Bone regeneration capacity of magnesium phosphate cements in a large animal model

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.

Corrosion Resistance and Apatite-Forming Ability of Composite Coatings formed on Mg-Al-Zn-Ca Alloys

The properties of composite coatings formed by plasma electrolytic oxidation (PEO) were affected by the alloy composition. The corrosion resistance and apatite-forming ability of PEO coatings formed on Mg–6Al–1Zn–xCa alloys with a variation of Ca content were investigated. Potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) measurements showed an order magnitude improvement of corrosion resistance in the AZ61 alloy as a result of the coating. A higher enhancement in polarization resistance was obtained in the Mg–6Al–1Zn–1Ca and Mg–6Al–1Zn–2Ca alloys due to thicker coatings were formed as a result of the incorporation of calcium oxide/hydroxide. However, the underlying substrates were more prone to localized corrosion with increasing Ca content. The microstructure investigation revealed an enlargement in precipitates (Al₂Ca, Mg₂Ca) sizes with increasing Ca content in the alloys. The growth of larger size precipitates increased the danger to micro galvanic corrosion. Apatite layers were formed on all of the coatings indicating high apatite-forming ability, but the layers formed on the Mg–6Al–1Zn–1Ca and Mg–6Al–1Zn–2Ca alloys contained higher Mg, possibly due to the accumulation of corrosion product, than that on the Mg–6Al–1Zn alloy. The alloying element Ca should be limited to 1 wt.% as the excess tended to degrade the corrosion resistance and apatite-forming ability of the PEO coating.

Development and Bone Regeneration Capacity of Premixed Magnesium Phosphate Cement Pastes

Magnesium phosphate cements (MPC) have been demonstrated to have a superior bone regeneration capacity due to their good solubility under in vivo conditions. While in the past only aqueous MPC pastes have been applied, the current study describes the fabrication and in vitro/in vivo testing of an oil-based calcium doped magnesium phosphate (CaMgP) cement paste. Premixed oil-based pastes with CaMgP chemistry combine the advantages of conventional MPC such as high mechanical strength and good resorbability with a prolonged shelf-life and an easier clinical handling. The pastes set in an aqueous environment and predominantly form struvite and achieve a compressive strength of ~8-10 MPa after setting. The implantation into a drill-hole defect at the distal femoral condyle of New Zealand white rabbits over a course of 6 and 12 weeks demonstrated good biocompatibility of the materials without the formation of soft connective tissue or any signs of inflammation. In contrast to a hydroxyapatite forming reference paste, the premixed CaMgP pastes showed subsequent degradation and bony regeneration. The CaMgP cement pastes presented herein are promising bone replacement materials with excellent material properties for an improved and facilitated clinical application.

Biomechanical Evaluation of Promising Different Bone Substitutes in a Clinically Relevant Test Set-Up

(1) Background: Bone substitutes are essential in orthopaedic surgery to fill up large bone defects. Thus, the aim of the study was to compare diverse bone fillers biomechanically to each other in a clinical-relevant test set-up and to detect differences in stability and handling for clinical use. (2) Methods: This study combined compressive strength tests and screw pullout-tests with dynamic tests of bone substitutes in a clinical-relevant biomechanical fracture model. Beyond well-established bone fillers (ChronOS^TM Inject and Graftys^® Quickset), two newly designed bone substitutes, a magnesium phosphate cement (MPC) and a drillable hydrogel reinforced calcium phosphate cement (CPC), were investigated. (3) Results: The drillable CPC revealed a comparable displacement of the fracture and maximum load to its commercial counterpart (Graftys^® Quickset) in the clinically relevant biomechanical model, even though compressive strength and screw pullout force were higher using Graftys^®. (4) Conclusions: The in-house-prepared cement allowed unproblematic drilling after replenishment without a negative influence on the stability. A new, promising bone substitute is the MPC, which showed the best overall results of all four cement types in the pure material tests (highest compressive strength and screw pullout force) as well as in the clinically relevant fracture model (lowest displacement and highest maximum load). The low viscosity enabled a very effective interdigitation to the spongiosa and a complete filling up of the defect, resulting in this demonstrated high stability. In conclusion, the two in-house-developed bone fillers revealed overall good results and are budding new developments for clinical use.

