In vitro stability of biphasic calcium phosphate ceramics

Hydroxyapatite accelerates differentiation and suppresses growth of MC3T3‐E1 osteoblasts

Hydroxyapatite describes both the natural mineral phase of bone as well as the widely used calcium-phosphate implant substitute. Given that hydroxyapatite is a major component of the in vivo surface with which osteoblasts interact, it is surprising that most studies examining the regulation of osteoblast growth and differentiation utilize plastic surfaces. Here we demonstrate that the phenotype of mouse MC3T3-E1 osteoblasts is significantly altered on hydroxyapatite compared with plastic surfaces. Specifically, alkaline phosphatase activity and messenger RNA levels, markers of early stages of osteoblast differentiation, are increased in osteoblasts cultured on hydroxyapatite. The precocious appearance of alkaline phosphatase activity on the hydroxyapatite surface suggests that osteoblast differentiation is activated earlier compared with plastic surfaces. Osteocalcin expression, a marker of late-stage differentiation, is also increased on hydroxyapatite and further demonstrates enhanced differentiation. Cell counts indicate that fewer osteoblasts are present on hydroxyapatite versus plastic surfaces 24 h after plating. Measurement of osteoblast attachment, apoptosis, and necrosis indicated no differences between surfaces. In contrast, the number of bromodeoxyuridine-incorporating cells was significantly decreased on hydroxyapatite compared with plastic surfaces. Taken together, our findings indicate that hydroxyapatite enhances osteoblast differentiation while also suppressing growth.

The fabrication and biochemical evaluation of alumina reinforced calcium phosphate porous implants

Alumina reinforced calcium phosphate porous implants were manufactured to improve the mechanical strength while maintaining the bioactivity of calcium phosphate ceramics. The alumina porous bodies, which provided the mechanical strength, were fabricated by a polyurethane sponge method and multiple coating techniques resulted in the porous bodies with a 90-75% porosity and a compressive strength of up to approximately 6MPa. The coating of hydroxyapatite (HAp) or tricalcium phosphate (beta-TCP) was performed by dipping the alumina porous bodies into calcium phosphate ceramic slurries and sintering the specimens. The fairly strong bonding between the HAp or TCP coating layer and the alumina substrate was obtained by repeating the coating and sintering processes. The biochemical evaluations of the porous implants were conducted by in vitro and in vivo tests. For in vitro test, the implants were immersed in Ringer's solution and the release of Ca and P ions were detected and compared with those of calcium phosphate powders. For in vivo test, the porous bodies were implanted into mixed breed dogs and bone mineral density measurements and histological studies were conducted. The alumina reinforced HAp porous implants had a higher strength than the HAp porous implants and exhibited a similar bioactivity and osteoconduction property to the HAp porous implants.

The biodegradation mechanism of calcium phosphate biomaterials in bone

This study was undertaken to understand the biodegradation mechanisms of calcium phosphate (Ca-P) biomaterials with different crystallization. Two types of sintered Ca-P porous ceramic (HA and beta-TCP) and a Ca-P bone cement (CPC) were implanted into cavities drilled in rabbit femoral and tibiae condyles. The results have shown that a material biodegradation was rapid in the beta-TCP and the CPC, but very weak in the HA. This biodegradation presented a decrease of material volume from the periphery to the center as well as a particle formation causing phagocytosis by numerous macrophages and multinucleated giant cells in the CPC. In the beta-TCP, there was a peripheral and central decrease of material volume as well as an absence of particle formation or visible phagocytosis. The process of biodegradation is considered to be directly influenced by the type of material crystallization. The sintered bioceramics processed at a high temperature exhibit good crystallization and are primarily degraded by a process dependent on interstitial liquids. However, the bone cement is formed by physicochemical crystallization and is degraded through a dissolution process associated with a cellular process.

