In the past, medical ceramics were represented by ceramic and clay implants that remained inert in the host and acted as scaffolds or supports. Today, the scenario has changed remarkably due to the introduction of an entirely new generation of bioceramics. These implants are, amazingly, structurally and functionally compatible with living tissue in the human body and contribute to the development of new tissue. Over the past two decades, there has been tremendous improvement in the performance of these bioceramics, and technology advances have created a very huge market for ceramics in the medical sector.
The two key markets for medical ceramics are:
• Implantable bioceramics, which consist of medical devices and implants that are on the market as tooth and bone replacements. Bone and joint replacements are essentially metal and ceramic composites, whereas dental implants are mostly made of all-ceramic systems. Bioceramics are a huge success as implantable materials because they are bioactive in their natural compositions and can be fabricated into various composites with metals, both natural and synthetic polymers, carbon fibers, and most recently, carbon nanotubes.
• Medical equipment, including analytical and scientific instrumentation; ceramics are primarily used in analytical, diagnostic, vision, and therapy systems.
Although there are a few risks and ambiguities regarding the use of implants and medical devices based on ceramics, NanoMarkets certainly believes that the market for implantable bioceramics will continue to grow in the future. This growth can possibly be converted into profitable businesses by the companies manufacturing the medical ceramic devices and the firms that supply the necessary raw materials.
Implantable Bioceramics Market Dominated by Tooth and Bone Replacements
Biocompatibility and resistance to wear have made ceramic materials ideal for a range of medical applications, from artificial joints to electronic sensors, stimulators, and drug delivery devices. Alumina and zirconia, among other ceramics, have been successful in withstanding the hostile environment of the human body. The implantable bioceramics market primarily consists of two segments: tooth and bone replacements.
Dental implants: The dental consumables segment includes crowns/bridges, implants, orthodontics, impressive materials, composites, endodontics, adhesives, and cements, while the dental equipment segment is composed of large equipment, such as autoclaves, sterilizers, chairs, communication systems, compressors, cuspidors, and digital imaging systems. Small equipment, including amalgam removal systems, amalgamators, hand piece cleaners, lab equipment, duplicators, and ultrasonic cleaners, also fall into this product segment.
The leading multinational manufacturers account for approximately two-thirds of the global implant market and pursue premium strategies. The remainder of the market is very fragmented, consisting of several hundred competitors, the majority of which have a local country or regional focus.
The competition in the global dental implant market is intense, with only a few large players, viz. Nobel Biocare, Straumann, Dentsply, and Zimmer. The main drivers of the global dental market include low dental implant penetration rates and an increasing worldwide elderly population. Another factor that drives the dental market is longer life expectancies, because an increase in life expectancy results in a more elderly population. Increasing consumer incomes and increasing urban populations are other major factors that are boosting the dental market.
Bone implants: Alumina and zirconia are the main ceramic materials for bone implants, largely due to their mechanical strength and chemical inertness. Morgan Technical Ceramics (MTC) is one of the globally renowned medical ceramic manufacturers that has substantial experience in developing clinically proven ceramic joints using alumina and zirconia.
MTC’s Vitox AMC alumina matrix composite bioceramic material used in hip joints has been shown to have exceptionally low wear rates compared with alternative materials. It is therefore a dependable solution that does not have the potential health risks associated with metal hip joints, and it is longer lasting, thus enabling patients to continue to lead active lifestyles.
Medical-grade silicon nitride ceramics U.S.-based Amedica have good potential to find applicability in the spinal and arthroplasty segments.
Ceramics are also used in bone tissue engineering because of their osteoinductive and biocompatible properties. Scaffolds that typically act as engineered bone grafts can be used in several specialty applications, such as bone regeneration and wound healing.
Wide Use Of Ceramics In Biomedical Equipment
Ceramics are widely used in biomedical equipment, such as ultrasound machines, point-of-care systems, medical test equipment, and imaging instruments. MTC has, for example, launched its piezoceramic objective focusing device that provides the millisecond responsiveness essential for DNA research. Piezoceramics have become the premium choice for medical device manufacturers for the execution of accurate positioning and precise movements.
Because the number of people that need implants is always on the rise, demand for implantable bioceramics and composites continues to increase, while the number of ceramic parts used in biomedical equipment depends on the number of pieces of equipment manufactured and their utility. Thus, NanoMarkets believes that the demand for implantable bioceramics materials will be higher than that for ceramic components used in medical equipment.
Market Opportunities for Implantable Bioceramics Materials
Dental consumables represent the largest segment of the dental care industry, followed by dental equipment. In other words, implantable bioceramics consisting of tooth and bone replacements are in great demand and account for most of the market, while the tools and instruments used during implantation account for just a small part of the overall market.
The scenario described above suggests that not only the number of small implants used by the global population is growing and likely to continue to grow, but also the magnitude of sales are steadily increasing. Due to this steady growth in the small implants market, NanoMarkets expects the bioceramics materials market to continue to grow over the next eight years.
In this growing market, bioceramics materials suppliers will have expanded opportunities to generate new business revenues from both natural substrates and composites and novel manufacturing technologies, such as injection molding and electro-spinning. However, the significant contributors to clinical success will be materials that are bioactive, improve lifetimes, and reduce manufacturing costs.
The implant manufacturing giants like Nobel Biocare, Strauman, and Zimmer offer end-to-end solutions to patients that receive bone and joint replacements, from computed tomography (CT) scans to the actual devices. More than 20 percent of all of the prosthetic elements (tooth-based and implant-based) were produced using CAD/CAM in 2012. Although the majority of prosthetic elements are still made by hand, the share of dentists using CAD/CAM prosthetic elements continues to increase.
Nanoceramic Composites: Promising but Risky
Ceramic materials fabricated in the form of nano-sized particles show excellent promise in bone tissue regeneration applications. In fact many in vitro studies have proved beyond a doubt that bone-forming cells called osteoblasts have proliferated on substrates with nanoceramic particles and coatings.
However, when the ceramics are formed into composites with carbon nanotubes (CNTs), cytotoxicity has been observed in some experiments. In addition, nanoceramic polymer composites with amine and amide groups may lead to the accumulation of toxic debris that can evoke inflammatory and/or immune responses and ultimately lead to the rejection of the composite when implanted in a human host. Moreover, the rejection of the implant sometimes can lead to sepsis or septic shock.
Therefore, while nanoceramic composites have great potential in the future as implants and medical devices, NanoMarkets believes that key questions about their biocompatibility and bioactive properties must first be addressed before that potential can be realized.
Major implant manufacturers must conduct thorough research studies and, more importantly, appropriate clinical trials before implants and prostheses containing nanoceramic composites are released to the market.
In addition, NanoMarkets has observed that the number of companies offering nanoceramics is growing. Therefore, firms that simply offer acceptable clinical solutions, and not clinically significant advantages, will only be able to compete on price. However, if they can offer a price advantage, because most clinicians are price sensitive, they may gravitate to the newer lower-cost substitute implants.
