Jurnal Pendukung 2

ANRV315-MR37-01 ARI 21 May 2007 13:10
Low-Temperature
Degradation of Zirconia
Annu. Rev. Mater. Res. 2007.37:1-32. Downloaded from arjournals.annualreviews.org
and Implications for

Biomedical Implants
by 195.68.31.231 on 08/06/07. For personal use only.
Jérôme Chevalier,1 Laurent Gremillard,1

and Sylvain Deville2
1
Mateis, INSA Lyon, CNRS UMR 5510, 69621 Villeurbanne, France;
email: Jerome.chevalier@insa-lyon.fr
2
Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley,
California 94720
Annu. Rev. Mater. Res. 2007. 37:1–32 Key Words

First published online as a Review in Advance on Y-TZP, transformation, aging, orthopedics, dental
April 13, 2007
The Annual Review of Materials Research is online at Abstract

http://matsci.annualreviews.org
This review describes the mechanisms responsible for low-
This article’s doi: temperature degradation (LTD) of zirconia ceramics and its detri-
10.1146/annurev.matsci.37.052506.084250
mental consequences for biomedical devices. Special emphasis is
Copyright c 2007 by Annual Reviews. given to the critical issue of zirconia degradation actually observed
All rights reserved
for hip prostheses. Experimental methods to accurately measure and
1531-7331/07/0804-0001$20.00 predict LTD in a given zirconia ceramic are presented. Different so-
lutions to inhibit LTD or at least reduce its kinetics are reviewed,
with the objective of highlighting alternative options for the gener-
ation of new zirconia-based biomedical ceramic devices.
1
ANRV315-MR37-01 ARI 21 May 2007 13:10
INTRODUCTION
From low to high temperatures, zirconia exhibits three allotropic crystal structures:
Zirconia: zirconium monoclinic (m), tetragonal (t), and cubic (c). A tetragonal-to-monoclinic (t-m) trans-
dioxide (ZrO2 ), generally formation occurs at approximately 1000◦ C in pure zirconia and is associated with a
used in the form of a large volume increase and shear strains. As a consequence, samples of pure zirconia
polycrystalline technical
fracture during cooling from the sintering temperature. Only the addition of oxides
ceramic, stabilized with
another oxide [such as yttria (Y2 O3 )], lowering the t-m transformation temperature, can stabilize
the t phase to a certain extent at room temperature, thus allowing zirconia to be used
Y-TZP: yttria-stabilized
tetragonal zirconia as a bulk, structural material. However, zirconia in the t phase remains metastable.
polycrystal Zirconia’s ability to transform under mechanical stress (stress-induced phase trans-
Femoral head: component formation) represents one of the most remarkable (somewhat unexpected) findings
of a hip prosthesis in the in the ceramic field.
form of a ball affixed to a Indeed, in the 1970s, first Garvie et al. (1) and then Gupta et al. (2) showed that
metallic femoral stem and zirconia exhibits a transformation toughening mechanism that acts to resist crack
bearing against the
propagation. The stress-induced phase transformation involves the transformation
acetabular cup
of metastable tetragonal crystallites to the m phase at the crack tip, which, accompa-
LTD: low-temperature
nied by a volumetric expansion, induces compressive stresses. Y-TZP (yttria-stabilized
degradation
tetragonal zirconia polycrystal) zirconia ceramics belong to this family of toughened
materials. They can exhibit bending strength of more than 1000 MPa, with a tough-
√
ness of approximately 5–10 MPa m. Such outstanding properties for oxide ceramics
opened the way to new structural devices and designs not available with standard,
more brittle ceramics like alumina. As an example, since the late 1980s, Y-TZP zir-
conia has been very popular in the manufacturing of femoral heads for hip prosthesis
applications (3). Y-TZP was preferred to other zirconia ceramics because of its unique
balance of toughness and strength. Today, more than 600,000 zirconia femoral heads
have been implanted worldwide, mainly in the United States and in Europe. Zirconia
is also increasingly used in dental applications such as endodontic posts and brack-
ets and more recently inlays, crowns, and bridges for restorative dentistry, owing to
recent developments in CAD/CAM procedures.
However, the excitement created by these materials was rapidly dampened by the
findings of Kobayashi et al. (4), who discovered a serious limitation of Y-TZP ceram-
ics, first for applications near 250◦ C. These authors revealed that Y-TZP ceramics
could suffer a slow t-m transformation at the sample surface in a humid atmosphere,
followed by microcracking and a loss in strength. Following this work, a series of
papers attempted to understand the basic micromechanisms of the slow t-m trans-
formation [often referred to as aging or low-temperature degradation (LTD)] and to
reduce this limiting phenomenon. After more than 20 years of research, the exact
mechanism is still under discussion. The increase of internal stresses associated with
a penetration of water species inside the lattice is likely to trigger the initiation of
transformation (5). A cascade of events then occurs, the transformation propagating
first inside one grain (6) and then invading the surface by a nucleation-and-growth
(N-G) mechanism (7) and the core for severe treatments (8).
This review first aims to describe the different processes and sequences of ag-
ing. Among the numerous interpretations proposed in the abundant literature, we
2 Chevalier · Gremillard · Deville

ANRV315-MR37-01 ARI 21 May 2007 13:10
emphasize the most recent and likely models that offer an acceptable coherence be-
tween theoretical analysis and multiscale experimental facts. New interpretations of
aging were made possible in the past decade by the development or improvements of
ZTA: zirconia-toughened
techniques that allow monitoring of LTD from the atomic to the macroscopic scale. alumina
This review therefore describes briefly the techniques that may be used to follow
aging kinetics.
Until the beginning of the present decade, aging kinetics were measured well
above room or body temperature. Indeed, the transformation rate is the highest at
approximately 250◦ C and was considered negligible at 37◦ C (9). Therefore, the zir-
conia manufacturers assumed that the problem of aging under an in vivo situation was
irrelevant until 2001, when several hundreds of hip prosthesis failures were reported
in a very short period (10, 11). These failures are now attributed to an accelerated
aging of the zirconia femoral head in particular batches. Even if limited in time
and number and clearly identified to be process controlled, these events have had a
catastrophic impact on the use of zirconia. More importantly, recent reports suggest
that significant aging even occurs in vivo at the surface of implants processed under
“normal” conditions (12). This could lead to critical health and economical issues in
the near future, considering the large number of zirconia femoral heads that have been
implanted during the past decade. The second objective of this paper is to describe
the potential consequences of aging on the integrity of zirconia orthopedic implants.
They are assessed on the basis of current knowledge of the aging mechanism and the
study of retrieved components.
Current state of the art shows the strong variability of zirconia sensitivity to in vivo
degradation as a consequence of the strong influence of microstructure and process on
LTD. Therefore, here we examine the effects of the most important microstructural
features on LTD. This analysis leads us to propose options to improve the resistance
of zirconia-based ceramics to aging. In particular, the future of zirconia-toughened
alumina (ZTA) composites is discussed, as it represents one trend followed by ceramic
manufacturers.
MECHANISMS OF AGING: FROM PHYSICOCHEMICAL TO

MICROMECHANICAL PROCESSES
All the stages of aging have been discussed in the literature. However, a complete
overview from the early stages to the macroscopic consequences is still lacking. This
section’s objective is to document each stage of the transformation and describe how
they relate to each other. Some fundamentals of the t-m transformation are necessary
to discuss before describing the aging mechanism.
Tetragonal-to-Monoclinic Transformation in Zirconia

The t-m transformation in zirconia is martensitic in nature. A martensitic transfor-
mation is a “change in crystal structure . . . that is athermal, diffusionless and involves
the simultaneous, cooperative movement of atoms over distances less than an atomic
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ANRV315-MR37-01 ARI 21 May 2007 13:10
diameter, so as to result in a macroscopic change of shape of transformed regions”

