Fabrication and characterization of a novel carbon fiber-reinforced calcium phosphate silicate bone cement with potential osteo-inductivity.

The repair of bone defects is still a pressing challenge in clinics. Injectable bone cement is regarded as a promising material to solve this problem because of its special self-setting property. Unfortunately, its poor mechanical conformability, unfavorable osteo-genesis ability and insufficient osteo-inductivity seriously limit its clinical application. In this study, novel experimental calcium phosphate silicate bone cement reinforced by carbon fibers (CCPSC) was fabricated and characterized. First, a compressive strength test and cell culture study were carried out. Then, the material was implanted into the femoral epiphysis of beagle dogs to further assess its osteo-conductivity using a micro-computed tomography scan and histological analysis. In addition, we implanted CCPSC into the beagles' intramuscular pouches to perform an elementary investigation of its osteo-inductivity. The results showed that incorporation of carbon fibers significantly improved its mechanical properties. Meanwhile, CCPSC had better biocompatibility to activate cell adhesion as well as proliferation than poly-methyl methacrylate bone cement based on the cell culture study. Moreover, pronounced biodegradability and improved osteo-conductivity of CCPSC could be observed through the in vivo animal study. Finally, a small amount of osteoid was found at the heterotopic site one month after implantation which indicated potential osteo-inductivity of CCPSC. In conclusion, the novel CCPSC shows promise as a bioactive bone substitute in certain load-bearing circumstances.

Preparation, characterization, release kinetics, and in vitro cytotoxicity of calcium silicate cement as a risedronate delivery system.

Injectable bone cements have been well characterized and studied in non-load bearing bone fixation and bone screw augmentation applications. Current calcium phosphate cement or poly(methyl methacrylate) cement have drawbacks like low mechanical strength and in situ exothermic properties. This leads especially in patients with osteoporosis to worsening contact between implant and bone and can finally lead to implant failure. To improve these properties, a calcium silicate cement (CSC) was prepared, which additionally contained the bisphosphonate risedronate (RA) to promote osteoblast function. Cement setting rate and compressive strength were measured and found to be reduced by RA above 0.5 wt%. X-ray diffraction, Rietveld refinement analysis, scanning electron microscopy, and porosity measurements by gas sorption revealed that RA reduces calcium silicate hydrate gel formation and changes the cement's microstructure. Cumulative release profiles of RA from CSC up to 6 months into phosphate buffer solution were analyzed by high-performance liquid chromatography, and the results were compared with theoretical release curves obtained from the Higuchi equation. Fourier transform infrared spectra measurements and drug release studies indicate that calcium-RA formed within the cement, from which the drug can be slowly released over time. An investigation of the cytotoxicity of the RA-CSC systems upon osteoblast-like cells showed no toxic effects of concentrations up to 2%. The delivery of RA from within a CSC might thus be a valuable and biocompatible new approach to locally deliver RA and to reconstruct and/or repair osteoporosis-related bone fractures.

In vitro studies of calcium phosphate silicate bone cements.

A novel calcium phosphate silicate bone cement (CPSC) was synthesized in a process, in which nanocomposite forms in situ between calcium silicate hydrate (C-S-H) gel and hydroxyapatite (HAP). The cement powder consists of tricalcium silicate (C(3)S) and calcium phosphate monobasic (CPM). During cement setting, C(3)S hydrates to produce C-S-H and calcium hydroxide (CH); CPM reacts with the CH to precipitate HAP in situ within C-S-H. This process, largely removing CH from the set cement, enhances its biocompatibility and bioactivity. The testing results of cell culture confirmed that the biocompatibility of CPSC was improved as compared to pure C(3)S. The results of XRD and SEM characterizations showed that CPSC paste induced formation of HAP layer after immersion in simulated body fluid for 7 days, suggesting that CPSC was bioactive in vitro. CPSC cement, which has good biocompatibility and low/no cytotoxicity, could be a promising candidate as biomedical cement.

Influence of apatite seeds on the synthesis of calcium phosphate cement.

This preliminary study explores the seeding effect (using crystalline hydroxyapatite particles) on the setting time, compressive strength, phase evolution, and microstructure of calcium phosphate cements (CPC) based on monocalcium phosphate monohydrate and calcium hydroxide. Experimental results showed that the setting time varies from 5 to about 30 min, as the seed concentration increased from 0 to 20 wt%. The compressive strength of CPC increased from 4 to 17 MPa, followed by decrease to 12 MPa, for the same range of seeds content. The CPC transformed to predominantly apatitic structure within 24 h for all the samples, with or without the seeds. However, increase of the seed concentration improved the final crystallinity of the apatite phase, suggesting nucleation and growth effects during precipitation of CPC from the precursor solution. The microstructure of the resulting apatitic cement showed a change from essentially featureless (or glass-like) to thin, elongated plate-like morphology, as seeds concentration increased. Correlation between microstructural evolution and corresponding compressive strength of seeded CPC is investigated.

Structural evolution of sol-gel-derived hydroxyapatite.

Structural evolution upon transformation of sol to gel, and gel to final ceramic during the synthesis of hydroxyapatite is investigated using Fourier transform infrared (FTIR) analysis, X-ray diffraction (XRD), thermal behavior (DTA and TGA), and electron microscopy examination (SEM/TEM). The sol was first thermally aged at 45 C for various time periods up to 120 min. The colloidal sol, which may have an oligomeric structure, was relatively stable against coagulation. Upon drying, the sol particles consolidated into dry gel through van der Waals attraction, and showed X-ray amorphous phosphate structure. The solid gels showed a particulate microstructure, composed of primary particles of about 8-10 nm in diameter. The amorphous gel transformed into crystalline apatite at temperatures > 300 C. The calcined gels showed a nano-scale microstructure, with grains of 20-50 nm in diameter. Through an appropriate heat treatment between 300 and 400d degrees C. the apatite prepared using current process exhibits a nano-scale, low-crystallinity, carbonated apatitic structure, which closely resembles that of human bone apatite.

Sol-gel hydroxyapatite coatings on stainless steel substrates.

Thin film hydroxyapatite deposits onto sandblasted 316L stainless steel substrates were prepared using water-based sol-gel technique recently developed in our lab. The coatings were annealed in air at 375 degrees C, 400 degrees C, and 500 degrees C. Phase formation, surface morphology, interfacial microstructure, and interfacial bonding strength of the coatings were investigated. Apatitic structure developed within the coatings while annealing at temperatures > or = 400 degrees C, while those heat-treated at 375 degrees C showed poor crystallinity. The coatings were dense and firmly attached to the underlying substrates, reaching an average bonding strength (as determined through the pull-out test) of 44 MPa. Nano-porous structure was found for the coatings annealed at 500 degrees C, believed to result from grain growth, and causing a slight decrease in the bonding strength. Surface microcracking, although not extensive, occurred after annealing at temperatures > or = 400 degrees C, and was linked to non-uniform thickness of the coating due to roughness of the substrate. A contraction of the coatings as a result of sintering, and phase transition from amorphous (or poor crystalline) to reasonably good crystalline apatite, may be responsible for the loss of structural integrity of the thicker sections of the coatings. It seems quite promising that a dense and adhesive apatite coating can be achieved through water-based sol gel technology after short-term annealing at around 400 degrees C in air.