Abstract
Various types of grafts have been traditionally used to restore damaged bones. In the late 1960s, a strong interest was raised in studying ceramics as potential bone grafts due to their biomechanical properties. A bit later, such synthetic biomaterials were called bioceramics. In principle, bioceramics can be prepared from diverse materials but this review is limited to calcium orthophosphate-based formulations only, which possess the specific advantages due to the chemical similarity to mammalian bones and teeth. During the past 40 years, there have been a number of important achievements in this field. Namely, after the initial development of bioceramics that was just tolerated in the physiological environment, an emphasis was shifted towards the formulations able to form direct chemical bonds with the adjacent bones. Afterwards, by the structural and compositional controls, it became possible to choose whether the calcium orthophosphate-based implants remain biologically stable once incorporated into the skeletal structure or whether they were resorbed over time. At the turn of the millennium, a new concept of regenerative bioceramics was developed and such formulations became an integrated part of the tissue engineering approach. Now calcium orthophosphate scaffolds are designed to induce bone formation and vascularization. These scaffolds are often porous and harbor different biomolecules and/or cells. Therefore, current biomedical applications of calcium orthophosphate bioceramics include bone augmentations, artificial bone grafts, maxillofacial reconstruction, spinal fusion, periodontal disease repairs and bone fillers after tumor surgery. Perspective future applications comprise drug delivery and tissue engineering purposes because calcium orthophosphates appear to be promising carriers of growth factors, bioactive peptides and various types of cells.
Highlights
One of the most exciting and rewarding areas of the engineering discipline involves development of various devises for health care
The following conclusions were made: (1) Octacalcium phosphate (OCP) formation ubiquitously occurred on all types of bioceramic surfaces both in vitro and in vivo, except on β-Tricalcium phosphate (β-TCP); (2) Apatite formation did not occur on every type of bioceramic surface; it was less likely to occur on the surfaces of HA and α-Tricalcium phosphate (α-TCP); (3) Precipitation of calcium orthophosphates on the bioceramic surfaces was more difficult in vivo than in vitro; (4) Differences in calcium orthophosphate precipitation among the bioceramic surfaces were less noticeable in vitro than that in vivo; and (5) β-TCP bioceramics showed a poor ability of calcium orthophosphate precipitation both in vitro and in vivo [710]. These findings clearly revealed that apatite formation in the physiological environments could not be confirmed as the common feature of bioceramics
The available chronology of seeking for a suitable bioceramics for bone substitutes is as follows: since the 1950s, the first aim was to use bioinert bioceramics, which had no reaction with living tissues
Summary
One of the most exciting and rewarding areas of the engineering discipline involves development of various devises for health care. Bioceramics might be prepared from alumina, zirconia, magnesia, carbon, silica-contained and calcium-contained compounds, as well as from a limited number of other chemicals All these formulations might be manufactured in both dense and porous forms in bulk, as well as in the forms of crystals, powders, particles, granules, scaffolds and/or coatings [1,2,3]. In 2010, only in the USA the sales of bone graft substitutes were valued at ~$1.3 billion with a forecast of ~$2.3 billion by 2017 [5] This clearly demonstrates an importance of calcium orthophosphate-based bioceramics. To narrow the subject further, with a few important exceptions, bioceramics prepared from undoped and un-substituted calcium orthophosphates will be considered and discussed only. The readers interested in both topics are advised to study the original publications
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