and can be further break down in to sub categories as shown in the Figure 1 below. Fibre Natural Plant based fibre Synthetic Animal based Fibre Figure 1: Groups of Fibre 2.0 Milestone of FRP in Medical Industry Plastics such as vinyl, polystryne, phenoil and polyester were developed in 1900’s. The drawback of these materials is its strength and rigidity. In 1935, Owen Corning introduced the first fibre glass. With this fibre polymer and its application in developing bio material had begun. In 1930‘s a documented report on biopolymers by the Micro-biologist, Lemoyne describing polyhydroxybutyrate[9] was published marking the starting point of FRP development in bio medical industry. FRP was further developed in 1970s with technology advancement. Better plastic resins and improved reinforcing fibers were developed. DuPont developed an aramid fiber known as Kevlar, this fiber is still being used in developing dental bridges ,tendon ligament bone cement 3 and many more applications[13]. Parallel to this development carbon fiber is introduced replacing metals. 3.0 Characteristics of FRP One of the mandatory requirement for biomaterial is sterilization and meet the reuired characteristic. It is known that sterilization of FRP(particularly properties of carbon fiberreinforced Polyetheretherketone PEEK composites) material that would alter the micro mechanical properties to the certain extend. It is crucial to analyse the changes in FRP material as such changes in micro mechanical properties would affects in vivo behaviour of the material. Test ought to be done to analyse the level alteration during such process. Two established tests namely Nanoindention and nanoscratch are used for this purpose[6]. Sterilization is a mandatory test for implant materials therefore the required parameter of FRP must be analysed first to ensure its full potential. The characteristic of FRP has been summarised in the Table 1. 4.0 Application of FRP in biomedical industry Various importance factors be must considered in material selection for biomedical applications. In brief factors influence the selection summarized in the Table 1 below. Factors Description 1st level properties Chemical/biological characteristics chemical absorption (bulk and surface) Physical characteristics Density 2nd Level material properties Adhesion Surface topology Texture and roughness Specific functional requirement (Based on application) Bio functionality ( Non thrombogenic, cell adhesion.etc),Bio-inert (nontoxic, non-irritant, non-allergic, non- carcinogenic, etc),BioActive, Bio Stability (resistant to corrosion, hydrolysis, oxidation, etc) Bio degradation. Form (solid, porous ,coating ,film, fibre, mesh, powder), Geometry, Coefficient of thermal expansion, Electrical conductivity, colour ,Aesthetic, Refractive index, Opacity or trancesluency Mechanical/structural characteristics, elastic modulus Poisson's ratio Yield Strength Tensile Strength compressive strength Hardness Shear modulus Shear strength flexural modulus flexural strength Stiffness or rigidity Fracture toughness Fatigue strength Creep resistance Friction and wear resistance Adhesion strength, proof stress Abrasions resistance 4 processing and fabrication Characteristic of host Reproducibility , quality, Sterilizablity, packaging, secondary process ability Tissue ,organ, species, age ,sex, race, health condition, activity, systemic response Medical /surgical procedure, period of application/usage. Table 1 : Various factors Of Importance in Material Selection for Biomedical application 4.1 Hard Tissue Application. The application of FRP in biomedical can be grouped into hard tissue and soft tissue applications. Hard tissue application comprises of bone fracture repair, dental application, total hip replacement, knee, ankle and other joint replacement. Usually the material selection for hard tissue application is from resorbable and partially resorbable FRP materials. Selection of FRP material should consider the mechanical properties of the tissue. Two key areas to be considered in the selection can be summarized in the Table 2 below: Hard Tissue Cortical bone (longitudinal direction) Cortical bone (transverse direction) Cancellous bone Enamel Dentine Modulus ( GPa) 17.7 12.8 0.4 84.3 11.0 Tensile Strength(MPa) 133 52 7.4 10 39.3 Table 2: Mechanical properties of hard tissues [5] 4.1.1 Bone Fracture Repair. It can be divided in two types ; External Fixation and Internal Fixation. The different between of these two types is the first does not require opening of the fracture location and the later does. External repairing is done by keeping the bone fragments aligned by using casts, splints, braces or other sort of supports. FRP materials have been widely used in bone fracture repairing in both fixation types. Material like carbon fibres (CF), polyetherethrketone (PEEK) , Epoxy ,etc are the common material in manufacturing bone plates and screws. [5] The bone density is proportionate to stress that applied to it, in other words the higher the applied stress the denser the bone become. Bone weakening on the other hand generally is due to lack of 5 stressing/exercising of the bone. Therefore, heavy loading may impact bone fractures and there are many types of fractures depending on the crack, size, position and orientation[5] The fundamental purpose of fracture fixation is to stabilize the fractured bone, and facilitate speedy recovery of injured bone.