Prediction of the Setting Properties of Calcium Phosphate Bone Cement

Setting properties of bone substitutes are improved using an injectable system. The injectable bone graft substitutes can be molded to the shape of the bone cavity and set in situ when injected. Such system is useful for surgical operation. The powder part of the injectable bone cement is included of β-tricalcium phosphate, calcium carbonate, and dicalcium phosphate and the liquid part contains poly ethylene glycol solution with different concentrations. In this way, prediction of the mechanical properties, setting times, and injectability helps to optimize the calcium phosphate bone cement properties. The objective of this study is development of three different adaptive neurofuzzy inference systems (ANFISs) for estimation of compression strength, setting time, and injectability using the data generated based on experimental observations. The input parameters of models are polyethylene glycol percent and liquid/powder ratio. Comparison of the predicted values and measured data indicates that the ANFIS model has an acceptable performance to the estimation of calcium phosphate bone cement properties

Critical review: Injectability of calcium phosphate pastes and cements

Calcium phosphate cements (CPC) have seen clinical success in many dental and orthopaedic applications in recent years. The properties of CPC essential for clinical success are reviewed in this article, which includes properties of the set cement (e.g. bioresorbability, biocompatibility, porosity and mechanical properties) and unset cement (e.g. setting time, cohesion, flow properties and ease of delivery to the surgical site). Emphasis is on the delivery of calcium phosphate (CaP) pastes and CPC, in particular the occurrence of separation of the liquid and solid components of the pastes and cements during injection; and established methods to reduce this phase separation. In addition a review of phase separation mechanisms observed during the extrusion of other biphasic paste systems and the theoretical models used to describe these mechanisms are discussed

Porosity prediction of calcium phosphate cements based on chemical composition

The porosity of calcium phosphate cements has an impact on several important parameters, such as strength, resorbability and bioactivity. A model to predict the porosity for biomedical cements would hence be a useful tool. At the moment such a model only exists for Portland cements. The aim of this study was to develop and validate a first porosity prediction model for calcium phosphate cements. On the basis of chemical reaction, molar weight and density of components, a volume-based model was developed and validated using calcium phosphate cement as model material. 60 mol% beta-tricalcium phosphate and 40 mol% monocalcium phosphate monohydrate were mixed with deionized water, at different liquid-to-powder ratios. Samples were set for 24 h at 37 degrees C and 100 % relative humidity. Thereafter, samples were dried either under vacuum at room temperature for 24 h or in air at 37 degrees C for 7 days. Porosity and phase composition were determined. It was found that the two drying protocols led to the formation of brushite and monetite, respectively. The model was found to predict well the experimental values and also data reported in the literature for apatite cements, as deduced from the small absolute average residual errors (<2.0 %). In conclusion, a theoretical model for porosity prediction was developed and validated for brushite, monetite and apatite cements. The model gives a good estimate of the final porosity and has the potential to be used as a porosity prediction tool in the biomedical cement field.Peer ReviewedPostprint (author's final draft

Synthesis and characterization of calcium phosphate cement based macroporous scaffolds

Thesis (Doctoral)--Izmir Institute of Technology, Chemical Engineering, Izmir, 2012Includes bibliographical references (leaves: 254-267)Text in English; Abstract: Turkish and Englishxviii, 315 leavesThe goal of this thesis is to synthesize unique, clinically relevant macroporous calcium phosphate cement blocks to be utilized both in vivo and in vitro tissue engineering applications. Calcium phosphate cements which essentially consist of hydroxyapatite or brushite are constantly improved to overcome their inherent shortcomings such as low strength, low functional porosity, and low resorption. Recent literature on the topic points to monetite forming cements as an alternative phase. A novel method to utilize monetite that is finer and stronger with respect to brushite in load bearing scaffold applications is introduced in the results section of this thesis as a contribution to ever growing literature on this scope. In the preliminary study on the conversion extent of apatite forming cement, ionic strength of the setting liquid was determined as the prime effective factor on monetite conversion extent. Subsequently brushite forming β-tricalcium phosphate – monocalcium phosphate monohydrate cement system was modified by NaCl and citric acid so that brushite formation was selectively inhibited. Singular and synergistic monetite promoting effects of NaCl and citric acid were determined by monitoring the kinetics of cement setting in excess setting liquid. Spectrometric studies revealed the difference in brushite and monetite crystal surface site density which enabled selective inhibition of brushite and promotion of monetite by the synergistic effect of NaCl anc citric acid. Proposed phase control mechanism enables tailoring the composition of biphasic cements comprising of a predetermined monetite content and brushite or hydroxyapatite. In the final stage of the thesis, size distributed NaCl particles were introduced into the cement paste containing optimum amount of citric acid to enable complete monetite formation. Resultant macroporous monetite blocks were characterized in terms of microporosity, macroporosity, density, morphology, strength, phase composition, and surface area. Interconnectivity of the cement was optimized based on the correlation of porogen size distribution and morphological data

