Effects of hydroxyapatite on PMMA-HAp cement for biomedical applications.

OBJECTIVE: The main goal of this study was to examine the influence of hydroxyapatite (HAp) macroaggreate concentrations on thermal and mechanical properties of radioactive bone cement and to study the relation of glass transition Tg with its mechanical properties. METHODS: The bone cement as (1-x)PMMA-xHAp binary system was prepared in six [x] distinct concentration parameters of 0.0 up to 0.5. The HAp was synthesized using a solgel procedure following calcination by thermal treatment. The composite was prepared in cold based (non-radioactive) mixing polymethyl methacrylate (PMMA) and HAp. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and mechanical compressive strength (CS) were used to measure the thermal and mechanical properties. RESULTS: The DSC and TGA thermal profiles in function to concentration parameter [x] were presented. The CS lies in a range of 3.71-7.37 MPa and the glass transition temperature Tg = 126.27 °C. There was a direct relationship between the PMMA-HAp thermoplastic properties with mechanical and thermal properties in function of HAp concentrations. CONCLUSION: The specific PMMA-HAp composite, with a concentration ratio of 1:1 and HAp thermal treatment at the Tg, provides a material with a compression strength of 7.37 MPa and a suitable amount of porous similar to a trabecular bone, possible to apply in bone cement implants, regardless of whether they are radioactive or not.

Absorptive and expansive behaviors of poly(methyl methacrylate-co-acrylic acid) bone cement.

Some additives had provided the expansion capacity to the polymethylmethacrylate (PMMA) bone cement and also reduced its maximum reaction temperature. However, the corresponding modified bone cement displayed inferior simulated body fluid (SBF) absorption capacity and expansion behavior, the mechanism of SBF absorption and the trend of expansion stress were ignored additionally. In this study, a homogeneous distribution of poly (methyl methacrylate-co-acrylic acid) [P(MMA-AA)] microspheres led to the formation of microchannels that favored the delivery of SBF to the interior, causing an increased absorption capacity and enhanced expansion behavior before solidification of the bone cement, with the maximum equilibrium absorption ratio and the expansion ratio reaching 27.3 % and 26.3 %, respectively, at an AA content of 50 %. In addition, the expansion stress induced by the expansion behavior experienced a gradual increase from the 0 s to 2590s, followed by a sharp climbed in a short period ranging from 2590s to 2900s, finally reaching maximum stress of 82.1 MPa. Furthermore, the expansion stress within the maximum value could be obtained by controlling the AA content in the P(MMA-AA) bone cement. With the above characteristics, the prepared P(MMA-AA) bone cement has potential applications as a filling and adhesive material in arthroplasties, vertebroplasties, joint replacements, bone screws, and dentistry.

Study on strontium doped tricalcium silicate synthesized through sol-gel process.

We successfully synthesized a strontium-doped tricalcium silicate (SrxCa3-xSiO5, Sr = 0 to 2 mol%) bone cement using the sol-gel process. The material properties including crystallinity, setting time, mechanical strength, and hydration products were characterized. Release of ions and pH values of simulated body fluid soaked with the bone cement were measured. In vitro biocompatibility of different concentrations of the material was evaluated by the viability of L929 cells. The setting times of as-prepared slurries were all <70 min. Doping with 0.5 mol% Sr reduced the final setting time by 20 min. After 14 days curing, 0.25 mol% Sr-doped SrxCa3-xSiO5 possessed the highest compressive strength of 45 MPa among all the Sr-doped groups with no statistical difference to Ca3SiO5. The bioactivity of the materials was confirmed with the formation of an apatite layer on the surface of the materials after immersion in simulated body fluid. In addition, the proliferation of L929 cells exposed to 1 mol% Sr was significantly promoted as compared to no Sr doping. SrxCa3-xSiO5 is a novel and advanced material that has the potential to serve as a bone cement in bone restoration with appropriate mechanical strength and favorable biocompatibility.

3D plotting in the preparation of newberyite, struvite, and brushite porous scaffolds: using magnesium oxide as a starting material.

