The effect of calcium phosphate ceramic composition and structure on in vitro behavior. I. Dissolution

Effect of Post-Treatment on Dissolution and Biomineralization on Surface of ha Coatings in Simulated Body Fluid (SBF)

The HA coatings were heated separately in vacuum, air and water vapor. The dissolution of the HA coatings was investigated by immersion in Tris buffer and SBF The dissolubility of HA coatings in the solutions decreased in this order: as-received, heated in vacuum, in air and in water vapor. The nucleation of bone-like apatite on the surfaces of HA coatings after immersing a period of 11 days in SBF was observed by SEM. The microenvironment with a sufficient supersaturation of Ca and P ions was crucial for the nucleation and growth of apatite in SBF. The dissolution of amorphous phase in coatings played an important part in establishing the supersaturation of Ca and P ions.

Osteoblast interactions within a biomimetic apatite microenvironment

Numerous reports have shown that accelerated apatites can mediate osteoblastic differentiation in vitro and bone formation in vivo. However, how cells interact within the apatite microenvironment remains largely unclear, despite the vast literature available today. In response, this study evaluates the in vitro interactions of a well-characterized osteoblast cell line (MC3T3-E1) with the apatite microenvironment. Specifically, cell attachment, spreading, and viability were evaluated in the presence and absence of serum proteins. Proteins were found to be critical in the mediation of cell–apatite interactions, as adherence of MC3T3-E1 cells to apatite surfaces without protein coatings resulted in significant levels of cell death within 24 h in serum-free media. In the absence of protein–apatite interaction, cell viability could be “rescued” upon treatment of MC3T3-E1 cells with inhibitors to phosphate (PO₄³⁻) transport, suggesting that PO₄³⁻ uptake may play a role in viability. In contrast, rescue was not observed upon treatment with calcium (Ca²⁺) channel inhibitors. Interestingly, a rapid “pull-down” of extracellular Ca²⁺ and PO₄³⁻ ions onto the apatite surface could be measured upon the incubation of apatites with α-MEM, suggesting that cells may be subject to changing levels of Ca²⁺ and PO₄³⁻ within their microenvironment. Therefore, the biomimetic apatite surface may significantly alter the microenvironment of adherent osteoblasts and, as such, be capable of affecting both cell survival and differentiation.

A review of the mechanical behavior of CaP and CaP/polymer composites for applications in bone replacement and repair

Repair of load-bearing defects resulting from disease or trauma remains a critical barrier for bone tissue engineering. Calcium phosphate (CaP) scaffolds are among the most extensively studied for this application. However, CaPs are reportedly too weak for use in such defects and, therefore, have been limited to non-load-bearing applications. This paper reviews the compression, flexural and tensile properties of CaPs and CaP/polymer composites for applications in bone replacement and repair. This review reveals interesting trends that have not, to our knowledge, previously been reported. Data are classified as bulk, scaffolds, and composites, then organized in order of decreasing strength. This allows for general comparisons of magnitudes of strength both within and across classifications. Bulk and scaffold strength and porosity overlap significantly and scaffold data are comparable to bone both in strength and porosity. Further, for compression, all composite data fall below those of the bulk and most of the scaffold. Another interesting trend revealed is that strength decreases with increasing β-tricalcium phosphate (β-TCP) content for CaP scaffolds and with increasing CaP content for CaP/polymer composites. The real limitation for CaPs appears not to be strength necessarily, but toughness and reliability, which are rarely characterized. We propose that research should focus on novel ways of toughening CaPs and discuss several potential strategies.