Calcium phosphate /poly (ethylene glycol) bone cement: cell culture performance

Calcium phosphate cement (CPC) for injectable bone cement application has been developed in this study. The CPC was produced using a novel wet chemical precipitation method derived hydroxyapatite (HA) powder. The calcium and phosphorus precursors used to synthesize HA powder were calcium hydroxide, Ca(OH)2 , and di-ammonium hydrogen phosphate, (NH4 )2HPO4 . The HA powder was mixed with distilled water at certain powder-to-liquid (P/L) ratios. In this study, the P/L ratios were varied at 1.3 and 1.7. PEG was added into CPC with the P/L ratio of 1.3, and it was adjusted at 1 and 5 wt%. The results of this study revealed that higher P/L ratio contributed to the decreased in porosity of CPC. Meanwhile, the addition of PEG increased the porosity of CPC. This is significant for cells adhesion and proliferation, such that cell proliferate faster and better adhesion with the incorporation of PEG into CPC. The cell culture on CPC has proven that the fabricated CPC shows no toxic reaction and cells grow well

Investigation of the behavior of various calcium phosphate material during in vitro cell culture

The great acceptance of calcium phosphate materials in the biomedical field comes from their close similirity to the mineral phase of bone. This make CaPs excellent subtrates for bone regeneration applications. In spite of possessing excellent bioactivity, osteoconductivity and biocompatibility in vivo, their behaviour in vitro is not always satisfactory. This is the case of calcium phosphate cements (CPC) which show hampered cell proliferation and differentiation it is believed that is caused by the extrememly high sp3ecific surface of these materials the problem is not that simple as the high surface areas lead to high ionic exchanges thus complicating interpretation of results. Thus, the purpose of this project is to determines which factor has major implications in cell behaviour wether topography will be evalutated: altaTCP, betaTCP, CDHA coarse, CDHA fine, HA and DCPA. Characterization of the materials: X-ray diffraction, SEM and B.E.T. With regards and differentiation will be evaluated after 4 hours, 3 and 7 days by LDH and ALP measurements. In addition, the pH and ion content will also be measured.Incomin

Utilization of Compounds of Phosphorus

The last chapter of this book provides brief description of utilization of apatites and phosphorus-bearing compounds in industry and material science research. Since the chemistry of phosphorus is quite complicated and a quickly developing field of science, the topics described below are only limited insights to chemically bonded ceramics and refractories, dental phosphate cements, oil-well cements, phosphate glasses and glass ceramics. Chapter continues with description of functional phosphate materials applied as solid oxide fuel cells electrolytes, sensors, phosphors, catalysts and coatings. The chapter ends with introduction of basic ideas for biological apatite in bone tissue engineering, collagen apatite composites, apatite layers and biocoatings

Novel Biodegradable Composite of Calcium Phosphate Cement and the Collagen I Mimetic P-15 for Pedicle Screw Augmentation in Osteoporotic Bone

Osteoporotic vertebral fractures often necessitate fusion surgery, with high rates of implant failure. We present a novel bioactive composite of calcium phosphate cement (CPC) and the collagen I mimetic P-15 for pedicle screw augmentation in osteoporotic bone. Methods involved expression analysis of osteogenesis-related genes during osteoblastic differentiation by RT-PCR and immunostaining of osteopontin and Ca2+ deposits. Untreated and decalcified sheep vertebrae were utilized for linear pullout testing of pedicle screws. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DEXA). Expression of ALPI II (p p p p p p p p p = 0.04) with PMMA, and 1252 ± 131 N (p < 0.0078) with CPC-P-15. CPC-P-15 induces osteoblastic differentiation of human MES and improves pullout resistance of pedicle screws in osteoporotic and non-osteoporotic bone

Hip fractures : A biomechanical analysis of fracture strength prediction, prevention, and repair