Calcium phosphate (CaP)-containing materials, such as hydroxyapatite and brushite, are well studied bone grafting materials owing to their similar chemical compositions to the mineral phase of natural bone and kidney calculi. In recent studies, magnesium phosphate (MgP)-containing compounds, such as newberyite and struvite, have shown promise as alternatives to CaP. However, the different ways in degradation and release of Mg2+ and Ca2+ ions in vitro may affect the biocompatibility of CaP and MgP-containing compounds. In the present paper, newberyite, struvite, and brushite 3D porous structures were constructed by 3D-plotting combining with a two-step cementation process, using magnesium oxide (MgO) as a starting material. Briefly, 3D porous green bodies fabricated by 3D-plotting were soaked in (NH4)2HPO4 solution to form semi-manufactured 3D porous structures. These structures were then soaked in different phosphate solutions to translate the structures into newberyite, struvite, and brushite porous scaffolds. Powder X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectrometry (EDS) were used to characterize the phases, morphologies, and compositions of the 3D porous scaffolds. The porosity, compressive strength, in vitro degradation and cytotoxicity on MC3T3-E1 osteoblast cells were assessed as well. The results showed that extracts obtained from immersing scaffolds in alpha-modified essential media induced minimal cytotoxicity and the cells could be attached merely onto newberyite and brushite scaffolds. Newberyite and brushite scaffolds produced through our 3D-plotting and two-step cementation process showed the sustained in vitro degradation and excellent biocompatibility, which could be used as scaffolds for the bone tissue engineering.

Injectable dicalcium phosphate bone cement prepared from biphasic calcium phosphate extracted from lamb bone.

Quick setting and poor injectability due to liquid-solid phase separation have limited the clinical use of brushite and monetite cements. The presence of certain ions in the cement during the setting reaction moderate the setting time and properties of the cement. This study reports the preparation of injectable bone cement by using biphasic calcium phosphate (BCP) extracted from femur lamb bone by calcination at 1450 °C. EDX analysis infers the presence of Mg and Na ions as trace elements in BCP. X-ray diffraction patterns of the prepared cement confirmed the formation of brushite (DCPD) along with monetite (DCPA) as a minor phase. DCPA phase diminished gradually with a decrease in powder to liquid ratio (PLR). Initial and final setting time of 5.3 ±â€¯0.5 and 14.67 ±â€¯0.5 min respectively are obtained and within the acceptable recommended range for orthopedic applications. Exceptional injectability of ≈90% is achieved for all prepared bone cement samples. A decrease in compressive strength was observed with increase in the liquid phase of the cement, which is attributed to the higher degree of porosity in the set cement. Immersion of bone cement in simulated body fluid (SBF) for up to 7 days resulted in the formation of apatite layer on the surface of cement with Ca/P ratio 1.71, which enhanced the compressive strength from 2.88 to 9.15 MPa. The results demonstrate that bone cement produced from BCP extracted from femur lamb bone can be considered as potential bone substitute for regeneration and repair of bone defects.

Thermoresponsive Brushes Facilitate Effective Reinforcement of Calcium Phosphate Cements.

Calcium phosphate ceramics are frequently applied to stimulate regeneration of bone in view of their excellent biological compatibility with bone tissue. Unfortunately, these bioceramics are also highly brittle. To improve their toughness, fibers can be incorporated as the reinforcing component for the calcium phosphate cements. Herein, we functionalize the surface of poly(vinyl alcohol) fibers with thermoresponsive poly(N-isopropylacrylamide) brushes of tunable thickness to improve simultaneously fiber dispersion and fiber-matrix affinity. These brushes shift from hydrophilic to hydrophobic behavior at temperatures above their lower critical solution temperature of 32 °C. This dual thermoresponsive shift favors fiber dispersion throughout the hydrophilic calcium phosphate cements (at 21 °C) and toughens these cements when reaching their hydrophobic state (at 37 °C). The reinforcement efficacy of these surface-modified fibers was almost double at 37 versus 21 °C, which confirms the strong potential of thermoresponsive fibers for reinforcement of calcium phosphate cements.

Osteoimmunomodulation, osseointegration, and in vivo mechanical integrity of pure Mg coated with HA nanorod/pore-sealed MgO bilayer.