Controlled nucleation of hydroxyapatite on alginate scaffolds for stem cell-based bone tissue engineering

Current bone tissue engineering strategies aim to grow a tissue similar to native bone by combining cells and biologically active molecules with a scaffold material. In this study, a macroporous scaffold made from the seaweed-derived polymer alginate was synthesized and mineralized for cell-based bone tissue engineering applications. Nucleation of a bone-like hydroxyapatite mineral was achieved by incubating the scaffold in modified simulated body fluids (mSBF) for 4 weeks. Analysis using scanning electron microscopy and energy dispersive x-ray analysis indicated growth of a continuous layer of mineral primarily composed of calcium and phosphorous. X-ray diffraction analysis showed peaks associated with hydroxyapatite, the major inorganic constituent of human bone tissue. In addition to the mineral characterization, the ability to control nucleation on the surface, into the bulk of the material, or on the inner pore surfaces of scaffolds was demonstrated. Finally, human MSCs attached and proliferated on the mineralized scaffolds and cell attachment improved when seeding cells on mineral coated alginate scaffolds. This novel alginate- HAP composite material could be used in bone tissue engineering as a scaffold material to deliver cells, and perhaps also biologically active molecules.

Tetracalcium phosphate: Synthesis, properties and biomedical applications

Monoclinic tetracalcium phosphate (TTCP, Ca(4)(PO(4))(2)O), also known by the mineral name hilgenstockite, is formed in the (CaO-P(2)O(5)) system at temperatures>1300 degrees C. TTCP is the only calcium phosphate with a Ca/P ratio greater than hydroxyapatite (HA). It appears as a by-product in plasma-sprayed HA coatings and shows moderate reactivity and concurrent solubility when combined with acidic calcium phosphates such as dicalcium phosphate anhydrous (DCPA, monetite) or dicalcium phosphate dihydrate (DCPD, brushite). Therefore it is widely used in self-setting calcium phosphate bone cements, which form HA under physiological conditions. This paper aims to review the synthesis and properties of TTCP in biomaterials applications such as cements, sintered ceramics and coatings on implant metals.

Mechanical Properties and In Vitro Bioactivity of Ca5(PO4)2SiO4 Bioceramic

Pure Ca5(PO4)2SiO4 bioceramic was first prepared by a sol–gel method using triethyl phosphate, tetraethoxysilane, and calcium nitrate tetrahydrate as original materials. Simulated body fluid (SBF) immersion tests revealed that Ca5(PO4)2SiO4 samples had a greater in vitro apatite-forming ability than hydroxyapatite (HA). After soaking Ca5(PO4)2SiO4 samples in the SBF for 1 day, bone-like apatite precipitated on the surfaces and the apatite layer became thicker with increasing the soaking time. However, few bone-like apatites precipitated on the HA samples even after soaking in the SBF for 7 days. The good in vitro bioactivity of Ca5(PO4)2SiO4 samples was attributed to the silanol (Si-OH) groups and greater solubility of Ca5(PO4)2SiO4. In addition, hot-pressed Ca5(PO4)2SiO4 ceramic exhibited lower bending strength and elastic modulus than hot-pressed HA, since the former had a lower relative density than the latter. The results have shown that Ca5(PO4)2SiO4 is a potential candidate material for bone repair.

N-acetyl cysteine improves affinity of beta-tricalcium phosphate granules for cultured osteoblast-like cells

Enhancement of bone substitute's biocompatibility may accelerate healing of surrounding bone. Although widely used as a biodegradable alloplastic bone substitute for alveolar bone augmentation, the osteocompatibility of beta-tricalcium phosphate (β-TCP) remains to be proven. The adverse cellular response to biomaterials is associated with oxidative stress. We hypothesized that commercially available β-TCP granules for clinical use, caused oxidative stress and was not optimal in osteocompatibility and that application of antioxidant amino acid derivative N-acetyl cysteine (NAC) would improve osteoblastic responses to the material. Only 20% of rat calvarial osteoblasts cultured on β-TCP granules remained viable at 24 h after seeding as opposed to 90% on polystyrene. Cell death on β-TCP granules was characterized by necrosis. However, the percentage of viable osteoblasts cultured on β-TCP granules showed a 100% increase with pre-treatment with NAC. NAC restored suppressed alkaline phosphatase activity on β-TCP granules at day 5. Intracellular ROS level on β-TCP granules was 16-fold greater than that on polystyrene, but decreased by half with pre-treatment with NAC. Cell death and intracellular ROS elevation were also induced in polystyrene culture under β-TCP granules even when the osteoblasts were not in direct contact with the β-TCP granules. NAC, however, prevented induction of cell death and elevation of intracellular ROS under β-TCP granules. These results indicate that commercially available β-TCP granules negatively affect cultured osteoblastic viability and function via oxidative stress and that NAC improves these negative responses to the material. This implies enhanced bone regeneration around biodegradable calcium phosphate-based bone substitute by NAC.