Surface reactivity of calcium phosphate based ceramics in a cell culture system

Surface reactivity of Calcium Phosphate materials--Hydroxyapatite (HA), Tricalcium Phosphate (beta-TCP), Hydroxyapatite-Tricalcium Phosphate (HA-TCP) were elucidated in a cell culture system. MG-63 osteoblast-like cells were seeded onto the ceramic discs to evaluate changes in the cell morphology and functionality with respect to the different substrates. The dissolution and re-precipitation of calcium phosphate phases on the surface of the discs in the culture medium was found to be prominent on beta-TCP when compared with HA. Low calcium (Ca), magnesium (Mg) and alkaline phosphatase (ALP) levels and high phosphorous (P) levels in the medium of beta-TCP were observed. This indicated that P must have leached out into the medium from beta-TCP and Ca in turn deposited from the medium onto beta-TCP resulting in the apatite phase transformation. The low ALP activity in beta-TCP medium is however an indication of low osteoblastic activity. Under the phase contrast microscope, the osteoblast cells around HA material were found to be confluent and viable, while in the vicinity of beta-TCP only cellular debris was observed. In the case of HA-TCP, only a few viable cells surrounded the material amidst the debris. Scanning electron microscopy revealed numerous cells on the surface of HA showing different cell behaviour like anchorage, attachment, adhesion and spreading in the early time period as the surface was only slightly disturbed with re-crystallisation. But with time the entire surface of HA had changed due to precipitation and re-crystallization which did not support cell behaviour while the cells surrounding the material showed normal growth. On the contrary, cells were scarcely observed on the entirely changed surface of beta-TCP and HA-TCP even from the earlier days of the culture and the morphology of cells surrounding the material too started changing. These results establish that HA promoted the activity of osteoblast cells. HA surface remained unaltered for some time, while the surface of beta-TCP underwent dissolution of surface ions and resulted in the re-crystallization of apatite over the surface. The resulting changes in the surrounding milieu of beta-TCP with high phosphate and low Ca levels probably was responsible for the death of the cells.

Calcium phosphate apatites with variable Ca/P atomic ratio III. Mechanical properties and degradation in solution of hot pressed ceramics

Calcium deficient hydroxyapatite powders Ca(10-x)(PO4)(6-x)(HPO4)x(OH)(2-x) (0 < or = x < or = 1) were hot pressed to produce dense hydroxyapatite-tricalcium phosphate (HAP/TCP) biphasic materials. Ceramics hot pressed at 1000 degrees C were composed of an homogeneous distribution of the HAP and beta-TCP grains with an average size of 0.2 microm. Grain growth was observed for TCP loading > 70 wt%. The strength exhibited a maximum of sigma(f) = 150 MPa for 90/10 (w/w) HAP/TCP and it dropped for smaller and greater amounts of TCP. This value was twice that of pure HAP. When placed in Ringer's solution, only the surface of biphasic compounds was degraded after 60 days of immersion with a preferential etching of the TCP phase. After hot pressing at 1200 degrees C, grain growth was observed and the mechanical properties were decreased. This was explained by the allotropic transformation alpha/beta of TCP.

Effect of albumin on brushite transformation to hydroxyapatite

Brushite (CaHPO(4) x 2H(2)O) is a precursor to hydroxyapatite [HA, Ca(5)(PO(4))(3)OH]. It has been shown that a modified form of brushite, with potassium substituting for calcium at specific sites, demonstrated accelerated transformation to HA when exposed to nonproteinaceous Hanks' balanced aqueous salt solutions (HBSS). The biocompatibility of a transforming material is related to cellular response to the process, which is initiated by protein adsorption. The effect of adsorbed protein on the kinetics and chemistry of brushite transformation to HA, when exposed to HBSS containing bovine serum albumin (BSA), was examined using Fourier transform IR spectroscopy, X-ray diffraction, and energy dispersive spectrometry techniques. The effect of solution pH was also studied. Results show that, in the presence of a protein-free environment, transformation is faster in buffered medium than in nonbuffered medium. Moreover, curve fitting and second derivatives of the IR spectra show that some bands shift depending on whether the brushite transforms in a buffered or nonbuffered medium. Therefore, variation in pH affects both transformation rate and the associated chemistry. The presence of BSA in either buffered or nonbuffered medium retards the transformation in comparison to the corresponding BSA-free medium. The extent of this retardation increases with the increase in bulk concentration of BSA but does not alter the transformation chemistry. This suggests the retardation on the transformation rate is due to BSA adsorption coverage on the calcium phosphate ceramic. This may be due to the shielding of Ca(2+) and PO(4)(-3) sites, preventing their interaction with the HBSS.

