After 30 years of human implantation of various commodity materials, backed up by in vitro and animal studies along the way, a secure knowledge base now exists regarding the critical bioadhesive phenomena encountered by biomedical devices that must resist or develop secure biological attachments. Well-healed “osseointegrated” implants in human jaws signaled the significant—and, in many ways, surprising—advances that attention to surface properties and, especially, to surface cleanliness and surface energy of biomedical materials could foster for related systems.

Two of the many active, successful areas of current patient benefits from biocompatible engineering materials are dental restoratives and prosthetic implants. Others include the continuing development of surgical adhesives, extracorporeal circuits, cardiovascular devices, fixed-film processors, bioreactors, and even improved coatings for the prevention of marine fouling on commercial ships. A short review of the fundamental issues in some of these areas follows to illustrate the branches of medicine that are being addressed and how the technology of biocompatibility control assists in each of them.

It is emphasized that principles of adhesion science and technology, respected at the earliest stages of these efforts, were and remain the key principles allowing safe and effective interfacing of engineering materials with biological systems.

One major difficulty that had to be overcome in many early studies of biomedical implants for any use, be it in the dental, orthopedic, or cardiovascular environment, had been the tendency of the investigators to focus mainly on either the mid-term (hours to days) and the longer term behavior of the materials—from weeks to months to years post-implantation. There are numerous active research programs to provide proper characterization and detailed knowledge of the original surface states of these implants at their time of placement and of the early bioadhesive sequela (over minutes, hours, and days) converting the initial surface properties to others that promote or inhibit adhesion of formed biological elements (such as tissue cells or bacteria).