Fast degradation of Mg-based implants results in the loss of mechanical integrity and poor osseointegration. Herein, a bilayer-structured coating (termed as HAT), comprising an outer layer of hydroxyapatite (HA) nanorods and an inner layer of pores-sealed MgO with HA/Mg(OH)2, was formed on Mg using plasma electrolytic oxidation and hydrothermal treatment. Osteoimmunomodulation, osseointegration, mechanical integrity, and bone-implant interfacial structure evolution of the HAT-coated Mg were investigated by implantation in rabbit femora, together with Mg coated with plasma electrolytic oxidized porous MgO (termed as PEO0) and bare Mg. As compared to PEO0-coated and bare Mg, HAT-coated Mg greatly downregulated pro-inflammatory TNF-α and IL-1ß, upregulated anti-inflammatory IL-10, and suppressed osteoclastogenesis, modulating the surrounding microenvironment toward favoring the recruitment of osteogenetic cells. Moreover, HAT-coated Mg accelerated bone sialoprotein and osteopontin secretion of osteogenetic cells and their mineralization to form a cement line matrix. It also promoted the differentiation of osteogenetic cells, secretion of collagen overlying on the cement line matrix, inducing an earlier and more pronounced bone matrix formation. The cement line matrix wrapped the HA nanorods and filled the interrod spaces of the HAT coating, forming strong interdigitation at the bone-coating interface, and therefore, yielding enhanced osseointegration by means of contact osteogenesis. Due to the considerably reduced corrosion of Mg by the pores-sealed bilayer structure of HAT coating, HAT-coated Mg maintained the mechanical integrity for a longer duration than PEO0-coated and bare Mg. It is clarified that the degradation of MgO and HA, rather than delamination, was the vanishing mode of PEO0 and HAT coatings during long-term implantation, avoiding osteolysis induced by the delamination-generated particles.

Study on an injectable biomedical paste using cross-linked sodium hyaluronate as a carrier of hydroxyapatite particles.

Exploring the long-term filler for minimally invasive plastic surgery has been widely concerned. In the present study, a series of injectable paste composed of hydroxyapatite (HAp) spherical particles and cross-linked sodium hyaluronate (cHA) solution were prepared. The physicochemical properties of cHA as a carrier of high content HAp microspheres (>50%) and as-obtained injectable HAp/cHA paste were studied. The cross-linking degree (DC), viscosity and molecular weight (Mw and Mn) of cHA increased with the increasing of the cross-linker dosage from 7.5 to 17.5 wt% under the certain conditions. HAp/cHA pastes were fabricated by homogeneously blending different sizes of HAp microspheres with cHA solution. The stability, rheological performance and push-out force of the pastes were studied, and the influence factors were discussed. The results indicated that moderate crosslinked cHA with 60% middle size HAp (HAp-M60/cHA-15.0) had appropriate comprehensive property. Finally, the in vitro cell culture approved the paste had no cytotoxicity. Although the biological performance of the pastes still need to be investigated, this preliminary study demonstrates that it is possible to carry high content HAp in cHA, expecting the better volumetric maintenance after long term implantation.

Different post-processing conditions for 3D bioprinted α-tricalcium phosphate scaffolds.

The development of 3D printing hardware, software and materials has enabled the production of bone substitute scaffolds for tissue engineering. Calcium phosphates cements, such as those based on α-tricalcium phosphate (α-TCP), have recognized properties of osteoinductivity, osteoconductivity and resorbability and can be used to 3D print scaffolds to support and induce tissue formation and be replaced by natural bone. At present, however, the mechanical properties found for 3D printed bone scaffolds are only satisfactory for non-load bearing applications. This study varied the post-processing conditions of the 3D powder printing process of α-TCP cement scaffolds by either immersing the parts into binder, Ringer's solution or phosphoric acid, or by sintering in temperatures ranging from 800 to 1500 °C. The porosity, composition (phase changes), morphology, shrinkage and compressive strength were evaluated. The mechanical strength of the post-processed 3D printed scaffolds increased compared to the green parts and was in the range of the trabecular bone. Although the mechanical properties achieved are still low, the high porosity presented by the scaffolds can potentially result in greater bone ingrowth. The phases present in the scaffolds after the post-processing treatments were calcium-deficient hydroxyapatite, brushite, monetite, and unreacted α-TCP. Due to their chemical composition, the 3D printed scaffolds are expected to be resorbable, osteoinductive, and osteoconductive.

