Performance Of Calcium Phosphate Cement Research Articles

Incorporating the Antioxidant Fullerenol into Calcium Phosphate Bone Cements Increases Cellular Osteogenesis without Compromising Physical Cement Characteristics.

Herein, fullerenol (Ful), a highly water-soluble derivative of C60 fullerene with demonstrated antioxidant activity, is incorporated into calcium phosphate cements (CPCs) to enhance their osteogenic ability. CPCs with added carboxymethyl cellulose/gelatin (CMC/Gel) are doped with biocompatible Ful particles at concentrations of 0.02, 0.04, and 0.1 wt v%-1 and evaluated for Ful-mediated mechanical performance, antioxidant activity, and in vitro cellular osteogenesis. CMC/gel cements with the highest Ful concentration decrease setting times due to increased hydrogen bonding from Ful's hydroxyl groups. In vitro studies of reactive oxygen species (ROS) scavenging with CMC/gel cements demonstrate potent antioxidant activity with Ful incorporation and cement scavenging capacity is highest for 0.02 and 0.04 wt v%-1 Ful. In vitro cytotoxicity studies reveal that 0.02 and 0.04 wt v%-1 Ful cements also protect cellular viability. Finally, increase of alkaline phosphatase (ALP) activity and expression of runt-related transcription factor 2 (Runx2) in MC3T3-E1 pre-osteoblast cells treated with low-dose Ful cements demonstrate Ful-mediated osteogenic differentiation. These results strongly indicate that the osteogenic abilities of Ful-loaded cements are correlated with their antioxidant activity levels. Overall, this study demonstrates exciting potential of Fullerenol as an antioxidant and proosteogenic additive for improving the performance of calcium phosphate cements in bone reconstruction procedures.

Regenerating Craniofacial Dental Defects With Calcium Phosphate Cement Scaffolds: Current Status and Innovative Scope Review

The management and treatment of dental and craniofacial injuries have continued to evolve throughout the last several decades. Limitations with autograft, allograft, and synthetics created the need for more advanced approaches in tissue engineering. Calcium phosphate cements (CPC) are frequently used to repair bone defects. Since their discovery in the 1980s, extensive research has been conducted to improve their properties, and emerging evidence supports their increased application in bone tissue engineering. This review focuses on the up-to-date performance of calcium phosphate cement (CPC) scaffolds and upcoming promising dental and craniofacial bone regeneration strategies. First, we summarized the barriers encountered in CPC scaffold development. Second, we compiled the most up to date in vitro and in vivo literature. Then, we conducted a systematic search of scientific articles in MEDLINE and EMBASE to screen the related studies. Lastly, we revealed the current developments to effectively design CPC scaffolds and track the enhanced viability and therapeutic efficacy to overcome the current limitations and upcoming perspectives. Finally, we presented a timely and opportune review article focusing on the significant potential of CPC scaffolds for dental and craniofacial bone regeneration, which will be discussed thoroughly. CPC offers multiple capabilities that may be considered toward the oral defects, expecting a future outlook in nanotechnology design and performance.

Performance of Calcium Phosphate Cements in the Augmentation of Sheep Vertebrae-An Ex Vivo Study.

Oil-based calcium phosphate cement (Paste-CPC) shows not only prolonged shelf life and injection times, but also improved cohesion and reproducibility during application, while retaining the advantages of fast setting, mechanical strength, and biocompatibility. In addition, poly(L-lactide-co-glycolide) (PLGA) fiber reinforcement may decrease the risk for local extrusion. Bone defects (diameter 5 mm; depth 15 mm) generated ex vivo in lumbar (L) spines of female Merino sheep (2–4 years) were augmented using: (i) water-based CPC with 10% PLGA fiber reinforcement (L3); (ii) Paste-CPC (L4); or (iii) clinically established polymethylmethacrylate (PMMA) bone cement (L5). Untouched (L1) and empty vertebrae (L2) served as controls. Cement performance was analyzed using micro-computed tomography, histology, and biomechanical testing. Extrusion was comparable for Paste-CPC(-PLGA) and PMMA, but significantly lower for CPC + PLGA. Compressive strength and Young’s modulus were similar for Paste-CPC and PMMA, but significantly higher compared to those for empty defects and/or CPC + PLGA. Expectedly, all experimental groups showed significantly or numerically lower compressive strength and Young’s modulus than those of untouched controls. Ready-to-use Paste-CPC demonstrates a performance similar to that of PMMA, but improved biomechanics compared to those of water-based CPC + PLGA, expanding the therapeutic arsenal for bone defects. O, significantly lower extrusion of CPC + PLGA fibers into adjacent lumbar spongiosa may help to reduce the risk of local extrusion in spinal surgery.

Experimental and numerical analysis on bending and tensile failure behavior of calcium phosphate cements

Since their discovery in the 1980s, injectable self-setting calcium phosphate cements (CPCs) are frequently used in orthopedic, oral and maxillofacial surgery due to their chemical resemblance to the mineral phase of native bone. However, these cements are very brittle, which complicates their application in load-bearing anatomical sites. Polymeric fibers can be used to transform brittle calcium phosphate cements into ductile and load-bearing biomaterials. To understand and optimize this process of fiber reinforcement, it is essential to characterize the mechanical properties of fiber-free calcium phosphate matrices in full detail. However, the mechanical performance of calcium phosphate cements is usually tested under compression only, whereas bending and tensile tests are hardly performed due to technical limitations. In addition, computational models describing failure behavior of calcium phosphate cements under these clinically more relevant loading scenarios have not yet been developed. Here, we investigate the failure behavior of calcium phosphate cements under bending and tensile loading by combining, for the first time, experimental tests and numerical modeling. To this end, a 3-D gradient-enhanced damage model is developed in a finite element framework, and numerical results are correlated to experimental three-point bending and tensile tests to characterize the mechanical properties of calcium phosphate cements in full detail. The presented computational model is successfully validated against experimental results and is able to predict the mechanical response of calcium phosphate cement under different types of loading with a unique set of parameters. This model offers a solid basis for further experimental and computational studies on the development of load-bearing bone cements.

