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Titanium, silicon and calcium ions have demonstrated positive effects in bone  healing. Therefore, this paper investigates the densification, mechanical  properties and in vitro biological behaviour of TiO2, together with SiO2 and  CaO, on silicon nitride ceramics to be used in clinical applications. The  results revealed that the sintered samples reached high values of relative  density and fracture toughness, non-cytotoxicity as well as good ability to  promote cell proliferation and form a layer of carbonated hydroxyapatite on  their surfaces, after immersion in simulated body fluid. The sample with the  highest amount of TiO2 reached the highest value of relative density and the  best results of cell proliferation and fracture toughness, indicating the  great potential to be explored by in vivo experiments for later application  as intervertebral devices.

Silicon nitride with titania, calcia and silica additives for orthopaedic applications