Diffusion-Controllable Biomineralization Conducted In Situ in Hydrogels Based on Reversibly Cross-Linked Hyperbranched Polyglycidol.

We present biocompatible hydrogel systems suitable for biomineralization processes based on hyperbranched polyglycidol cross-linked with acrylamide copolymer bearing carbonyl-coordinated boronic acid. At neutral pH, diol functional groups of HbPGL react with boronic acid of polyacrylamide to generate 3D network in water by the formation of boronic ester cross-links. The dynamic associative/dissociative characteristics of the cross-links makes the network reversible. The presented hydrogels display self-healing properties and are injectable, facilitating gap filing of bone tissue. The 1H HR MAS DOSY NMR studies reveal that acrylamide copolymer plays the role of the network framework, whereas HbPGL macromolecules, due to their compact structure, move between reactive sites of the copolymer. The influence of the copolymer macromolecules entanglements and overall polymer concentrations on macromolecules mobility and stress relaxation processes is investigated. The process of hydrogel biomineralization results from hydrolysis of 1-naphthyl phosphate calcium salt catalyzed by encapsulation in hydrogel alkaline phosphatase. The environment of the hydrogel is entirely neutral toward the enzyme. However, the activity of alkaline phosphatase encapsulated within the hydrogel structure is diffusion-limited. In this article, based on the detailed characteristics of three model hydrogel systems, we demonstrate the influence of the hydrogel permeability on the encapsulated enzyme activity and calcium phosphate formation rate. The 1H HR MAS DOSY NMR is used to monitor diffusion low-molecular weight compound within hydrogels, whereas 31P HR MAS NMR facilitates monitoring of the progress of biomineralization in situ within hydrogels. The results show a direct correlation between low molecular diffusivity in hydrogels and network dynamics. We demonstrate that the morphology of in situ-generated calcium phosphate within three model HbPGL/poly(AM-ran-APBA) hydrogels of different low molecular permeability varies substantially from sparsely deployed large, well-defined crystals to an even distribution within the polymers polycrystalline continuous network.

Surfactant-assisted synthesis of polyvinylpyrrolidone-hydroxyapatite composites as a bone filler.

BACKGROUND: Different methods have been used to prepare bone-like composites from inorganic nanoparticles embedded in polymeric matrixes to obtain the properties and structures required for bone fillers. METHODS: Bone-like nano-hydroxyapatite (nHA) was synthesized using a biomimetic method, with polyvinylpyrrolidone (PVP) as template and sodium dodecyl sulfate (SDS) as surfactant. RESULTS: The results demonstrated the formation of HA composites and showed that polymer and surfactant as the polymer capsule can be properly used to control the size, shape, morphology and dispersion of HA crystals. All of the samples were bioactive due to their ability to form carbonate apatite and grow HA on their surface. The MTT assay showed that the samples were biocompatible. CONCLUSIONS: Based on bioactivity and biocompatibility evaluations, the prepared composites can be considered as good candidates for bone filler applications.

Modification of Mechanical Properties, Polymerization Temperature, and Handling Time of Polymethylmethacrylate Cement for Enhancing Applicability in Vertebroplasty.

Polymethylmethacrylate (PMMA) bone cement is a popular bone void filler for vertebroplasty. However, the use of PMMA has some drawbacks, including the material's excessive stiffness, exothermic polymerization, and short handling time. This study aimed to create an ideal modified bone cement to solve the above-mentioned problems. Modified bone cements were prepared by combining PMMA with three different volume fractions of castor oil (5%, 10%, and 15%). The peak polymerization temperatures, times to achieve the peak polymerization temperature, porosities, densities, modulus and maximum compression strengths of standard (without castor oil), and modified cements were investigated following storage at ambient temperature (22°C) or under precooling conditions (3°C). Six specimens were tested in each group of the aforementioned parameters. Increasing castor oil content and precooling treatment effectively decreased the peak polymerization temperatures and increased the duration to achieve the peak polymerization temperature (P < 0.05). Furthermore, the mechanical properties of the material, including density, modulus, and maximum compression strength, decreased with increasing castor oil content. However, preparation temperature (room temperature versus precooling) had no significant effect (P > 0.05) on these mechanical properties. In conclusion, the addition of castor oil to PMMA followed by precooling created an ideal modified bone cement with a low modulus, low polymerization temperature, and long handling time, enhancing its applicability and safety for vertebroplasty.