Petal-like apatite formed on the surface of tricalcium phosphate ceramic after soaking in distilled water

In the present study six types of tricalcium phosphate ceramic were prepared and soaked in distilled water for different periods to investigate whether a surface apatite layer was formed on TCP ceramics or not. X-ray diffractometry (XRD) and Fourier-transformed infrared (FTIR) spectrometer were used to examine the changes in crystalline phases and functional groups of TCP ceramics for different soaking periods. Calcium and phosphate ions released from TCP ceramics during soaking were recorded by atomic absorption analysis and ion-coupled plasma. Results revealed that alphaTCP, alphaTCP/betaTCP mixture (alphabetaTCP) and betaTCP ceramic were gradually dissolved. There was no apatite layer formed on their surface after being immersed in distilled water for different durations of time. Mg-TCP ceramic, tricalcium phosphate doped with Mg ions, exhibited a lower dissolution rate than the other types of TCP ceramics. Apatite crystals were also not formed on the surface of Mg-TCP ceramic when immersed in distilled water. Tribasic calcium phosphate, prepared from wet precipitation method, was converted to betaTCP/HAP (HbetaTCP) or alphaTCP/betaTCP/HAP (HalphabetaTCP) crystalline composition at different sintering temperatures (1,150 degrees C and 1,300 degrees C). The surface apatite layer did not appear on HbetaTCP ceramic after soaking. We observed that petal-like apatite was formed on the HalphabetaTCP ceramic surface after being immersed for 2 weeks. alphaTCP phase of HalphabetaTCP ceramic was not directly converted to apatite during soaking. The surface apatite layer formed on the HalphabetaTCP ceramic surface was due to the precipitation of the calcium and phosphate ions released from alphaTCP dissolution. HAP, which existed in the structure of HalphabetaTCP ceramic, plays a role as apatite-precipitating seed to uptake calcium and phosphate ions. TCP ceramics which lacked alphaTCP and HAP content neither converted to apatite nor formed surface apatite on their surfaces during immersion.

Preparation of betaTCP/HAP biphasic ceramics with natural bone structure by heating bovine cancellous bone with the addition of (NH(4))(2)HPO(4)

In this study, the calcined bovine bone (CBB)-removing the organic substance by a burning process-with addition of different quantities of ammonium phosphate [(NH(4))(2)HPO(4)] (AP) was heated to a high temperature to transform its crystalline phase constitution from hydroxyapatite (HAP) into a tricalcium phosphate (TCP)/HAP biphasic structure. Results revealed that the CBB without AP appeared to be mainly composed of an HAP type pattern when heated to 1300 degrees C. After adding doped AP to CBB, the HPO(4)(2-) ions of AP condensed into P(2)O(7)(4-) ions at temperatures of 400-600 degrees C. P(2)O(7)(4-) ions reacted with the OH(-) ions of HAP to form betaTCP at temperatures up to 600 degrees C. The conversion reaction of HAP to betaTCP finished at around 900 degrees C. With increasing AP in the CBB, HAP gradually converted into different phase compositions of TCP/HAP or TCP at high temperature. Mechanical testing results showed that there was no significant difference in sintered CBB with different quantities of AP. By heating calcined bovine cancellous bone with different quantities of AP, we obtained different crystalline phase compositions of bioceramics with a natural porous structure.

In vitro stability of plasma-sprayed hydroxyapatite coatings on Ti-6Al-4V implants under cyclic loading

The success of hydroxyapatite (HA)-coated Ti-6Al-4V implants relies on the long-term stability of HA coatings. In this study, the mechanical stability of plasma-sprayed HA coatings on Ti-6Al-4V implants under four-point cyclic bending was systematically investigated in both air and simulated body fluid (SBF) environments at room temperature. To have a clear view of the microscale damage evolution, the surface morphology change of HA coatings during cyclic loading was carefully examined by scanning electron microscopy at the same locations on the coating surfaces after four-point bending for 4, 6.5, 8.5, and 10 million cycles. Also, possible changes of other characteristics such as thickness, weight, crystallinity, and residual stress of HA coatings were measured as a function of loading cycles. Up to 10 million cycles of bending in air and SBF, we found no significant microcracking or coating spalling on the surface of coatings, and no significant changes in thickness, weight, crystallinity, or residual stress of the plasma-sprayed HA coatings. The experiment results indicate that thickness and crystallinity had no effects on the stability of the HA coatings. HA coating resistance to the cyclic four-point bending might result from the stress shielding effects of preexisting microcracks in the coatings.