Due to the aging population, hip fracture incidence has been increasing over the past decades. Measurements of bone mineral density with dual energy X-ray absorptiometry are the gold standard for hip fracture risk assessment, where patients with a low bone density have a high risk of fracture. However, many people that are not diagnosed to be at risk, still fracture their hip. Calculations of bone strength using subject-specific finite element (FE) models, can improve fracture risk prediction, but further improvement is required.Patients with a high fracture risk are often prescribed pharmaceutical treatment in order to increase bone density systemically. As systemic response to treatment is limited, other options to prevent fractures by improving the bone strength are investigated. One of those options is the injection of biomaterials in the femoral neck. In case of a hip fracture due to a low-energy fall, total hip replacement is generally preferred over joint-preserving methods like fixation using a dynamic hip screw. Screw fixation comes with a risk of screw instability, especially in low-density bone. Bone cements can be used to improve fixation of orthopaedic implants and fracture fixation devices. Calcium sulphate/hydroxyapatite (CaS/HA) is an injectable biomaterial that has been used, for example, to reinforce collapsed vertebrae and to stabilize wrist fractures. The work presented in the thesis aims to improve fracture risk prediction, and fracture prevention and repair methods with use of CaS/HA. This is achieved through a combination of experimental mechanical tests at organ and tissue scale, and development and thorough validation of FE models of the proximal femur.In the first part of this thesis, 12 cadaveric femora were used in an experiment where the bones were loaded until fracture in a configuration developed to replicate a fall to the side. During loading, high-speed cameras were used to image both the medial and lateral side of the femoral neck allowing for full-field strain measurements using digital image correlation. The femora were imaged with clinical CT before and micro-CT before and after mechanical testing. Using the acquired CT images, FE models were developed at two different resolutions to determine their ability to capture the fracture force, fracture location and surface strains. The FE models based on the clinical CT images were able to accurately capture the fracture force and identify regions where the bone would fracture. These models could also capture the strains with high accuracy. However, the strains were not predicted as accurately in regions with high surface irregularity. The models based on the micro-CT images could show with higher accuracy how the strains were distributed around local porosity (e.g., due to vascularization) in the femoral neck and how these influenced the fracture pattern.The thesis continues with an investigation of fracture prevention and repair methods through the use of CaS/HA. The ability of CaS/HA to increase the fracture strength of the proximal femur for fracture prevention and its ability to stabilize a dynamic hip screw used for fracture repair was investigated. The increase in fracture strength was investigated using FE models. These models showed that CaS/HA can increase the fracture strength of the femur approximately 20% when injected close to the cortex in the lateral neck. Pullout tests using a dynamic hip screw were performed on synthetic bone blocks and femoral heads from hip fracture patients. In the synthetic blocks, CaS/HA significantly increased the pullout strength. However, in the human bone the stability of the screw was not improved, because the cement could not easily spread into the threads of the screws. The mechanical behaviour of CaS/HA and bone was further investigated using high-resolution synchrotron X-ray tomography. Cylindrical trabecular bone specimens with and without CaS/HA were imaged with tomography during in-situ loading of the samples. The images revealed that CaS/HA reinforced the bone, and that CaS/HA is a brittle material that will crack before the bone.To conclude, in this thesis FE models are presented showing accurate prediction of fracture strength, which can be used for improved fracture risk assessments. Furthermore, the work provides insight in how CaS/HA behaves mechanically and how it can be used to increase the fracture strength and to stabilize fixation devices in the femur, improving fracture prevention and fracture repair methods

Development of 3D PCL microsphere/TiO\u3csub\u3e2\u3c/sub\u3e nanotube composite scaffolds for bone tissue engineering

In this research, the three dimensional porous scaffolds made of a polycaprolactone (PCL) microsphere/TiO2 nanotube (TNT) composite was fabricated and evaluated for potential bone substitute applications. We used a microsphere sintering method to produce three dimensional PCL microsphere/TNT composite scaffolds. The mechanical properties of composite scaffolds were regulated by varying parameters, such as sintering time, microsphere diameter range size and PCL/TNT ratio. The obtained results ascertained that the PCL/TNT (0.5 wt%) scaffold sintered at 60 °C for 90 min had the most optimal mechanical properties and an appropriate pore structure for bone tissue engineering applications. The average pore size and total porosity percentage increased after increasing the microsphere diameter range for PCL and PCL/TNT (0.5 wt%) scaffolds. The degradation rate was relatively high in PCL/TNT (0.5 wt%) composites compared to pure PCL when the samples were placed in the simulated body fluid (SBF) for 6 weeks. Also, the compressive strength and modulus of PCL and PCL/TNT (0.5 wt%) composite scaffolds decreased during the 6 weeks of storage in SBF. MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide) assay and alkaline phosphates (ALP) activity results demonstrated that a generally increasing trend in cell viability was observed for PCL/TNT (0.5 wt%) scaffold sintered at 60 °C for 90 min compared to the control group. Eventually, the quantitative RT-PCR data provided the evidence that the PCL scaffold containing TiO2 nanotube constitutes a good substrate for cell differentiation leading to ECM mineralization