(13). A consequence of the diffusionless nature of martensitic transformation is the
existence of crystallographic correspondences between the parent and the product
phase, described by habit planes and directions (shape strain), as schematically shown
in Figure 1. The tetragonal (P42 /nmc) to monoclinic (P21 /c) transformation occurs
at ≈950◦ C (Ms ) on cooling in pure zirconia and is accompanied by a shear strain
amplitude of ≈0.16 and a volume expansion of approximately 0.05. The transfor-
mation is reversible and occurs at approximately 1150◦ C (As ) on heating. Table 1
summarizes the features of the transformation (14).
Lange (15) first described the thermodynamics of the t-m transformation in zir-
conia, considering the simple ideal case of a spherical tetragonal particle in a matrix.
The change of total free energy (Gt−m ) due to the transformation is given by
Gt−m = Gc + USE + US , 1.
where Gc (<0 when T < Ms ) is the chemical free energy (dependent on temperature
and composition), USE (>0) is the strain energy associated with the transformed
particles (dependent on the surrounding matrix, the size and shape of the particle,
and the presence of stresses), and US (>0) is the change in energy associated with
the surface of the particle (creation of new interfaces and microcracking).
Through a decrease in |Gc | and an increase in USE , the addition of alloying
oxides such as Y2 O3 in Y-TZP decreases the driving force of the t-m transformation
and hence its temperature, as shown in the ZrO2 -Y2 O3 diagram in Figure 2 (16, 17).
It even makes possible, for Y2 O3 content above 2 mol.%, the retention of metastable
tetragonal particles in dense bodies at room temperatures. USE is directly related to
the surrounding matrix modulus: High matrix modulus will increase USE , stabilizing
the t phase. USE is also directly influenced by applied or internal stresses: Tensile
stresses will act to reduce USE , destabilizing the t phase.
Early Stages of Aging: Stress Accumulation due to Water Penetration

Aging occurs experimentally in zirconia samples, mostly in humid atmosphere or in
water. Therefore, several models currently attempt to explain how the presence of
water could promote the t-m transformation in zirconia. Early models (18)—based
on the reaction between H2 O and Y2 O3 to form Y(OH)3 during aging—have been
rejected, and the fundamental role of internal stresses associated with water diffusion
in the zirconia lattice has been demonstrated (5, 19).
Several experimental results show that water radicals do indeed penetrate inside
the zirconia lattice during exposure to humidity. Most likely, the oxygen from the
water is located on vacancy sites, and the hydrogen is placed on an adjacent interstitial
site (19). This emphasizes the primary role of oxygen vacancies initially present in
−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−→
Figure 1
(a) Schematic of the tetragonal-to-monoclinic (t-m) martensitic transformation, showing habit
plane and shape strain. (b) Simple arrangement of the t-m transformation when the free surface
corresponds to (001)t [the surface uplift is observed by atomic force microscopy (AFM)].

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Chevalier
Table 1 Crystallographic features of the tetragonal-monoclinic martensitic transformation in zirconia.a From Reference 14
·
Lattice Lattice-invariant Habit plane Shape strain Shear Volume
correspondence shearb Magnitude of g normalc Shape strainc amplitude component change
⎡ ⎤ ⎡ ⎤
Gremillard
−0.9537 −0.0026
·
ABC 1 (011)[01̄1] 0.0344 ⎣ ◦0.0055 ⎦ ⎣ ◦0.0028 ⎦ 0.1640 0.1556 0.0518
◦0.3005 ◦0.1640
⎡ ⎤ ⎡ ⎤
Deville
◦0.0915 ◦0.1597
ABC 2 (011)[01̄1] 0.0344 ⎣−0.0171⎦ ⎣−0.0007⎦ 0.1640 0.1556 0.0518

−0.9956 −0.0373
⎡ ⎤ ⎡ ⎤
◦0.0034 ◦0.0030
BCA 1 (110)[11̄0] 0.0344 ⎣ ◦0.3935 ⎦ ⎣◦0.1751⎦ 0.1761 0.1683 0.0518

−0.9193 ◦
0.0186
⎡ ⎤ ⎡ ⎤
−0.0168 −0.0004
BCA 2 (110)[11̄0] 0.0344 ⎣−0.9996⎦ ⎣−0.0558⎦ 0.1761 0.1683 0.0518
−0.0241 ◦
0.1670
⎡ ⎤ ⎡ ⎤
◦0.3006 ◦0.1640
CAB 1 (101)[101̄] 0.0027 ⎣−0.9537⎦ ⎣−0.0026⎦ 0.1640 0.1556 0.0518

−0.0001 −0.0002
⎡ ⎤ ⎡ ⎤
−0.9958 −0.0373
CAB 2 (101)[101̄] 0.0027 ⎣ ◦0.0915 ⎦ ⎣ ◦0.1597 ⎦ 0.1640 0.1556 0.0518
◦0.0003 ◦0.0001
◦ ◦ ◦ ◦ ◦
a
Input parameters: t phase: at = 5.128 A , ct = 5.224 A ; m phase: am = 5.203 A , bm = 5.217 A , cm = 5.388 A , β m = 98.91◦ .
b
Expression in the lattice axis system of the tetragonal parent phase.
c
Expression in the orthonormal axis system bounded to the tetragonal lattice axis system.
ANRV315-MR37-01 ARI 21 May 2007 13:10
3Y-TZP Figure 2
ZrO2 -YO1.5 phase diagram
3000 (after Reference 16).
Liquid (L) Metastable phases retained
at room temperature are
L+F
indicated just above the
horizontal axis. The red
2500 dotted lines show the
nonequilibrium
monoclinic-tetragonal and
Cubic (F) cubic-tetragonal transition
regions (after Reference 17).
2000
Temperature (°C)
Tetragonal (T)
1500
T+F
T0
(F
1000
⇒
T)
Monoclinic (M)
500
T0
M+F
(T
⇒
M)
Tetragonal
Monoclinic Cubic
0
0 5 10 15 20
Mol.% YO1.5
zirconia (20). In Y-TZP, the presence of numerous vacancies due to the trivalent
character of Y2 O3 makes the diffusion rate of species from the water higher than
in other zirconia ceramics (i.e., CeO2 -doped ZrO2 ). According to Schubert & Frey
(19), the penetration of water radicals leads to a lattice contraction, which results in
the formation of tensile stresses in the surface grains that destabilize the t phase by
reducing USE in Equation 2. Martensitic transformation of grains (or part of grains)
at the surface can then proceed.
Martensitic Transformation at the Surface of Zirconia During Aging

In zirconia, several lattice correspondences and lattice-invariant shears can be fol-
lowed (Table 1). However, during aging the transformation occurs on the surface,

ANRV315-MR37-01 ARI 21 May 2007 13:10
allowing only one lattice correspondance, ABC 1, which means that the at , bt , and ct
axes of the t phase change into, respectively, the am , bm , and cm axes of the m phase (14).
Figure 1 displays a simple arrangement of the t-m transformation when the free sur-
MAJ:
Mehl-Avrami-Johnson face corresponds to (001)t . All the t-m interfaces are habit planes and are unchanged
during the transformation. All the interfaces between the variants are of the kind
{100}t or {110}t and are jointly elongated in the direction [001]t . For this particular
configuration, all the volume change is exactly relaxed outside of the free surface, and
no internal stresses are generated inside the volume. In fact, as the strain directions
are not exactly [001]t (Table 1), some negligible internal strains are expected. More
importantly, in general the angles between the ct axis and the normal vector to the
free surface are randomly distributed. This results in an increase of tensile stresses
in the t phase surrounding the transformed zone, accelerating the transformation

by a near-to-near mechanism (Figure 3). The figure emphasizes the facts that the
transformation begins mostly at grain corners, where residual tensile stresses are the
largest (21), and that one given grain does not transform all at once but rather pro-
gressively as the stress state due to water attack and earlier transformation increases.
Some reports (8, 22) show that tensile stresses generated by the transformation may
induce microcracking at the grain boundaries, easing the diffusion of the water species
inside the bulk.
Transformation Extension by Nucleation-and-Growth Process

