Transformation from calcium sulfate to calcium phosphate in biological environment.

The formation of a nano-apatite surface layer is frequently considered a measure of bioactivity, especially for non-phosphate bioceramics. In the present study, strontium-doped calcium sulfate, (Ca,Sr)SO4, was used to verify the feasibility of this measure. The (Ca,Sr)SO4 specimen was prepared by mixing 10% SrSO4 by weight with 90% CaSO4·½H2O powder by weight. A solid solution of (Ca,7.6%Sr)SO4 was then produced by heating the powder mixture at 1100 °C for 1 h. The resulting (Ca,Sr)SO4 specimen was readily degradable in phosphate solution. A newly formed surface layer in the form of flakes was formed within one day of specimen immersion in phosphate solution. Structural and microstructure-compositional analyses indicated that the flakes were composed of octacalcium phosphate (OCP) crystals. An amorphous interface containing OCP nanocrystals was found between the newly formed surface layer and the remaining (Ca,Sr)SO4 specimen. The specimen was also implanted into a rat distal femur bone defect. In addition to new bone, fibrous tissue and inflammatory cells were found to interlace the (Ca,Sr)SO4 specimen. The present study indicated that a more comprehensive evaluation is needed to assess the bioactivity of non-phosphate bioceramics. The newly formed surface layer on the (Ca,Sr)SO4 specimen after soaking in phosphate solution for 28 days.

Long-term in vitro degradation and in vivo evaluation of resorbable bioceramics.

An essential criterion for the selection of resorbable bioceramics is their ability to degrade inside human body within a reasonable time frame. Furthermore, if the bioceramic can release beneficial ions, such as strontium, as it degrades, recovery time might be shortened. The present study demonstrates that strontium-containing calcium sulfate (Sr,Ca)SO4 can fulfill these criteria. A long-term in vitro degradation analysis for 12 weeks using sintered (Sr,Ca)SO4 discs in phosphate buffered solution (PBS) was conducted. The sintered (Sr,Ca)SO4 disc was then implanted into defects in the distal femur of rats. The degradation rate of (Sr,Ca)SO4 discs showed a strong dependence on the Sr content. Similar results were observed between the long-term in vitro degradation analysis and the in vivo evaluation. The sintered (3.8%Sr,Ca)SO4 disc lost more than 80% of its initial weight after soaking in PBS with shaking at 37 °C for 12 weeks. After 12 weeks in vivo, the remaining volume of the (3.8%Sr,Ca)SO4 disc within the bone defect was ~25%. Over the same time period, new bone was formed at a relative volume of 40%. This study demonstrates the potential of (Sr,Ca)SO4 bioceramic, and the benefits of using a long-term degradation test during the evaluation of resorbable bioceramics.

Porous calcium sulfate ceramics with tunable degradation rate.

It would be ideal if bone substitutes could be absorbed by the human body upon the formation of new bone. Although calcium sulfate is absorbable, its biodegradation rate is very fast. Fortunately, this rate can be reduced significantly through various sintering techniques. This study demonstrates that the degradation rate of sintered CS specimens can be adjusted through the introduction of pores. Through various techniques, we introduced spherical pores with amounts ranging from 6.7 to 68 % into sintered CS specimens. The corresponding degradation rate in Hank's solution varied from 1.9 to 7.7 %/day and the cytotoxicity test results indicated low toxicity within the sintered CS specimens.

Biphasic ceramic bone graft with biphasic degradation rates.

In this study, the characteristics of a novel biphasic bone graft are reported. The bone graft is a physical mixture of calcium sulfate (CS) and hydroxyapatite (HA). This biphasic bone graft was prepared by sintering at 1100 °C. Since the degradation rate of CS is much faster than that of HA, the CS/HA biphasic bone graft exhibits two degradation rates. The degradation rate is rapid (~10 wt%/week) in the first stage and then slow (~1 wt%/week) in the second stage. The biphasic bone graft has been implanted into the distal femur of rat. Most the bone graft was degraded 13 weeks postoperatively. Instead, trabecular bone and vascular tissue are observed at the location of implant. The bone graft is unique for its burst of calcium ions at the start and its ability to remain stable throughout the degradation process. Its stable porous structure serves as an ideal scaffold for the formation of new bone as well as vascularization.