Exploring the unexpected influence of the Si:Ge ratio on the molecular architecture and mechanical properties of Al-free GICs.

Germanium (Ge)-based glass ionomer cements have demonstrated the ability to balance strength with extended setting times, a unique set of characteristics for aluminum-free glass ionomer cements. However, the mechanical properties of current Ge-based glass ionomer cements significantly deteriorate over time, which jeopardizes their clinical potential. This work explores the effect of incrementally decreasing the Si:Ge ratio in the glass phase of zinc-silicate glass ionomer cements to identify potential mechanisms responsible for the time-induced mechanical instability of Ge-based glass ionomer cements. The influence of Ge was evaluated on the basis of changes in mechanical properties and molecular architecture of the cements over a 180-day period. It was observed that the compressive strength and modulus of the cements were sustained when Si:Ge ratios were ≥1:1, but when Si:Ge ratios are <1:1 these properties decreased significantly over time. These mechanical changes were independent of structural changes in the glass ionomer cement matrices, as the level of metal-carboxylate crosslinks remained constant over time across the various Si:Ge ratios explored. However, it was noted the temporal decline of mechanical properties was proportional to the increased release of degradation byproducts, in particular Ge that was released from the cements in substantially greater quantities than other glass constituents. Unexpectedly, the slowest setting cement (Si:Ge 1:1) was also the strongest; behavior that is uncommon in Si-based glass ionomer cements, supports the potential of Ge-containing glass ionomer cements as injectable bone cements in applications such as percutaneous vertebroplasty.

Bone cement with a modified polyphosphate network structure stimulates hard tissue regeneration.

In this study, a calcium polyphosphate cement (CpPC) consisting of basic components was investigated to assess its potential for hard tissue regeneration. The added basic components for improving the structural stability, which controlled the setting time, where the setting reaction resulted in the formation of amorphous structure with a re-constructed polyphosphate. Moreover, the characteristics were controlled by the composition, which determined the polyphosphate structure. CpPC exhibited outstanding dissolution rate compared with the common biodegradable cement, brushite cement (2.5 times). Despite high amounts of dissolution products, no significant cytotoxicity ensued. Induction of calcification in MG-63 cells treated with CpPC, the level of calcification increased with increasing CpPC dissolution rate. Induced calcification was observed also in CpPC-treated ST2 cells, in contrast with MG-63 and ST2 treated with brushite cement, for which no calcification was observed. In vivo tests using a rat calvarial defect model showed that resorbed CpPC resulted in favorable host responses and promoted bone formation. Additionally, there was a significant increase in defect closure, and new bone formation progressed from CpPC mid-sites as well as defect margins. From these results, CpPC exhibits significant potential as biodegradable bone substitute for bone regeneration.

Synthesis and characterization of a new vertebroplasty cement based on gold-containing PMMA microspheres.

There are a number of drawbacks to incorporating large concentrations of barium sulfate (BaSO4) as the radiopacifier in PMMA-based bone cements for percutaneous vertebroplasty. These include adverse effects on injectability, viscosity profile, setting time, mechanical properties of the cement and bone resorption. We have synthesized a novel cement that is designed to address some of these drawbacks. Its powder includes PMMA microspheres in which gold particles are embedded and its monomer is the same as that used in commercial cements for vertebroplasty. In comparison to one such commercial cement brand, VertaPlex™, the new cement has longer doughing time, longer injection time, higher compressive strength, higher compressive modulus, and is superior in terms of cytotoxicity. For augmentation of fractured fresh-frozen cadaveric vertebral bodies (T6-L5) using simulated vertebroplasty, results for compressive strength and compressive stiffness of the construct and the percentage of the volume of the vertebral body filled by the cement were comparable for the two cements although the radiopacity of the new cement was significantly lower than that for VertaPlex™. The present results indicate that the new cement warrants further study.