In the above section, we describe how the transformation can start and propagate in-
side one grain. If, for some specific orientation relationships, a monoclinic plate can
go through two or more tetragonal grains (Figure 4), in most cases grain boundaries
may prevent the extension of a martensitic lath from one grain to another. However,
the transformation of the surface of Y-TZP takes place by an apparent N-G mech-
anism; i.e., once a grain is transformed, the extension of the transformation occurs
not only at random on the surface but also preferentially on the neighboring grains
(nucleation is here considered as the transformation of one grain, whereas growth is
the extension to its near neighbors). A typical N-G process observed experimentally
in the literature (7, 23) is shown in Figure 3. Nucleation occurs on the most unsta-
ble grains (with less Y2 O3 and/or with large size and/or subjected to higher internal
stresses) subjected to the highest tensile stresses (either internal or applied). The
number of nuclei increases continuously with the stresses, owing to the penetration
of water. At the same time, growth occurs because the transformation of one grain
puts its neighbors under tensile stresses, favoring their transformation under the ef-
fect of water. Describing a martensitic transformation by an overall N-G process may
appear contradictory, but one must keep in mind that the whole process is controlled
by the diffusion of water species.
The most detailed studies (7, 23–25) have shown that LTD kinetics follow sig-
moidal laws related to the N-G process. The kinetics were described using Mehl-
Avrami-Johnson (MAJ) laws (see, for example, Reference 26):
α = 1 − exp (− (b.t)n ) , 2.

ANRV315-MR37-01
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Figure 3
Description of the tetragonal-to-monoclinic transformation at different steps and with
different techniques. (Central plot) Evolution of the monoclinic fraction versus time measured
by X-ray diffraction along with numerical and analytical modeling. (Upper left corner) Early
stage of the transformation observed by atomic force microscopy. The transformation starts at
one grain corner (white arrows) and propagates to the rest of the grain. (Bottom)
Nucleation-and-growth process observed by optical interferometry (the circled area indicates a
monoclinic spot). (Right side) Growth into the bulk observed by cross-sectional scanning
electron microscopy.

ANRV315-MR37-01
Figure 4
Martensitic lath crossing a grain boundary (AFM relief map). The dashed lines indicate the
interface between monoclinic variants that are growing in a neighboring grain through a grain
boundary (white dashed line).
where α is the degree of transformation of the t phase in the surface [e.g., the mono-
clinic:(tetragonal + monoclinic) ratio in the volume accessible by the technique used
for the measure of α], t the time, and n a constant (the MAJ exponent). b is a param-
eter dependent on temperature. In the 37◦ C–140◦ C temperature range, b follows an
Arrhenius law:

Q
b = b 0 · exp − , 3.
RT

ANRV315-MR37-01 ARI 21 May 2007 13:10
where b0 is a constant, R the gas constant, Q the apparent activation energy, and T the
absolute temperature. Time-temperature equivalences can be derived from Equation
3. For example, steam sterilization at 134◦ C for 5 h is now proposed to simulate 15–20
XRD: X-ray diffraction
years at 37◦ C (27).
SEM: scanning electron
One analytical modeling of zirconia aging kinetics (7) led to an MAJ-type equation
microscopy
for the degree of transformation versus time. In this model, aging occurs by a constant
nucleation of new transformation zones with time and an increase in diameter and
height of existing ones at constant rate (provided that there is enough space to grow).
With these features, the monoclinic fraction f versus time t measured by X-ray
diffraction (XRD) should be

π · αd2 · αh · Nr
f = ft0 · 1 − exp − · t4 , 4.
48 · k · l
where αd and αh are the diameter and height growth rates, Nr the nucleation rate, k
the linear expansion accompanying the t-m transformation (1.3%), and l the X-ray
penetration depth (5 μm in standard conditions: Cu Kα radiation, θ-2θ configuration).
ft0 corresponds to the initial tetragonal fraction before aging [lower than 1, owing to
the presence of up to 20% c phase after a standard sintering condition (Figure 2)]. In
Equation 4, α d , α h , and Nr depend on the temperature. The parameter b in Equation
2 is thus given by
1/4
π · αd2 · αh · Nr
b= . 5.
48 · k · l
This shows that Q is an apparent activation energy that reflects the overall N-G
mechanism but depends on α d , α h , and Nr , which are also thermally activated with
different activation energies.
Equation 4 was successfully applied to one zirconia material in References 7 and
28 and to the commercial Prozyr zirconia femoral heads. However, this MAJ-type
equation is valid only in a limited range of N-G rates: Some zirconia follow MAJ ki-
netics, but with an n exponent different than 4 (typically between 0.3 to 4). Therefore,
numerical simulation based on the same assumptions (constant N-G rates) was also
proposed to better fit the aging kinetics, whatever the N-G rates (28). Both simulation
and experiments show that the exponent of the MAJ laws is controlled not only by
the N-G mechanisms but also—and mainly—by their respective kinetic parameters
(Figure 5). Measurements of nucleation and growth rates at the surface and at the
very beginning of aging and the use of numerical simulation allow for the accurate
prediction of kinetics for longer aging duration.
In Equation 4, saturation of the surface monoclinic fraction is reached when f
approaches ft0 : All the volume accessible by XRD underwent a t-m transformation.
However, aging still proceeds into the volume of the material (8). The transformed
layer can be observed by scanning electron microscopy (SEM) on cross section, as
shown in Figure 3. The transformed layer appears rougher as a consequence of
extensive pullout during polishing, owing to the microcracks generated by aging.

ANRV315-MR37-01 ARI 21 May 2007 13:10
Figure 5 5
Variations of the
exponent n of the
Mehl-Avrami-Johnson law
(Equation 2) with the n max
nucleation and growth 4
rates. αd is the diameter
growth rate, Nr is the
nucleation rate, and D is
the initial size of the nuclei
3
(typically the grain size).
n
2
1
Simulated points
Experimental points
0
10 –2 1 102 104 106 108
αd /N rD (m)
2
EXPERIMENTAL TECHNIQUES TO MEASURE AGING

Because it is a crystallographic change, aging can be easily characterized by techniques
sensitive to crystallography or chemical environment. Among them, XRD is most
extensively used (29). It is conducted mostly with a classical Bragg-Brentano geometry,
between 27–33◦ (2θ), with copper Kα radiations. This characterization is based on the
equation proposed by Garvie & Nicholson (30) and modified by Toraya et al (31):
m
I111 + I111
m
Xm = . 6.
m
I111 + I111
m
+ I101
t
XRD is fast and nondestructive, allowing the monitoring of LTD evolution on one
piece. It can be used to characterize large zones (a few square millimeters) or smaller
zones through the use of microdiffraction (mapping is possible). However, only the
surface is characterized (typical depth of a few micrometers), and thus this method is
unable to provide any information when the transformation propagates to the bulk. It
is also not very precise for monoclinic contents lower than 5%, making it unsuitable
for monitoring the beginning of the transformation. It is however possible to improve
the quality of the measure at short aging times by using XRD at grazing incidence
angles [1–5◦ (2θ )]; then, the penetration depth of X rays is even lower (from ∼5 μm
at 30◦ to ∼0.3 μm at 1◦ with the copper Kα radiation). The surface:bulk signal ratio
is increased, thus apparently increasing the quantity of m phase (but only because
the analyzed depth is smaller). Through the use of this property, several measures