Degradable magnesium-based alloys for biomedical applications: The role of critical alloying elements

Magnesium-based alloys exhibit biodegradable, biocompatible and excellent mechanical properties which enable them to serve as ideal candidate biomedical materials. In particular, their biodegradable ability helps patients to avoid a second surgery. The corrosion rate, however, is too rapid to sustain the healing process. Alloying is an effective method to slow down the corrosion rate. However, currently magnesium alloys used as biomaterials are mostly commercial alloys without considering cytotoxicity from the perspective of biosafety. This article comprehensively reviews the status of various existing and newly developed degradable magnesium-based alloys specially designed for biomedical application. The effects of critical alloying elements, compositions, heat treatment and processing technology on the microstructure, mechanical properties and corrosion resistance of magnesium alloys are discussed in detail. This article covers Mg-Ca based, Mg-Zn based, Mg-Sr based, Mg-RE based and Mg-Cu-based alloy systems. The novel methods of fabricating Mg-based biomaterials and surface treatment on Mg based alloys for potential biomedical applications are summarized.

Effect of Fe2O3 on the Immobilization of High-Level Waste with Magnesium Potassium Phosphate Ceramic

For the proposed novel procedure of immobilizing HLW with magnesium potassium phosphate cement (MKPC), Fe2O3 was added as a modifying agent to verify its effect on the solidification form and the immobilization of the radioactive nuclide. The results show that Fe2O3 is inert during the hydration reaction. It slows down the hydration reaction and lowers the heat release rate of the MKPC system, leading to a 3°C-5°C drop in the mixture temperature during hydration. Early comprehensive strength of Fe2O3 containing samples decreased slightly while the long-term strength remained unchanged. For the sintering process, Fe2O3 played a positive role, lowering the melting point and aiding the formation of ceramic structure. CsFe(PO4)2, or CsFePO4, was generated by sintering at 900°C. These products together with the ceramic structure and absorption benefit the immobilization of Cs+. The optimal sintering temperature for heat treatment is 900°C; it makes the solidification form a fired ceramic-like structure.

Spine Intervention—An Update on Injectable Biomaterials

Back pain is the second most common reason for primary-care physician visits after the common cold. New understanding of the spine pathophysiology and biomechanics led to the development of novel injectable biomaterials to treat those pain generators. Although not all biomaterials are currently ready for common use, there is significant interest by the medical community to invest time, resources, and energy to optimize these injectables. This review introduces basic concepts and advancements in the field of bioinjectables tailored for the vertebral body. Also, we highlight advances in injectable biomaterials which were presented at the Groupe de Recherche Interdisciplinaire sur les Biomatériaux Ostéoarticulaires Injectables (GRIBOI) (Interdisciplinary Research Society for Injectable Osteoarticular Biomaterials) meeting in March 2018 in Los Angeles, CA. Indeed, multidisciplinary translational research and international meetings such as GRIBOI bring together scientists and clinicians with different backgrounds/expertise to discuss injectable biomaterials innovations tailored for the interventional pain management field.

Effect of strontium substitution on the material properties and osteogenic potential of 3D powder printed magnesium phosphate scaffolds

3D powder printing is a versatile method for the fabrication of individual bone implants and was used for the processing of in vivo degradable ceramic scaffolds based on ammonium magnesium phosphate hexahydrate (struvite). In this study, synergetic effects could be achieved by the substitution of magnesium phosphate cements with strontium carbonate. This substitution resulted in 8.2 wt%, 16.4 wt%, and 24.6 wt% Sr²⁺ doped scaffolds, with a 1.9-3.1 times increased radiopacity compared to pure struvite. The maximal compressive strength of (16.1 ± 1.1) MPa found for strontium substituted magnesium phosphate was in the range of cancelleous bone, which makes these 3D printed structures suitable for medical application in low-load-bearing bone areas. In an ion release study over a course of 18 days, the release of strontium, magnesium, calcium, and phosphate ions from scaffolds was analyzed by means of inductively coupled plasma mass spectrometry. Independent of the scaffold composition the Mg²⁺ concentrations (83-499 mg/l) continuously increased in the cell media. The Sr²⁺ release varied between 4.3 μg/day and 15.1 μg/day per g scaffold, corresponding to a Sr²⁺ concentration in media between 1.14 mg/l and 7.24 mg/l. Moreover, decreasing calcium and phosphate concentrations indicated the precipitation of an amorphous calcium phosphate phase. The superior osteogenic properties of strontium substituted magnesium phosphate, e.g. the increase of osteoblast activity and cell number and the simultaneous suppression of osteoclast differentiation could be verified in vitro by means of WST-assay, TRAP-staining, and SEM imaging.