[19] FRP is more widely used in manufacturing breathable caste in which if compared to the conventional type it has many advantages, comfort to anatomical shape, strong, stiff , water proof, radiolucent are the most prominent advantages of this material. Usually for external fixation materials from non resorbable are used for example CF/Epoxy. [5] The internal fixation usually covers dental, total hip replacement, knee replacement and done by implanting screws, plates, intramedullary nails, wires and pins. Figure 1: Picture of External Fixation. Adopted from indiamart.com. Figure 2: Picture of Internal Fixation . Adopted from uihealthcare.org 6 4.1.2 Joint Replacements There have been many developments of material for joint replacement. Hip, knee, shoulder and elbow are few examples of synovial joints. FRP materials have been used in joint replacement, however there were too many complications in it such as stress shielding, reduction of blood supply at the implantation site and the possibility of corrosion wear and debris formation. [10] FRP was proven to have high resistance to fatigue failure as their structural stiffness strength that can be matched the modulli of bone.[1] It has been used in femoral component ( total hip replacement) as it can be customized as per require stiffness and strength.[3] 4.1.3 Dental application. Typical application of FRP in dental treatment includes filling cavities ( dental caries), replacing fractured or decayed teeth, crown and bridge, prosthetic and many more. The material that have been used for this treatment falls into biomaterial as well and can be grouped in internal fixation. The selection of material depends on the capability to resemble the physical, mechanical and aesthetic properties of natural tooth structure. Amalgam, gold, alumina, zirconia, acrylic resins and silicate cements are commonly used for restoring decayed teeth [5] .The problem with these materials is the suitability in certain conditions such as amalgams and gold are used in restoration of posterior (back) teeth not preferred for anterior teeth for cosmetics reasons. The capability of FRP is to increase the mechanical properties and good aesthetic attributes, that is why it has been widely used in dental application. The fibres enhance the mechanical properties of the polymers and there is a good initial bonding of glass fibres to polymer via an interface made from saline coupling agents[14]. Studies show that Silica-Glass ?Fibre Reinforced poly methyl methacrylate (PMMA) based polymers has a good mechanical properties in both wet and dry conditions [14] . The usage of traditional material in the manufacture of brackets shows high strength and stiffness but poor aesthetics. PMMA composite materials have been suggested as substitutes for this 7 traditional/conventional type. Furthermore composite post insertion proves less time consuming and making surgical procedure less traumatic for patients[19]. 4.2 Soft Tissue Application FRP based material implants in soft tissues application plays very important role, where special requirement particularly strength and modulus in repairing connective tissues need to be observed in orthopaedic and dentistry patients. The usage of FRP based implants depends on the types of corrective surgery intended, for example the deformities or defect which can be congenital, developed or acquired [5]. Composite material such as FRP can be a very convenient in such situations as the desired mechanical properties can obtained by choosing the right characteristics of composite materials. This is done by using micromechanics and lamination theory approach. Finite Elements Models (FEM) is used to analyse the stress pattern in detail in both natural and synthetic structure under the complex loading geometry [16] . Table 3 shows the two important parameters that ought to be considered in choosing or designing FRP based implants. Soft Tissue Modulus Tensile (MPa) Strength(MPa) Articular Cartilage 10.5 27.5 Fibrocartilage 159.1 10.4 Ligament 303.0 29.5 Tendon 401.5 46.5 Skin 0.1-0.2 7.6 Arterial Tissue(longitudinal direction) 0.1 Arterial Tissue(transverse direction) 1.1 Intraocular lens 5.6 2.3 Table 3: Mechanical properties of soft tissues [5]. 4.2.1.Connective tissues Connective tissues is tissue that connect or holds synovial joints. The application of FRP is widely used in connective tissues repairing, significant factor, particularly elastic modulus and strength ought to be considered. 8 In the current application FRP implants can be used in developing devices for various purposes, which depends on the intended functions, among which are fillers defect, enclose, store, isolate or transporting. Fillers usually are required to do restoration of cosmetic defects and atrophy.FRP is also being used in cartilage replacement, Articular cartilage which caused by deterioration by osteoarthritis , now can be replaced by FRP implant made of Silicone rubber(SR) and Polytetrafluoroethylene (PTFE) which believed to have the closest characteristics of meniscus or fibrous [5]. 4.2.2 Skin Materials such as PLLA (Poly-L-Lactic acid), collagen areresorbable polymers used in skin repair, particularly in facilitating the healing. 4.2.3 Arterial Blood vessels FRP application in repairing blood vessel comes in the form of grafts. Graft is a tubular structures that used to bypass vessels which is blocked /damaged to restore blood circulation. Vascular graft is used to replace segments of the natural cardiovascular system that are deceased or blocked. Typical example is to replace section of arteries in a diabetic patient’s leg where blockage has occurred. PET or extruded porous wall tubes PTFE and PU material widely used for this purpose[5]. 6.0 Conclusion In general, the application of FRP in bioengineering area are very wide. Since it was first developed, various materials have been modified to substitute less efficient traditional materials. It is apparent that in developing FRP materials two important parameters that have to be considerd are biocompatibility and its structural strength. With the advancement of technology new methods and manufacturing processes has been developed, this have laid the path for more advanced materials for more complicated 9 purpose. 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