ANRV315-MR37-01 ARI 21 May 2007 13:10
at different incidence angles give access to the depth profile of the monoclinic con-
centration (Figure 6). We know of very few published data on the application of
grazing angle XRD to the characterization of LTD (32), although it seems to be a
AFM: atomic force
very promising technique. microscopy
The intensity of a given Raman band is directly proportional to the concentration
OI: optical interferometry
of the scattering molecule to which it is associated, allowing quantitative analysis of
the phases by Raman spectroscopy. In zirconia, the monoclinic content is given by a
ratio between the intensities of the monoclinic peaks (∼181 and 192 cm−1 ) and the
tetragonal peaks (∼148 and 264 cm−1 ) (33):
m
I181 + I192
m
Rm =
t . 7.
m
I181 + m
I192 + 0.97 I148 + I264
t
Several authors have calibrated the technique by comparison with XRD results with
varying dependences: either linear (34), logarithmic (35), or in power law (36). An
agreement has not yet been reached, and systematic studies are needed.
Raman spectroscopy seems to be more sensitive than XRD to smaller traces of

m phase (37). It also allows for discrimination between the t phase and the t phase
(a t phase that can appear after rapid cooling of large cubic grains), which is more
difficult with XRD. It is therefore particularly appropriate for investigating coatings,
for which the t phase is present after the process (38). Furthermore, strains lead to
a change in the interatomic distances; this translates in Raman spectra by a shift of
the peaks, and after calibration this effect can be used to measure the stress in the
material (33, 39). Above all, micro-Raman spectroscopes are now available in confocal
configurations: Confocal Raman microscopy offers three-dimensional mapping of
both monoclinic content and stress state, with a micrometer resolution along the
three axes (34). Although less widely used than XRD, Raman spectroscopy is one of
the most powerful tools for characterizing zirconia LTD.
Surface imaging techniques such as optical interferometry (OI) (7) and atomic
force microscopy (AFM) (23, 40) are more sensitive to the early stages of aging and
give access to topological changes (cf. Figure 3). AFM offers a better spatial resolu-
tion in the three directions (it can reach atomic resolution), as compared with OI, but
its depth of field is limited to a few micrometers, making difficult its use on nonflat
samples such as femoral heads. Only small areas (typically 50 × 50 μm2 ) can be ob-
served by AFM, making this tool qualitative but not very suitable for any statistical
analysis. OI permits the observation of larger areas that are not necessarily flat and is
a faster and easier technique. These characteristics are emphasized with the new gen-
eration of optical interferometers that are fitted with mapping capabilities and that
can provide local (micrometer scale) information as well as macroscopic information
(macroscopic shape) over a several-millimeter square area. Both techniques can be
nondestructive. They both provide relief maps (where the m phase protrudes from the
tetragonal surface) from which the surface monoclinic fraction can be determined (by
image analysis) and the roughness calculated. They also allow the determination of
the geometry and repartition of the transformed zones and thus are particularly useful
for quantifying and understanding the first stages of transformation (7, 40). With its
better resolution, AFM is very powerful in detecting and characterizing the earliest

ANRV315-MR37-01 ARI 21 May 2007 13:10
Figure 6 1.25
Depth profile of the
monoclinic concentration Incident angle: a
from grazing incident 1° t (101)
angle XRD. (a) X-ray 1.00 3°
diffractograms at different 30°
incident angles.
(b) Measured monoclinic
fraction versus the 0.75
incident angle (from
Equation 5 and the I/Imax
diffractograms in a).
(c) Calculated monoclinic

0.50
depth profile.
0.25
m(–111)
0
28 30 32
2θ (°)
0.2
b
monoclinic fraction
Measured
0.1
0
0 10 20 30 40
X-ray incidence angle (°)
c
monoclinic fraction
Calculated
0.1
0.01
0 1 2 3 4 5
Depth (µm)

ANRV315-MR37-01 ARI 21 May 2007 13:10
instants of the t-m transformation. A striking example is the application of the marten-
sitic transformation theory to zirconia aging by Deville et al. (14, 22) on the basis of
AFM images. In contrast, thanks to its wide field of observation, OI is a much more sta-
Osteolysis: progressive
tistical tool. For example, results of the number and size of monoclinic nuclei obtained bone resorption
by OI during early stages of aging can be used to predict a whole aging kinetic (7, 28).
However, none of the above-discussed techniques provide information on the ex-
tension of LTD into the bulk because only the surface or near-surface region (by
Raman) can be investigated. This last stage of aging can be monitored only by tech-
niques giving access to the volume. The most common is SEM (cf. Figure 3). After
cross-sectioning and polishing of an aged sample, the transformed zone exhibits a
stronger contrast owing to microcracking. This allows direct measurement of the
transformed thickness. Images of the surface can clearly show the uplifted trans-
formed zones and the microcracks, but owing to the high depth of field, SEM is not
suitable for the quantification of early stages of aging. However, associated with elec-
tron back-scattered diffraction (EBSD) (41), this technique can give useful insight on
the crystallography of the transformation.

Measurement of the microwave dielectric loss tangent has also been applied to
characterize severe aging (42). Because of differences in loss tangent between the
polymorphs of Y-TZP, and also because of the presence of water in the aged zirconia,
transformations of up to 500 μm deep result in a loss tangent roughly proportional
to the thickness of the monoclinic layer. This technique is nondestructive and seems
interesting, but the literature on the subject is very scarce.
CONSEQUENCES OF AGING ON ORTHOPEDIC IMPLANTS:

FROM CONCEPT TO IN VIVO CASE STUDIES
The consequences of the aging process on the long-term performance of zirconia im-
plants can be twofold: Aging is indeed associated with roughening and microcracking.
This will inevitably impact the wear performance of hip joint heads, as roughen-
ing will increase the wear rate of the antagonist part of the prosthesis, whereas the
coupled effect of surface microcracking and wear will generate pullout of zirconia
grains. The biological interaction of small particles with the immune system cells
then becomes critical. It is indeed currently believed that particles generated at the
contact surfaces enter the periprosthetic tissues, where they trigger macrophages to
react. Macrophages then release proinflammatory cytokines that stimulate osteoclas-
tic bone resorption, leading to osteolysis, eventual loosening of the prosthesis, and
a need for replacement. The extension of the microcracked, transformed zone also
generates defects. Because zirconia is prone to slow crack growth because of stress
corrosion (43), defects generated in stressed regions of the implant may grow with
the transformed zone until reaching a threshold size for slow crack propagation to
proceed; the fracture of the implant is then unavoidable. This can apply to both
orthopedic and dental devices.
Early publications, mainly by zirconia femoral head manufacturers, showed no
significant aging degradation after moderate in vivo duration (9). It was there-
fore thought that aging was very limited and well controlled near the ambient

ANRV315-MR37-01 ARI 21 May 2007 13:10
temperature. However, in 1997 the U.S. Food and Drug Administration (FDA) first
reported on the critical effect of the standard steam sterilization procedure (134◦ C,
2 bars pressure) on the surface roughness of zirconia implants (44). This procedure
3Y-TZP: 3 mol.%
yttria–stabilized tetragonal is now forbidden for zirconia. More importantly, in 2001, the FDA announced that
zirconia polycrystal firms distributing orthopedic implants were recalling series of Y-TZP hip prostheses
owing to a fracture episode of zirconia ceramic femoral heads. More than 300 failures
were reported during the fracture episode. The cause of the failures was related to
an accelerated t-m phase transformation of zirconia in a limited number of batches
(11). Although limited in the number of failures and duration, this episode has had
a strong negative impact on the application of zirconia in orthopedics. In particular,
the main supplier of zirconia implants, Saint Gobain Desmarquest, stopped Prozyr
activities. The question of the LTD of zirconia in vivo, even under normal processing
conditions, thus became salient from 2001 because thousands of femoral heads had
already been implanted at that time. A series of papers was then published, showing
surface degradation of zirconia hip joint head implants (45–48) or strong osteolysis
associated with the use of zirconia heads (49–51). In contrast, a few papers still show
good clinical results and low wear rates associated with the use of zirconia heads
(52–53). Therefore, the correlation between LTD and in vivo behavior is discussed
below to understand the current state of the art on retrieval analysis.
Zirconia Fractures due to Accelerated LTD: A Striking Example of a