In vitro dissolution and mechanical behavior of c-axis preferentially oriented hydroxyapatite thin films fabricated by pulsed laser deposition

Owing to its resemblance to the major inorganic constituent of bone and tooth, hydroxyapatite is recognized as one of the most biocompatible materials and is widely used in systems for bone replacement and regeneration. In this study the pulsed laser deposition technique was chosen to produce hydroxyapatite with different crystallographic orientations in order to investigate some of the material properties, including its in vitro dissolution behavior, as well as mechanical properties. The crystallographic orientations of hydroxyapatite coatings can be carefully controlled, mainly by varying the energy density of the KrF excimer laser (248 nm) used for deposition. Nanoindentation results showed that highly c-axis oriented hydroxyapatite coatings have higher hardness and Young's modulus values compared with the values of randomly oriented coatings. After 24h immersion in simulated physiological solution the overall surface morphology of the highly oriented coatings was dramatically altered. The porosity was drastically increased and sub-micron pores were formed throughout the coatings, whereas the average size of the grains in the coatings was not significantly changed. The composition of the textured hydroxyapatite coatings remained essentially unchanged. Their c-axis texture, on the other hand, was rather enhanced with an increase in immersion time. The c-axis oriented hydroxyapatite surfaces are likely to promote preferentially oriented growth through a cyclic process of dissolution and reprecipitation, followed by homoepitaxial growth. The remarkable morphological and microstructural changes after dissolution suggest a capability of highly textured hydroxyapatite as a tissue engineering scaffold with an interconnecting porous network that may be beneficial for cellular activity.

Effect of MgO contents on the mechanical properties and biological performances of bioceramics in the MgO-CaO-SiO2 system

The aim of this research was to investigate the effect of the chemical composition on the mechanical properties, bioactivity, and cytocompatibility in vitro of bioceramics in the MgO-CaO-SiO(2) system. Three single-phase ceramics (merwinite, akermanite and monticellite ceramics) with different MgO contents were fabricated. The mechanical properties were tested by an electronic universal machine, while the bioactivity in vitro of the ceramics was detected by investigating the bone-like apatite-formation ability in simulated body fluid (SBF), and the cytocompatibility was evaluated through osteoblast proliferation and adhesion assay. The results showed that their mechanical properties were improved from merwinite to akermanite and monticellite ceramics with the increase of MgO contents, whereas the apatite-formation ability in SBF and cell proliferation decreased. Furthermore, osteoblasts could adhere, spread and proliferate on these ceramic wafers. Finally, the elongated appearance and minor filopodia of cells on merwinite ceramic were more obvious than the other two ceramics.

Bone tissue engineering: a review in bone biomimetics and drug delivery strategies

Critical-sized defects in bone, whether induced by primary tumor resection, trauma, or selective surgery have in many cases presented insurmountable challenges to the current gold standard treatment for bone repair. The primary purpose of a tissue-engineered scaffold is to use engineering principles to incite and promote the natural healing process of bone which does not occur in critical-sized defects. A synthetic bone scaffold must be biocompatible, biodegradable to allow native tissue integration, and mimic the multidimensional hierarchical structure of native bone. In addition to being physically and chemically biomimetic, an ideal scaffold is capable of eluting bioactive molecules (e.g., BMPs, TGF-betas, etc., to accelerate extracellular matrix production and tissue integration) or drugs (e.g., antibiotics, cisplatin, etc., to prevent undesired biological response such as sepsis or cancer recurrence) in a temporally and spatially controlled manner. Various biomaterials including ceramics, metals, polymers, and composites have been investigated for their potential as bone scaffold materials. However, due to their tunable physiochemical properties, biocompatibility, and controllable biodegradability, polymers have emerged as the principal material in bone tissue engineering. This article briefly reviews the physiological and anatomical characteristics of native bone, describes key technologies in mimicking the physical and chemical environment of bone using synthetic materials, and provides an overview of local drug delivery as it pertains to bone tissue engineering is included.

