Ceramics for medical applications: A picture for the next 20 years

High-tech ceramics have always been associated to medical devices: they are used today as femoral heads and acetabular cups for total hip replacement, dental implants and restorations, bone fillers and scaffolds for tissue engineering. Here, we describe their current clinical use and propose a picture of their evolutions for the next 20 years. The need for tough, strong and stable bioinert ceramics should be met by either nano-structured, alumina and zirconia based ceramics and composites or by non-oxide ceramics. Nano-structured calcium phosphate ceramics and porous bioactive glasses, possibly combined with an organic phase should present the desired properties for bone substitution and tissue engineering. The position of ceramics in a gradual medical approach, from tissue regeneration to conventional implants, is discussed.