Process-Durability Relationship
Saint Gobain Desmarquest introduced yttria-stabilized zirconia (3Y-TZP) in
orthopedics in 1985, as an alternative to alumina. From 1985 to 2000, the French
company, which was the major zirconia manufacturer, sold more than 350,000 hip
joint heads (under the trade name Prozyr) worldwide. Within this period, only
28 brittle fractures were reported (12, 54), representing a fracture rate of less than
0.01% (1 per 10,000 units). Moreover, most of the failures were associated with
abnormal use of the hip joint heads (replacement surgery without change of the
metallic femoral stem, traumatism, etc.) and were reported in the early period of
fabrication (before 1993). With the systematic use of proof tests on all implants in
the mid-1990s, the fracture rate even fell to 0.002% (1 per 50,000 units). Zirconia
was therefore considered the second generation of ceramic hip joint heads, providing
low wear rates and high safety (55).
In January 1998, to address the increasing commercial demand of zirconia hip joint
heads (100,000 units per year), Saint Gobain Desmarquest introduced a tunnel fur-
nace in place of the usual batch furnace (kiln). A tunnel furnace provides a continuous
sintering operation and leads to a reduction of processing time for larger series. All
other steps, described in Figure 7, were kept identical. The new hip joint heads were
−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−→
Figure 7
Synopsis of the process of zirconia femoral heads. The change from Prozyr BH- to TH-balls
is emphasized. The sintering thermal cycles are reproduced from Reference 58.

ANRV315-MR37-01
ARI
21 May 2007
13:10
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17
ANRV315-MR37-01 ARI 21 May 2007 13:10
called TH-balls, whereas the first generations of heads sintered in kiln were called
BH-balls. By the end of 2000, two major orthopedic companies (Depuy France and
Smith and Nephew) reported an unusual brittle fracture rate for zirconia TH-balls.
HIP: hot isostatic pressing
Only seven batches (a batch representing ≈600 heads) were affected by the high failure
rate (11). They were all processed during the first phase of industrialization of TH-
balls, and the fractures occurred only months after implantation. In the seven batches,
356 fractures were reported, corresponding to a mean failure ratio of 8% (up to 36%
for batch TH-93038). This was a dramatic difference from the overall fracture rates
reported in the prior 15 years. The French Medical Agency immediately suspended
sales of the TH-balls (56), and the FDA issued a notice (10). Given these concerns,
and because thousands of TH-balls had already been implanted in patients, the manu-
facturer, the major customers, and the French Medical Agency independently formed
several groups of experts to answer a list of the following crucial questions:
1. What was the cause—material, process, or design related—of the failures?
2. What difference between BH- and TH-balls led to a dramatic decrease in
safety?
3. Why did the companies’ standard quality-control checks (i.e., for density, grain
size, and mechanical strength and including proof testing, accelerated aging
tests, etc.) not detect the vulnerability of TH-balls to delayed failure?
4. What was the risk of failure for patients with an implanted TH-ball?
Answers to some of these questions may have been kept confidential by the differ-
ent panels of experts and by the companies themselves. However, some papers (12,
57) and information disclosed by Saint Gobain Desmarquest (11) now clarify most
points and show the importance of the validation of a new process technology for
high-technology ceramics.
Because the failures did not occur with BH-balls of identical designs, the prob-
lem was obviously process related (i.e., involving a change in the sintering furnace).
Without going into detail as to the two technologies, the main differences lie in the
sintering cycle (58) and atmosphere, giving rise to a difference in microstructure af-
ter sintering. According to the case report of Maccauro et al. (57), the thermal cycle
applied on TH-balls likely leads to a lower intermediate density after sintering. More
importantly, an uneven radial distribution of density may have occurred owing to
the combination of cold isostatic pressing for the powder compaction and sintering
in the tunnel furnace. The difference was hardly visible via standard quality-control
checks. Density was measured on the entire ball after the hot isostatic pressing (HIP)
step (after HIP no significant change in density was detected). Saint Gobain Desmar-
quest tested a sample of every batch for resistance to failure and cyclic fatigue. The
persistence of very small microcracks inside the core of the heads was not detected.
The company also conducted accelerated aging tests on samples of each batch to
assess aging sensitivity. Steam sterilization procedures were applied; additionally, the
surface of the balls was inspected via XRD and OI because it was believed that aging
would have deteriorated the bearing surface and consequently the wear behavior.
Unfortunately, the zone affected by the process variation was inside the core, where
a taper has to be drilled to fit the ceramic head to the metallic stem. The drilling
process leads to residual stresses that may be critical for aging resistance. The critical

ANRV315-MR37-01 ARI 21 May 2007 13:10
events of 2001 may have been due to a combination of (a) the residual stresses and the
presence of a lower density in the core region, where the taper is drilled, and (b) an
unexpected aging rate and the growth of aging-induced defects in a region in which
Monoclinic spots: surface
tensile stresses are maximum (59). In other words, aging was proceeding very fast in uplifts resulting from the
a region in which no quality control was possible. In the papers dealing with heads volume expansion
belonging to a problematic batch (12, 57, 58), the monoclinic content on the bearing associated with the
surface was low (less than 5%), indicating a good stability, whereas the surface of the tetragonal-to-monoclinic
transformation
taper inside the head could reach more than 60% monoclinic content!
Although the above represents a dramatic experience and shows how validation Explanted head: a
prosthetic femoral head
of new processes is crucial, the unfortunate story of Prozyr TH-balls was unique.
retrieved after some months
Moreover, owing to this critical event, a number of studies have now clearly assessed
or years in vivo
the role of density, residual stresses, etc. on aging. Therefore, this provides the ex-
perience needed to continue the use of zirconia in biomedical applications, as the
material is even safer than before.
Other Clinical, Aging-Related Experiences with 3Y-TZP Ceramics

Despite 20 years of clinical experience regarding zirconia femoral heads and more
than 600,000 heads implanted, the literature concerning retrieval analysis of zirconia
femoral heads and clinical follow-up is sparse. Moreover, some results show excellent
behavior of some heads after several years in vivo (52, 53), whereas others show poor
follow-up results (49–51), with severe wear and osteolysis around the implant. A few
case studies report surface degradation of zirconia implants, which may be related to
aging (45–48).
Haraguchi et al. (45) reported for the first time two cases of surface degradation
(roughening and microcracking) caused by phase transformation. The zirconia used
in this work—presumably processed by Kyocera—followed ISO criteria. They mea-
sured monoclinic contents of 20% and 30% in both heads after only 3 and 6 years,
respectively, associated with a strong increase of roughness (from 6 nm to 120 nm).
From the photomicrographs provided by Haraguchi et al., small surface domes of
some dozen of microns were present on the pole of the heads. Such domes were
likely the monoclinic spots described in Figure 3, which were observed in previous
works with accelerated in vitro tests (7, 23). Craters of the same size were visible
at the equator (region of wear contact) as a consequence of extensive pullout of the
monoclinic spots. More recent papers from Moore and coworkers (46, 47) confirm
the degradation of surface properties for some zirconia heads by means of nanoin-
dentation hardness measurements on explanted heads that had undergone various
degrees of phase transformation in service (ranging from 0% to 78% monoclinic
content). The hardness dropped from 18 GPa to 11 GPa for high transformation
ratios, which indicates extensive microcracking on the transformation sites. Limited
information was given on the origin of the heads, their microstructural features, or
their clinical history, making an extended analysis of the results difficult. However,
one head exhibited approximately 78% of m phase after only 62 months of implan-
tation. On the status of zirconia as a biomaterial, Clarke et al. (12) also report on the
results of a collaborative research, between two Japanese groups and a U.S. group,