Cytotoxicity and cell response of preosteoblast in calcium sulfate-augmented PMMA bone cement.

Poly(methyl methacrylate) (PMMA) has been widely used in orthopedic applications, but bone ingrowth and toxic monomer release are drawback of this material. Particle reinforcement with osteoconductive substitute, such as calcium sulfate (CaSO4), is one of the solutions used to modify PMMA bone cement. The current study investigated the mechanical, chemical and biological properties of CaSO4-augmented bone cement. Mechanical strength was measured by a material testing machine. The concentration of methyl methacrylate (MMA) monomer from the various formulations of PMMA mixed with CaSO4was measured by ultra-performance liquid chromatography (UPLC). CCK-8 assay and ALP assay were performed to evaluate cytotoxicity of released MMA monomer and cell differentiation. The attachment of cells to CaSO4-augmented bone cement discs was observed by confocal and scanning electron microscopy, and surface topography was also evaluated by atomic force microscopy. The results revealed that increased CaSO4weight ratios led to compromised mechanical strength and increased MMA monomer release. Cell density and cell differentiation on CaSO4-augmented bone cement discs were decreased at CaSO4weight ratios above 10%. In addition, the presence of micropores on the surface and surface roughness were both increased for PMMA composite discs containing higher levels of CaSO4. These results demonstrated that fewer MC3T3-E1 cells on the surface of CaSO4-PMMA composites was correlated to increased MMA monomer release, micropore number and surface roughness. In summary, the augmentation of a higher proportion of CaSO4(>10 wt. %) to PMMA did not promote the biological properties of traditional PMMA bone cement.

A head-to-head comparison of the degradation rate of resorbable bioceramics.

Resorbable bioceramics offer advantages in healing bone defects due to their degradation capability. Degradation rates differ significantly from one bioceramic to another; nevertheless, the degradation rate should match the growth rate of new bone. In the present study, a head-to-head comparison of the degradation rate of calcium sulfate and tricalcium phosphate is conducted. First, the degradation behaviors of calcium sulfate and tricalcium phosphate are evaluated separately. The comparison indicates that the degradation rate of calcium sulfate is one order of magnitude faster than that of tricalcium phosphate. Along with a fast degradation rate, the formation of calcium phosphate on the surface of calcium sulfate pellets is also faster. A core-shell roll composed of a calcium sulfate core and a tricalcium phosphate shell is also prepared. After soaking the core-shell roll in phosphate buffered saline solution for 24 h, calcium phosphate precipitates form only on the surface of core, the part containing calcium sulfate anhydrite.

Manipulation of the degradation behavior of calcium sulfate by the addition of bioglass.

A bioactive calcium sulfate/glass composite was prepared using a sintering technique, and Ca-P-Si glass particles were prepared by spray pyrolysis. The glass exhibited bioactivity in terms of its ability to form apatite in a simulated body fluid. The glass was transformed into two crystallized phases, i.e., calcium phosphate and calcium silicate, respectively, during the heating stage. The presence of the crystallized phases retarded the densification of calcium sulfate. A high sintering temperature of 1200 °C was needed to prepare the composite. The increased addition of glass enhanced the strength and decreases the degradation rate of calcium sulfate. The new composite is not only degradable but also bioactive.

Improving biodegradation behavior of calcium sulfate bone graft tablet by using water vapor treatment.

The biodegradation rate of calcium sulfate hemihydrate (CSH) tablets is extremely rapid. This study adopts a water vapor treatment to modify the surface structure of a CSH tablet. After the treatment, a small amount of calcium sulfate dihydrate (CSD) forms on the surface; the porosity near the surface region decreases, consequently enhancing tablet strength and surface hardness. Because of the decrease in porosity at the surface, the time for complete disintegration increases from 1.2 h to 7.2 h; the time for complete dissolution increases from 7 days to 25 days.