Fabrication of interconnected pore forming α-tricalcium phosphate foam granules cement.

Interconnected pore forming calcium phosphate cement is useful for the reconstruction of bone defects as well as scaffold fabrication in tissue engineering. In this study, interconnected pore forming calcium phosphate cement was fabricated using α-tricalcium phosphate (α-TCP) foam granules. When α-TCP foam granules were mixed with acidic calcium phosphate solution prepared from monocalcium phosphate monohydrate (MCPM) and phosphoric acid solution, brushite crystals were precipitated. These crystals bridged the α-TCP foam granules immediately upon mixing. As a result of the brushite bridge between the α-TCP foam granules, fully interconnected macroporous α-TCP was obtained. The amount of brushite precipitate and the mechanical strength of the set cement increased with acidic calcium phosphate concentration.

In vitro evaluation of thermal frontally polymerized thiol-ene composites as bone augments.

Because of the large number of total knee replacement (TKR) surgeries conducted per year, and with projections of increased demand to almost a million primary TKR surgeries per year by 2030 in the United States alone, there is a need to discover more efficient working materials as alternatives to current bone cements. There is a need for surgeons and hospitals to become more efficient and better control over the operative environment. One area of inefficiency is the cement steps during TKR. Currently the surgeon has very little control over cement polymerization. This leads to an increase in time, waste, and procedural inefficiencies. There is a clear need to create an extended working time, moldable, osteoconductive, and osteoinductive bone augment as a substitution for the current clinically used bone cement where the surgeon has better control over the polymerization process. This study explored several compositions of pentaerythritol-co-trimethylolpropane tris-(3-mercaptopropionate) hydroxyapatite composite materials prepared via benzoyl peroxide-initiated thermal frontal polymerization. The 4:1 acrylate to thiol ratio containing augment material shows promise with a maximal propagation temperature of 160°C ± 10°C, with mechanical strength of 3.65 MPa, and 111% cytocompatibility, relative to the positive control. This frontally polymerized material may have application as an augment with controlled polymerization supporting cemented implants. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1152-1160, 2016.

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.

Antibacterial and bioactive composite bone cements containing surface silver-doped glass particles.

A bioactive silica-based glass powder (SBA2) was doped with silver (Ag(+)) ions by means of an ion-exchange process. Scanning electron microscopy (SEM), energy dispersion spectrometry (EDS) and x-ray diffraction (XRD) evidenced that the glass powder was enriched with Ag(+) ions. However, a small amount of Ag2CO3 precipitated with increased Ag concentrations in the exchange solution. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of Ag-SBA2 towards Staphylococcus aureus were also evaluated and were respectively 0.05 mg ml(-1) and 0.2 mg ml(-1). Subsequently, Ag-SBA2 glass was used as filler (30%wt) in a commercial formulation of bone cement (Simplex(™) P) in order to impart both antibacterial and bioactive properties. The composite bone cement was investigated in terms of morphology (using SEM) and composition (using EDS); the glass powder was well dispersed and exposed on the cement surface. Bioactivity tests in simulated body fluid (SBF) evidenced the precipitation of hydroxyapatite on sample surfaces. Composite cement demonstrated antibacterial properties and a compressive strength comparable to the commercial formulation.

Fabrication of bone cement that fully transforms to carbonate apatite.

The objective of this study was to fabricate a type of bone cement that could fully transform to carbonate apatite (CO3Ap) in physiological conditions. A combination of calcium carbonate (CaCO3) and dicalcium phosphate anhydrous was chosen as the powder phase and mixed with one of three kinds of sodium phosphate solutions: NaH2PO4, Na2HPO4, or Na3PO4. The cement that fully transformed to CO3Ap was fabricated using vaterite, instead of calcite, as a CaCO3 source. Their stability in aqueous solutions was different, regardless of the type of sodium phosphate solution. Rate of transformation to CO3Ap in descending order was Na3PO4>Na2HPO4>NaH2PO4. Transformation rate could be affected by the pH of solution. Results of this study showed that it was advantageous to use vaterite to fabricate CO3Ap-forming cement.