In Vitro and In Vivo Evaluations of 3D Porous TCP-coated and Non-coated Alumina Scaffolds

Both tricalcium phosphate (TCP) and alumina have been extensively studied and shown to have high biocompatibility. Tricalcium phosphate has improved biodegradability and a higher solubility than hydroxyapatite. In contrast, alumina (Al2O3) is almost completely inert at physiological conditions and has been used as a biomaterial due to its wear resistance, high surface finish, and excellent hardness. Thus, the combination of these two implants would result in greater biocompatibility and phenotype maintenance. A polyurethane (PU) foam replica method was employed in this study to coat TCP on an alumina scaffold. The TCP-coated alumina scaffold was then sintered to generate a porous surface morphology. The pore sizes obtained using this approach ranged between 100—600 µm, which is ideal for cellular proliferation. The cytotoxicity, cellular proliferation, differentiation, and ECM deposition on the coated scaffold resulted in longer-term viability of osteogenic markers compared to the non-coated scaffold. Moreover, the osteogenic properties of porous TCP-coated Al2O3 scaffolds were reported in this study using rabbit models. The TCP/Al2O 3 scaffold and control Al2O3 scaffolds were implanted in the rabbit femur. The bone tissue response was analyzed with micro-computed tomography (micro CT) at 12 and 24 weeks after implantation. The porous scaffolds exhibited favorable hard and soft tissue responses at both time points. At 24 weeks, a three-fold increase in bone tissue ingrowth was observed in defects containing TCP-coated Al2O3 scaffolds compared to control Al2O3 scaffolds.

Si complexes in calcium phosphate biomaterials

Silicon complexes in silicon doped calcium phosphate bioceramics have been studied using (29)Si magic angle spinning nuclear magnetic resonance spectroscopy with the objective of identifying the charge compensation mechanisms of silicon dopants. Three different materials have been studied: a multiphase material composed pre-dominantly of a silicon stabilized alpha-tricalcium phosphate(alpha-TCP) phase plus a hydroxyapatite (HA) phase, a single phase Si-HA material and a single phase silicon stabilized alpha-TCP material. NMR results showed that in all three materials the silicon dopants formed Q(1) structures in which two silicate tetrahedra share an oxygen, creating an oxygen vacancy which compensated the substitution of two silicon for phosphorus. This finding may explain the phase evolution previously found where silicon stabilized alpha-TCP is found at low temperature after sintering.

Mechanical properties of three different compositions of calcium phosphate bioceramic following immersion in Ringer's solution and distilled water

Dissolution tests were carried out to compare the mechanical properties of calcium phosphate based bioceramics with different compositions, before and after ageing for various time periods in Ringer's solution (pH 7.2) or distilled water (pH 7.2 and 4.0) at 37 degrees C. The results indicate that the sample composition seems to have more of an effect on the mechanical properties than does the storage environment. No obvious decrease in mechanical properties was found after samples had been aged in the various solutions during the different time periods. This indicates that these samples could be of significant clinical interest as their good structural properties were retained.

Synthesis and characterization of nanocrystalline apatites from eggshells at different Ca/P ratios

Nanocrystalline apatites with different Ca/P ratios were synthesized using eggshell as a calcium source by microwave processing. The apatites were found to have a minor amount of Mg, Sr, Si and Na ions inherited from the eggshells. The presence of several foreign ions results in a perturbed lattice structure indicated by an increase in lattice constants and shift in vibrational frequencies of the functional groups. The apatites were heat treated to investigate the influence of foreign ions on thermal stability. The minor amounts of ions do not affect the thermal stability. The differences in thermal behaviour of these apatites were due to the presence of HPO(2-)(4) ions only and not due to other ions because of their low content.