In vitro evaluation of a new injectable calcium phosphate material

The purpose of this study was to develop an injectable bone substitute (IBS) for percutaneous orthopedic surgery. The multiphasic material used was composed of a 2% aqueous solution of methylhydroxypropylcellulose (MHPC) and biphasic calcium phosphate (BCP, 60% hydroxyapatite and 40% beta-tricalcium phosphate) in which MHPC served as the carrier for 80-200 microm of BCP granules. The best BCP/polymer ratio was determined by the rheological properties and higher BCP content of the material. Steam sterilization was more effective than gamma irradiation in maintaining the stability of the mixture and conserving its physiochemical and mechanical properties. The in vitro biocompatibility of the composite was checked by direct-contact cytotoxicity and cell-proliferation assays. A preliminary in vivo test was performed in the rabbit using intraosseous implantations in the femoral epiphysis. Histological analysis was done after 1, 2, 4, and 10 weeks. Bone ingrowth into the IBS, in close association with BCP granules, was observed after 1 week and increased regularly from the surface inward at 2, 4, and 10 weeks. At the same time, smaller BCP granules (less than 80 microns in diameter) were degraded and resorbed. This injectable biomaterial proved suitable for cavity filling. The water solubility and viscosity of the polymer allow cells to recolonize, with in situ bonding of the mineral phase.

Degradation behaviour of a new bioceramic: Ca2P2O7 with addition of Na4P2O7.10H2O

A newly produced bioceramic, beta-Ca2P2O7 with addition of Na4P2O7.10H2O (SDCP), has been implanted into the femoral condyle of rabbits. Within 6 weeks after implantation, most of the bioceramic is replaced by new woven bone. On the contrary, block from hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP), which are osteoconductible, do not resorb within a short period of time. We believe that the biodegradable behaviour of SDCP may occur in two steps. The first and most important step is the digestion of particles and migration of the particles by phagocytosis. The object of this study is to examine the change in morphologies, chemical compositions and crystal structure of SDCP after soaking in distilled water for a certain period of time. The SDCP ceramic was also co-cultured with leucocytes to observe how the SDCP particles were digested by the leucocytes, so that the mechanism of biodegradable behaviour of SDCP ceramic in vivo might be clarified. Four types of sintered calcium phosphate ceramics were tested in the experiment: SDCP, pure beta-Ca2P2O7 (DCP), HA and beta-TCP. They wee soaked in distilled water at 37 degrees C for up to 30 days. The microstructure and morphology of crystals deposited on the surface were observed using scanning electron microscopy. Sodium, calcium and phosphorus ion contents in the supernatant solution were detected by atomic absorption analysis and ion coupled plasma. In summary, HA and DCP showed no significant evidence of dissolution in distilled water. In static distilled water, calcium ions may be released from beta-TCP into solution during the initial 7 days and then converted into HA by reprecipitation. The results showed that the SDCP was firstly dissolved into small grains or fragments by the solution. The small fragments should be so small as to be digested by the phagocytes in a physiological environment.

Effects of calcium phosphate bioceramics on skeletal muscle cells

With advances in ceramics technology, calcium phosphate bioceramics have been applied as bone substitutes. The effects of implants on bony tissue have been investigated. The effects upon adjacent skeletal muscles have not been determined. The focus of this work is to elucidate the biological effects of various calcium phosphate bioceramics on skeletal muscles. Four different kinds of powder of calcium phosphate biomaterials including beta-tricalcium phosphate (beta-TCP), hydroxyapatite (HA), beta-dicalcium pyrophosphate (beta-DCP) and sintered beta-dicalcium pyrophosphate (SDCP), were tested by myoblast cell cultures. The results were analyzed by cell count, cell morphology and concentration of transforming growth factor beta 1 (TGF-beta 1) in culture medium. The cell population and TGF-beta 1 concentration of the control sample increased persistently as the time of culture increased. The changes in cell population and TGF-beta 1 concentration in culture medium of the beta-TCP and HA were quite low in the first 3 days of culture, then increased gradually toward the seventh day. The changes in cell population and TGF-beta 1 concentration in culture medium of the silica, beta-DCP, and SDCP were quite similar. They were lower during the first day of culture but increased and reached that of the control medium after 7 days' culture. Most cells on B-TCP and HA diminished in size with radially spread, long pseudopods. We conclude that HA and beta-TCP are thought to have an inhibitory effect on growth of the myoblasts. The HA and beta-TCP may interfere with the repair and regeneration of injured skeletal muscle after orthopedic surgery.