The performance of CPC/PLGA and Bio-Oss® for bone regeneration in healthy and osteoporotic rats.

The current study aimed to evaluate the biological performance of calcium phosphate cement (CPC) with polylactic-co-glycolic acid (PLGA) micro-particles and Bio-Oss® in ovariectomized and healthy rats. Thirty-two Wistar rats received alternating experimental CPC/PLGA and Bio-Oss® in femoral condyle defects in both femurs 6 weeks after ovariectomy (OVX, n = 16) or sham operation (SHAM, n = 16). Six weeks after OVX or SHAM surgery, bone morphology was analyzed by in vivo computed tomography (CT) to confirm osteoporotic bone condition. Analysis of bone formation and material remnants at 4 and 12 weeks after material implantation was performed by micro-CT, descriptive histology, histomorphometry and bone dynamics by fluorochrome labeling. The in vivo CT scans showed effective induction of osteoporotic bone condition by ovariectomy. Our data showed CPC/PLGA degraded relatively faster and more steadily. However, Bio-Oss® had significantly less material remnants and showed significantly more bone formation compared to CPC/PLGA. Overall, our data showed relatively high amounts of CPC/PLGA for each time point, hampering new bone formation within the defect area. Osteoporotic conditions proved to significantly affect degradation rates, but did not significantly influence bone formation. An osteoporotic bone condition affects degradation of CPC/PLGA, which is vital information for its potential use in osteoporotic conditions. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 131-142, 2018.

Reinforcement of a new calcium phosphate cement with dopamine-mediated strontium-doped calcium polyphosphate-modified polycaprolactone fibers

To improve the performance of calcium phosphate cement, dopamine/PCL fibers and strontium-doped calcium polyphosphate/D/PCL fibers were respectively incorporated into Sr-containing calcium phosphate cement to develop a novel bone cement.

Treatment of bone defect with calcium phosphate cement subsequent to tumor curettage in pediatric patients.

The aim of the present study was to investigate the mid- to long-term clinical performance of calcium phosphate cement (CPC) in the treatment of benign bone tumors in pediatric patients with a follow-up of at least 2-years. The cases of 33 patients with benign bone tumors treated by curettage and subsequent implantation of CPC were retrospectively reviewed. The patients consisted of 13 males and 20 females, with a median age of 13 years and median follow-up time of 79 months. All patients were alive at the time of review. No toxicity was detected in routine blood tests. Radiography was used to confirm that CPC was well adapted to the surrounding host bone, although the resorbability of CPC was not obtained for all patients at the final follow-up. Local tumor recurrence occurred in 4 patients. None of the patients reported post-operative fractures. In total, 6 patients required a second surgical procedure, as follows: 4 patients in whom local tumor recurrence occurred; 1 patient with post-operative superficial wound infection, who underwent wound debridement; and 1 patient that required the removal of CPC due to deep infection at the proximal humerus. All patients had regained full physical function without any pain at the final follow-up. The present study recommends that the properties of CPC should be taken into consideration and applied to the reconstruction of bone defects subsequent to curettage of bone tumors.

Preparation of Tetracalcium Phosphate and the Effect on the Properties of Calcium Phosphate Cement

In the present study, three types of tetracalcium phosphate (TTCP) were prepared by solid-solid reaction or co-precipitation method and by different cooling modes. The effect of TTCP on the performance of calcium phosphate cement (CPC) was investigated. The result showed that the characteristic of TTCP varied with preparation method and played an important role in CPC performance. A solid-solid reacted TTCP yielded smaller particle size and resulted in bad workability and mechanical strength of CPC. The fast cooling of sintering TTCP by liquid nitrogen could avoid the decomposition of TTCP and make pure TTCP. TTCP prepared by wet-precipitation could improve performance of CPC and was promising to optimization of CPC.

Improvement of Anti-Washout Performance of Calcium Phosphate Cement Using Modified Starch

Calcium phosphate cements (CPCs) are well-known orthopedic materials for filling bone. However, CPC pastes tend to disintegrate immediately when contacting with blood or other aqueous (body) fluids, which is a main limitation of its clinical applications in bone repairing, reconstruction and augmentation. To improve the anti-washout performance of CPC, modified starches such as pre-gelatinized starch, etherified starch, and esterified starch were added to the liquid phase of CPC in this work. CPC with good anti-washout performance was prepared and the effects of the modified starches on the properties of CPC were investigated. The results showed that the CPC with the modified starches were more stable in simulated body fluid than that without modified starch, especially the CPC with the etherified starch (II). X-ray diffraction analysis revealed that the modified starches did not inhibit CPC components from converting to hydroxyapatite. Furthermore, the anti-washout mechanism of the modified starches in CPC was discussed. It is concluded that the addition of the modified starches such as pre-gelatinized starch, etherified starch, and esterified starch to CPC can improve its anti-washout performance and should be of value in clinical surgery where the cement is exposed to blood.