ANRV315-MR37-01 ARI 21 May 2007 13:10
on two explanted heads, one retrieved at eight years and the other at ten years. The
Y-TZP ball retrieved at eight years appeared badly transformed (more than 70%
monoclinic), with surface craters in the bearing region. The damage was even visi-
ble to the eye. As a counterpoint, the ball with the longest time in vivo (ten years)
showed minimal phase transformation and a high-quality bearing surface with very
low residual surface stresses as well as no change in surface roughness. These two
different behaviors reported by the same team show the strong variability of zirconia
heads with regard to LTD resistance. Figure 8 summarizes the results reported so
1.0
Clarke (12) Chevalier (48) Maccauro (57)
Haraguchi (45) Hernigou (50) Masonis (58)
Santos (47) Caton (52) Simulated on a

0.8 Prozyr® head, batch 87

Monoclinic surface fraction
0.6
0.4
0.2
0
0 40 80 120 160 200
Time in vivo (months)
Figure 8
Monoclinic fraction measured at the surface of retrieved heads versus implantation duration.
The two circled points were in fact measured inside the taper of two TH-heads affected by the
failure episode. These experimental points are compared with the kinetics predicted from
accelerated aging in autoclave in a batch of Prozyr BH-balls (27).

ANRV315-MR37-01 ARI 21 May 2007 13:10
far. Many processing factors may affect the LTD resistance, and it seems that, even
in the framework of ISO standards, some heads behave well, whereas others show
strong surface degradation.
Up-to-date clinical follow-up reports also appear quite controversial. Some au-
thors report a low wear rate at middle term follow-up (4 to 6 years) on 22.22-mm heads
processed at the end of the 1990s (52, 53). In contrast, other researchers report poor
clinical results after a mean follow-up of 5 to 12 years (49–51) on 28-mm heads pro-
cessed from 1988 to 1995. By poor clinical results, we mean an especially low survival
rate along with aseptic loosening and progressive osteolysis, most probably owing
to high wear rates and particle debris generation in the body. Especially interesting
is the French study from Hernigou et al. (50), which compares 10 years of follow-
up of stainless steel-polyethylene, alumina-polyethylene, and zirconia-polyethylene

configurations. Although in the first years the zirconia-polyethylene group compared
well with the two other combinations, Hernigou et al. noticed a strong increase of
wear rate after 5 years. More importantly, the wear rate continuously increased up to
12 years (which was the end of the clinical experience). The analysis of three explanted
heads reveals high monoclinic content, associated with an increase of roughness of
the head and progressive lack of sphericity of the polyethylene cup. In their report
on the poor 8-year survival rate of zirconia-polyethylene prostheses, Allain et al. (49)
reveal the presence of submicron zirconia grains small enough to be scavenged by
macrophages and to contribute to the inflammatory process and osteolysis. These
bad clinical experiences may therefore be related to the LTD of zirconia, which can
appear in vivo.
This leads us to propose a plausible scenario of zirconia degradation and conse-
quential implant failure, schematically described in Figure 9. After bedding-in regime
(that corresponds to an early decrease of wear rate due to polyethylene polishing by
the femoral head), a steady state (constant wear rate) is generally observed with metal
or alumina heads. In the case of zirconia, bedding-in regime is followed by a sig-
nificant increase in wear rate (50), correlated to the increases in monoclinic content
and roughness of the head that occur during aging (27). Zirconia grain pullout in the
bearing region and polyethylene debris may then lead to premature osteolysis.
INFLUENCE OF PROCESSING AND MICROSTRUCTURE

ON AGING
Aging can be controlled. For a given zirconia ceramic, density and grain size, as well as
the homogeneity of the phase distribution and the residual stress state on the surface,
are of primary importance.
Perhaps the most important parameter to limit aging is the density. Indeed, low
density—especially the presence of open porosity—offers water molecules easy access
to the bulk of the material, resulting in aging not only on the surface of the zirconia
piece but on all the internal surfaces (pore and crack surfaces). Under such conditions,
the material rapidly loses its cohesion, and the decrease in mechanical properties is
dramatic. Figure 10 shows a cross-sectional SEM micrograph of a pressed zirconia
pellet after aging. This piece presents a density gradient, with an average density

ANRV315-MR37-01 ARI 21 May 2007 13:10
Figure 9
a 500 1
Suggested scenario of
aseptic loosening triggered Rate of wear(mm3/year)
by aging of a zirconia head. Monoclinic fraction
(a) Monoclinic fraction and (simulated on a Prozyr® head)
400 0.8
Monoclinic surface fraction

wear rate versus time (27,
Rate of wear (mm3/year)

50). After bedding-in
regime (that corresponds to
an early decrease of wear
Decrease in
300 0.6
rate due to polyethylene PE roughness
polishing by the zirconia
head), the increase of wear
rate is correlated to the 200 0.4

increase of roughness of the
head that occurs during Increase
aging. (b) Schematic of a in ZrO2
polyethylene (PE) 100 roughness 0.2
cup–zirconia head system
after a few years in vivo.

Note the asymmetrical wear
of the PE cup and the 0 0
extensive pullout of zirconia 0 3 6 9 12 15
grains in the bearing region. Postoperative year
t-zirconia
b
m-zirconia
Zirconia and PE debris
Inflammatory response
Osteolysis
Aseptic loosening
of 5.7 (93% of theoretical density), and was aged in autoclave at 134◦ C for 10 h
(corresponding to roughly 30 years in vivo). The whole surface is covered by a 5-
μm-thick homogeneous monoclinic layer. In the bulk, only the zone with the highest
density (Figure 10) did not suffer from aging. Everywhere else, water was able to
infiltrate through the open porosities and lead to aging inside the material. This effect

ANRV315-MR37-01
Figure 10
Cross-sectional SEM micrograph after aging of a pressed zirconia pellet with a porosity
gradient [from the bottom-left corner (high porosity) to the upper-right corner (high density)].
The starting powder was spray dried, with granule sizes of approximately 100 μm. The
tetragonal zones are seen in dark gray, whereas the monoclinic ones are seen in white because
of the high contrast due to extensive microcracking. (a) General view. (b) Aging around the
granules in a medium-density area. The idealized view below shows the dense, tetragonal
granules in black and the transformed, monoclinic zone surrounding them in white. (c) Aging
on the surface of porosities (dashed white circle) in a dense zone close to the surface of the pellet.
The surface itself is also covered by a constant-thickness monoclinic layer. (d ) Homogeneous
monoclinic layer at the surface of the fully dense zone. (e) Generalized aging in the
lower-density zone. The granules are completely separated from each other by a thick
monoclinic layer, and the material has no remaining cohesion.
is hardly documented in the literature (60, 61). Indeed, no XRD investigation can
reveal it because XRD is limited to the outer surface, and cross-sectional observations
are necessary.
Many authors have pointed out the important influence of grain size on ag-
ing. Although the existence of critical grain size—below which no transformation
is possible—is still debated, the beneficial effect of reducing the grain size on the ag-
ing kinetics is widely recognized. Practically, the effect of grain size on LTD has also
been demonstrated on explanted heads (48). However, decreases in the grain size also