Clinical and histologic aspects of biphasic calcium phosphate ceramic (BCP) used in connection with implant placement

A granulate of biphasic calcium phosphate ceramic (BCP), composed of 50% hydroxyapatite and 50% beta-tricalcium phosphate, was used, in man, to fill defects resulting from cyst enucleation. The defects were covered with e-PTFE membranes, and at the re-entry procedure after six months, it was possible to see that the defects were filled by a newly formed tissue with the macroscopic features of mature bone. Smooth titanium implants were inserted in the newly regenerated tissue. Histological examination of this tissue showed that most of the particles were lined by newly formed bone. Some particles were undergoing resorption processes and were being gradually substituted by newly formed bone. No inflammatory infiltrate was present. Our results point, in conclusion, to a good biocompatibility and osteoconductivity of this material.

Characterization of apatite layer formation on P2O5-CaO, P2O5-CaO-Na2O, and P2O5-CaO-Na2O-Al2O3 glass hydroxyapatite composites

P2O5-based glass hydroxyapatite (HA) composites denoted HA-2 oxide, HA-3 oxide, and HA-4-oxide, were immersed in Hank's balanced salt solution for a period of 1, 2, 3, and 4 weeks at 37 degrees C in nonagitated condition for in vitro evaluation. A surface layer was precipitated on the composites that was analyzed using scanning electron microscopy (SEM), X-ray photoelecton spectroscopy, and thin film X-ray diffractometry (TF-XRD). SEM micrographs showed complete coverage of the composite surface by crystallites after immersion of 1 week in the solution, which grew thicker with respect to immersion time. The binding energies measured by XPS indicated apatite formation and the presence of carbonate on the composite surface, showing the newly formed layer was a carbonated apatite. Confirmation of the formed apatite layer was obtained by TF-XRD.

Surface modifications of glass-reinforced hydroxyapatite composites

Surface modifications of glass-reinforced hydroxyapatite composites immersed in a simulated physiological solution were studied using X-ray photoelectron spectroscopy, scanning electron microscopy and energy dispersive X-ray spectroscopy. In the first stages of the apatite formation process, calcium and silicon ions were leached out from the surface of the composites. After 12 days of immersion, apatite crystals were detected on the surface indicating bioactive behaviour. Sodium ions attributed to sodium sulphate were also found in the apatite layer. Bound water on the surface also increased with immersion time.

Effect of Ca/P coating resorption and surgical fit on the bone/implant interface

The effect of coating resorption on bone apposition and attachment strength to resorbable hydroxyapatite (HA), nonresorbable HA-coated, and uncoated rough titanium implants was evaluated in interference- and noninterference-fit (gap of 2-3 mm) surgical models 2, 4, and 12 weeks postoperatively. Interference and noninterference fits showed differences in bone bridging. Bone apposition was circumferential around the implants in noninterference fit. Significantly greater bone apposition was seen to nonresorbable HA-coated implants than uncoated and resorbable HA-coated implants at 4 and 12 weeks. Only resorbable HA coatings showed significantly lower bone apposition for noninterference versus interference fit and from 4-12 weeks. At 2 weeks, strengths of bone attachment to resorbable HA-coated implants were greater than the other implants, and decreased to lower values (not significant) than the nonresorbable HA-coated implants at 4 and 12 weeks. Differences in push-out shear strengths between interference- and noninterference-fit surgical models were significant for uncoated implants at 4 weeks, but not for HA-coated implants at any time period. Significant differences were seen between the three implant types only for the noninterference-fit model, where the HA-coated implants showed greater strengths than the uncoated implants (significant at 2 and 4 weeks). This study showed that presence of resorbable or nonresorbable HA coatings is beneficial when a gap of 2-3 mm is present between the implant and the bone. The resorbable HA-coated implants showed greatest strengths at the early time period. At later time periods, resorbable HA-coated implants showed lower bone apposition and attachment strengths than nonresorbable HA coatings.(ABSTRACT TRUNCATED AT 250 WORDS)

Formation of a bone apatite-like layer on the surface of porous hydroxyapatite ceramics

Phosphoric acid solution was used to react with commercial hydroxyapatite (HA) powders to demonstrate the possibility of converting HA to non-stoichiometric apatite and thus to treat porous HA ceramics, to form a thin bone-apatite like layer on the HA ceramic surface. Such a carbonate-containing non-stoichiometric apatite "bioceramic" would be more efficient in bone bonding or bone formation, due to its analogy to natural bone apatite.