There is a controversy about the biocompatibility of silicon nitride ceramics contained in the literature, which appears to be related to a factor of the individual chemical composition of different qualities of silicon nitride ceramics and of the different surface properties. This study attempts to investigate the cytotoxicity of different qualities of industrial silicon nitride ceramics applying an L929-cell culture model in a direct contact assay combined with a cell viability assessment. Five different qualities of industrial standard silicon nitride ceramics were chosen for in vitro testing. The chemical composition was determined by EDS analysis. Different biomedically approved aluminium oxide qualities, a titanium alloy, glass and polyvinylchloride (PVC) served as control materials. L929 mice fibroblasts were incubated directly on the materials for 24 h, stained with bisbenzimide and propidium iodine for double fluorochromasia viability testing, and evaluated by inversion-fluorescence microscopy to control cell morphology, viability and cell counts compared to empty well values. Scanning electron microscopy was applied to additionally investigate cell morphology. There was no observation of cytotoxic effects on the silicon nitride ceramic samples; moreover cell morphology remained the same as on aluminium oxide and titanium. Viability testing revealed the presence of avital cells exclusively on PVC, which served as a negative control. Cell counts on all polished surfaces showed significantly higher numbers, whereas some rough surface samples showed significantly lower numbers. We conclude that silicon nitride ceramics show no cytotoxic effects and should be considered for biomedical application owing to its favourable physiochemical properties, especially its superior resistance to mechanical stress, which would be useful for compression loaded conditions. Polished surfaces would appear to promote advanced biocompatibility.

Si3N4 ceramics show a good biocompatibility outcome both in vitro and in vivo. In ENT surgery, this ceramic may serve as a biomaterial for osteosynthesis (eg, of the midface including reconstruction the floor of the orbit and the skull base). To our knowledge, this is the first introduction of a ceramic-based miniplate-osteofixation system. Advantages compared with titanium are no risk of implantation to bone with mucosal attachment, no need for explantation, and no interference with radiologic imaging. Disadvantages include the impossibility of individual bending of the miniplates.

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The current results indicate a favorable biocompatibility of silicon nitride ceramic. Cell growth, viability and morphology are comparable to parameters of titanium. Polished surfaces appear to promote cell growth. Further in vivo studies are mandatory prior to human medical application. Owing to its favorable physiochemical properties, especially its superior resistance to mechanical stress, silicon nitride could serve as a biomaterial for osteosynthesis of bone with mucosal attachment.