ANRV315-MR37-01 ARI 21 May 2007 13:10
lead to a decrease in toughness and slow crack propagation threshold, mostly because
of less efficient phase transformation toughening. A relationship between grain size,
density, and aging was observed (61) but still needs to be refined.
3Y-TZP sintered at usual temperatures typically contains up to 15% c phase. For
long sintering times or high sintering temperatures, bimodal microstructures can
appear; the cubic grains are larger than the tetragonal ones and pump the Y2 O3
out of the t phase (62–64). The tetragonal grains neighboring the c phase are thus
depleted in Y2 O3 and act as preferential nucleation sites for aging (65).
It is now accepted that microscopic tensile stresses in a grain trigger the t-m
transformation (19). Macroscopical tensile stresses can play the same role (66, 67).
Thus, machining has to be carefully controlled. Rough polishing induces compression
stresses that delay aging, but the surface state is not suitable for wear applications;
fine polishing leads to an acceptable roughness but removes the compressive stresses
and allows tensile stresses to appear along the residual scratches. Thus, fine polishing
without any scratches is needed.
To summarize, LTD is accelerated by coarse grains, low density, and c-t phase
partitioning. Sintering conditions have to be tailored to avoid these characteristics.
This can necessitate the use of such tools as HIP or flash sintering (also called spark
plasma sintering). Machining has to be carefully controlled so as to limit the apparition
of residual tensile stresses on the surfaces exposed to aging. However, LTD can be
slowed down, but never completely suppressed, in 3Y-TZP. Other zirconia-based or
zirconia-containing materials can offer increased aging resistance.
Increasing the Y2 O3 content improves resistance to LTD (68). However, increas-
ing the stabilizer content inhibits the t-m transformation and thus decreases the
mechanical properties of the material (69). Furthermore, the proportion of c phase
increases with increasing Y2 O3 content. This results again in a loss of mechanical
properties and also in an Y2 O3 diffusion out of the tetragonal grains neighboring the
c phase, which may trigger a preferential t-m transformation around the cubic grains
(65).
Doping Y-TZP with other oxides is a more promising way. Over the many ox-
ides tested, only a few provide a satisfactory balance between aging resistance and
mechanical properties. These are antimony, bismuth, neptunium, niobium, cerium
(Ce), aluminum, and silicon oxides. Doping with antimony (70), bismuth (71) and
neptunium (72) oxides is beneficial for both mechanical properties, and LTD resis-
tance may be detrimental for biocompatibility. An addition of 5% Nb2 O5 to 3Y-TZP
(73) decreases sensitivity to LTD and improves toughness without decreasing fracture
stress. Ce doping in systems in which either Ce or Y is the main stabilizer has been
the most studied. Adding Ce to a Y-TZP increases the grain size (74–76) but im-
proves aging resistance (76–77), and the mechanical properties are influenced more
by the grain size than by the amount of Ce. Because Ce-TZP is biocompatible (it is
already used for dental implants), Ce-Y-TZP could prove an interesting biomedical
grade of zirconia. The presence of small alumina quantities (between 0.15% and 3%)
slows down LTD (78, 79) and increases the temperature at which transformation is
the fastest (80). The influence of silica is more controversial. Neither Lange et al.
(18) nor Schmauder & Schubert (21) noted any effect. However, slow cooling after

ANRV315-MR37-01 ARI 21 May 2007 13:10
sintering silica-doped 3Y-TZP allows the formation of rounded zirconia grains (81,
82) and thus a decrease of the internal stresses that results in an improvement in
aging resistance (83). In addition, commercial powders containing small amounts of
alumina and silica (such as Tosoh TZ3Y-E) are less sensitive to aging.
Because aging degradation starts as a surface phenomenon, surface treatments
(cementation and nitridation) may help prevent aging and retain the good mechanical
properties of 3Y-TZP (84–86). Such surface treatments can completely suppress aging
of the surface (84); its mechanical properties are completely retained even after severe
aging. However, between 600◦ C and 800◦ C, subsurface aging can occur (87), resulting
in the appearance of large internal stresses. Whether subsurface aging also takes place
at low temperatures remains to be confirmed.
Perhaps the most promising future of zirconia as a biomaterial is through its use
as reinforcement in zirconia-toughened alumina (ZTA), which may offer an excep-
tional balance between slow crack growth resistance and aging resistance (43, 88).
Controlling the size and homogeneity of the repartition of the zirconia grains is
crucial (89, 90). Indeed, above a critical amount (∼16 vol.%), geometrical percola-
tion of zirconia grains leads to a continuous path between zirconia particles, making
the composite sensitive to aging (88). Below this critical amount, only the largest
zirconia grains (or the zirconia clusters in a nonhomogeneously dispersed material)
undergo aging; the smallest ones are stabilized by the stiff alumina matrix (decrease
of USE in Equation 1). LTD can thus be completely suppressed in a ZTA contain-
ing fine-grained, well-dispersed zirconia particles below the geometrical percolation
threshold.
Optimal mechanical properties are obtained with only 10 vol.% intergranular zir-
conia particles (91). Alumina-zirconia nanocomposites containing 1.7 vol.% of nano-
metric intragranular zirconia particles offer even better crack propagation threshold
(∼5 MPa · m1/2 ) and toughness (∼6.5 MPa · m1/2 ) (to compare with 2.5 and 4 for a
typical alumina and 3 and 5.5 for a typical 3Y-TZP), but they are more difficult to
process (92). In the latter material, the reinforcement is achieved not through phase
transformation of zirconia but through the development in the alumina matrix of a
high compressive stress field (100–150 MPa) that results from the thermal stresses
appearing upon cooling from the sintering temperature. The relative effect of the
residual stress intensity factor is higher for lower applied stress intensity factors,
resulting in a high threshold:toughness ratio similar to those observed in covalent
materials. As a result, this material is less sensitive to delayed failure by slow crack
propagation.
To summarize, ZTA ceramics can offer very high mechanical properties as well
as complete stability. They lead the way to the manufacturing of more demanding
designs, e.g., 22.22-mm femoral heads, knee prostheses, or dental implants.
CONCLUDING REMARKS
Although in the 1990s 3Y-TZP ceramics were considered very promising materials for
biomedical applications, long-term follow-up is needed to address the critical problem
of aging in vivo and its negative impact on orthopedic implant durability. Even if in

ANRV315-MR37-01 ARI 21 May 2007 13:10
most cases the zirconia head still presents high mechanical resistance, aging leads
to increased wear and particle release in the body, which triggers an inflammatory
response and aseptic loosening. As 600,000 patients to date have been implanted with
zirconia hip joint heads, a careful explant analysis must be conducted, with a special
emphasis on LTD-microstructure relationships. However, most zirconia implants
were processed at a time when aging was not yet fully understood. Methods to assess a
priori the aging sensitivity of a given zirconia ceramic have been developed and should
lead to safer implants. In the meantime, new zirconia or zirconia-based materials that
overcome the major drawback of the standard 3Y-TZP are now available.
The present review describes aging and its consequences on biomedical implants.
It does not cover applications that may also be concerned, such as solid oxide fuel
cells or thermal barrier coatings. Owing to specific thermochemical environments,

the results obtained on biomedical grade zirconia may not be fully extended, and
further analysis is required.
SUMMARY POINTS
1. After more than 20 years of research, aging still remains a key issue for
zirconia components. Aging in zirconia orthopedic devices is so far the most
striking example.
2. Aging occurs by a water-assisted martensitic phase transformation, which
propagates at the surface by a nucleation-and-growth mechanism and then
invades the bulk.
3. Aging results in roughening and microcracking. For hip joint heads it leads
to increased wear and the release of wear debris in the body. In the most
extreme cases, it leads to failure of the component.
4. Explanted head analysis and clinical follow-up clearly demonstrate the detri-
mental effect of aging on implant durability. The extent of implant degra-
dation may vary from one head to another as a consequence of the strong
impact of processing on aging sensitivity.
5. During the past decade, improved techniques have been developed to mon-
itor and predict aging. Therefore, it is now possible to predict aging prior
to surgery.
6. New zirconia or zirconia-based materials that overcome the major drawback
of the standard 3Y-TZP are now available.
FUTURE ISSUES
1. To date, approximately 600,000 zirconia femoral heads have been implanted.
Large-scale, long-term clinical studies and explant analyses are necessary to
assess the risks associated with the use of zirconia in vivo.

ANRV315-MR37-01 ARI 21 May 2007 13:10
2. Orthopedics is a striking example of the negative impact of low-temperature

degradation in the presence of water on the long-term performance of zirco-
nia devices. With the increasing use of Y-TZP in other applications (dental,
coatings, solid oxide fuel cells), a careful understanding and control of aging
in different thermochemical conditions will be necessary.
3. Alternative zirconia-based materials have been successfully developed on the
laboratory scale. However, only in vivo studies will confirm their superiority
over 3Y-TZP.
LITERATURE CITED
1. Garvie RC, Hanninck RH, Pascoe RT. 1975. Ceramic steel? Nature 258:703–4
2. Gupta TK, Lange FF, Bechtold JH. 1978. Effect of stress-induced phase trans-
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AR315-FM ARI 31 May 2007 15:12
Annual Review of
Materials Research
Contents Volume 37, 2007
MATERIALS CHARACTERIZATION
Low-Temperature Degradation of Zirconia and Implications for

Biomedical Implants
Jérô me Chevalier, Laurent Gremillard, and Sylvain Deville p p p p p p p p p p p p p p p p p p p p p p p p p p p p p1
Single-Molecule Micromanipulation Techniques

K. C. Neuman, T. Lionnet, and J.-F. Allemand p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 33
Spin-Polarized Scanning Tunneling Microscopy of Magnetic
Structures and Antiferromagnetic Thin Films
Wulf Wulfhekel and Jürgen Kirschner p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 69
Microscale Characterization of Mechanical Properties
K. J. Hemker and W. N. Sharpe, Jr. p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 93
Three-Dimensional Atom-Probe Tomography: Advances and
Applications
David N. Seidman p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p127
The Study of Nanovolumes of Amorphous Materials Using Electron
Scattering
David J. H. Cockayne p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p159
Nanoscale Electromechanics of Ferroelectric and Biological Systems:
A New Dimension in Scanning Probe Microscopy
Sergei V. Kalinin, Brian J. Rodriguez, Stephen Jesse, Edgar Karapetian,
Boris Mirman, Eugene A. Eliseev, and Anna N. Morozovska p p p p p p p p p p p p p p p p p p p p p p p189
AFM and Acoustics: Fast, Quantitative Nanomechanical Mapping
Bryan D. Huey p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p351
Electron Holography: Applications to Materials Questions
Hannes Lichte, Petr Formanek, Andreas Lenk, Martin Linck,
Christopher Matzeck, Michael Lehmann, and Paul Simon p p p p p p p p p p p p p p p p p p p p p p p p p p539
Three-Dimensional Characterization of Microstructure by Electron
Back-Scatter Diffraction
Anthony D. Rollett, S.-B. Lee, R. Campman, and G.S. Rohrer p p p p p p p p p p p p p p p p p p p p p p p627
vii
AR315-FM ARI 31 May 2007 15:12
Atom Probe Tomography of Electronic Materials

Thomas F. Kelly, David J. Larson, Keith Thompson, Roger L. Alvis,
Joseph H. Bunton, Jesse D. Olson, and Brian P. Gorman p p p p p p p p p p p p p p p p p p p p p p p p p p p p681
Electron Holography: Phase Imaging with Nanometer Resolution
Martha R. McCartney and David J. Smith p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p729
FERROELECTRICS AND RELATED MATERIALS, David R. Clarke

and Venkatraman Gopalan, Guest Editors
Atomic-Level Simulation of Ferroelectricity in Oxides: Current Status
and Opportunities
Simon R. Phillpot, Susan B. Sinnott, and Aravind Asthagiri p p p p p p p p p p p p p p p p p p p p p p p p p239

Ferroelectric Domain Breakdown
Michel Molotskii, Yossi Rosenwaks, and Gil Rosenman p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p271
Local Structure of Ferroelectric Materials
T. Egami p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p297
Terahertz Polaritonics
T. Feurer, Nikolay S. Stoyanov, David W. Ward, Joshua C. Vaughan,
Eric R. Statz, and Keith A. Nelson p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p317
Spiral Magnets as Magnetoelectrics
T. Kimura p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p387
Universal Domain Wall Dynamics in Disordered Ferroic Materials
W. Kleemann p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p415
Defect–Domain Wall Interactions in Trigonal Ferroelectrics
Venkatraman Gopalan, Volkmar Dierolf, and David A. Scrymgeour p p p p p p p p p p p p p p p p p449
Influence of Electric Field and Mechanical Stresses on the Fracture of
Ferroelectrics
Gerold A. Schneider p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p491
Strain Tuning of Ferroelectric Thin Films
Darrell G. Schlom, Long-Qing Chen, Chang-Beom Eom, Karin M. Rabe,
Stephen K. Streiffer, and Jean-Marc Triscone p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p589
Ferroelectric Epitaxial Thin Films for Integrated Optics
Bruce W. Wessels p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p659
Index
Cumulative Index of Contributing Authors, Volumes 33–37 p p p p p p p p p p p p p p p p p p p p p p p p769
Errata
An online log of corrections to Annual Review of Materials Research chapters (if any,
1997 to the present) may be found at http://matsci.annualreviews.org/errata.shtml
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ANRV315-MR37-01 ARI 21 May 2007 13:10

and Implications for

Jérôme Chevalier,1 Laurent Gremillard,1

Annu. Rev. Mater. Res. 2007. 37:1–32 Key Words

The Annual Review of Materials Research is online at Abstract

2 Chevalier · Gremillard · Deville

MECHANISMS OF AGING: FROM PHYSICOCHEMICAL TO

Tetragonal-to-Monoclinic Transformation in Zirconia

www.annualreviews.org • Low-Temperature Degradation of Zirconia Implants 3

diameter, so as to result in a macroscopic change of shape of transformed regions”

Early Stages of Aging: Stress Accumulation due to Water Penetration

4 Chevalier · Gremillard · Deville

www.annualreviews.org • Low-Temperature Degradation of Zirconia Implants

ABC 2 (011)[01̄1] 0.0344 ⎣−0.0171⎦ ⎣−0.0007⎦ 0.1640 0.1556 0.0518

BCA 1 (110)[11̄0] 0.0344 ⎣ ◦0.3935 ⎦ ⎣◦0.1751⎦ 0.1761 0.1683 0.0518

CAB 1 (101)[101̄] 0.0027 ⎣−0.9537⎦ ⎣−0.0026⎦ 0.1640 0.1556 0.0518

Martensitic Transformation at the Surface of Zirconia During Aging

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in the t phase surrounding the transformed zone, accelerating the transformation

Transformation Extension by Nucleation-and-Growth Process

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EXPERIMENTAL TECHNIQUES TO MEASURE AGING

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Raman spectroscopy seems to be more sensitive than XRD to smaller traces of

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(c) Calculated monoclinic

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the crystallography of the transformation.

CONSEQUENCES OF AGING ON ORTHOPEDIC IMPLANTS:

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Zirconia Fractures due to Accelerated LTD: A Striking Example of a

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Other Clinical, Aging-Related Experiences with 3Y-TZP Ceramics

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Clarke (12) Chevalier (48) Maccauro (57)

Haraguchi (45) Hernigou (50) Masonis (58)

Santos (47) Caton (52) Simulated on a

0.8 Prozyr® head, batch 87

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up of stainless steel-polyethylene, alumina-polyethylene, and zirconia-polyethylene

INFLUENCE OF PROCESSING AND MICROSTRUCTURE

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Monoclinic surface fraction

Rate of wear (mm3/year)

rate is correlated to the 200 0.4

after a few years in vivo.

Zirconia and PE debris

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cells or thermal barrier coatings. Owing to speciﬁc thermochemical environments,

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2. Orthopedics is a striking example of the negative impact of low-temperature

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water diffusion in the

sitic transformation in yttria-stabilized tetragonal zirconia polycrystals during

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33. Clarke DR, Adar F. 1982. Measurement of the crystallographically transformed