Porous hydroxyapatite and biphasic calcium phosphate ceramics promote ectopic osteoblast differentiation from mesenchymal stem cells

Because calcium phosphate (Ca-P) ceramics have been used as bone substitutes, it is necessary to investigate what effects the ceramics have on osteoblast maturation. We prepared three types of Ca-P ceramics with different Ca-P ratios, i.e. hydroxyapatite (HA), beta-tricalcium phosphate (β-TCP), and biphasic calcium phosphate (BCP) ceramics with dense-smooth and porous structures. Comprehensive gene expression microarray analysis of mouse osteoblast-like cells cultured on these ceramics revealed that porous Ca-P ceramics considerably affected the gene expression profiles, having a higher potential for osteoblast maturation. In the in vivo study that followed, porous Ca-P ceramics were implanted into rat skeletal muscle. Sixteen weeks after the implantation, more alkaline-phosphatase-positive cells were observed in the pores of hydroxyapatite and BCP, and the expression of the osteocalcin gene (an osteoblast-specific marker) in tissue grown in pores was also higher in hydroxyapatite and BCP than in β-TCP. In the pores of any Ca-P ceramics, 16 weeks after the implantation, we detected the expressions of marker genes of the early differentiation stage of chondrocytes and the complete differentiation stage of adipocytes, which originate from mesenchymal stem cells, as well as osteoblasts. These marker gene expressions were not observed in the muscle tissue surrounding the implanted Ca-P ceramics. These observations indicate that porous hydroxyapatite and BCP had a greater potential for promoting the differentiation of mesenchymal stem cells into osteoblasts than β-TCP.

The research of degradability of a novel biodegradable coralline hydroxyapatite after implanted into rabbit

To examine the biodegradability and bone healing effect of a novel biodegradable coralline hydroxyapatite after implanting into the proximal tibia of rabbit. Seventy New Zealand white rabbits were enrolled, bone defects about 10 x 5 x 3 mm(3) of bilateral proximal tibias were prepared by drilling, then coralline hydroxyapatite and iliac crest bone were grafted into bilateral bone defects, respectively. Each time five rabbits were sacrificed at 1, 2, 3, 4, 6, 8, 10, 12, 20, 24, 32, 36, 40, and 60 weeks after surgery. Then a series of examination were carried out, including eye view, roentgenographically, and nondecalcification histological examination. Eye view and roentgenographical examination indicate that all the defects grafted with coralline hydroxyapatite exhibited bone fusion, similar to the iliac crest autograft. The bone density of the graft site decreases with time on the X-ray film. Nondecalcification histological examination results are as followed: In the early time on the sections, the coralline hydroxyapatite looks like interlinked trabecula. Few lymphocytes infiltrate around the trabecula. With time extending, coralline hydroxyapatite looks like thin line or thin circle remnant. The degradation sites are filled with renascence bone. Medulla cavity can be seen in the degradation sites. After grafted in body, coralline hydroxyapatite exhibits little local and general abnormal reaction. It conducts good bone fusion of fracture. Coralline hydroxyapatite can be degraded after grafted into body, which is good for remodeling of bone healing. Hence coralline hydroxyapatite is an ideal bone graft substitute of autograft.

Plasma-sprayed CaTiSiO5 ceramic coating on Ti-6Al-4V with excellent bonding strength, stability and cellular bioactivity

Novel Ca-Si-Ti-based sphene (CaTiSiO5) ceramics possess excellent chemical stability and cytocompatibility. The aim of this study was to prepare sphene coating on titanium alloy (Ti-6Al-4V) for orthopaedic applications using the plasma spray method. The phase composition, surface and interface microstructure, coating thickness, surface roughness and bonding strength of the plasma-sprayed sphene coating were analysed using X-ray diffraction, scanning electron microscopy, atomic force microscopy and the standard mechanical testing of the American Society for Testing and Materials, respectively. The results indicated that sphene coating was obtained with a uniform and dense microstructure at the interface of the Ti-6Al-4V surface and the thickness and surface roughness of the coating were approximately 150 and 10 microm, respectively. Plasma-sprayed sphene coating on Ti-6Al-4V possessed a significantly improved bonding strength and chemical stability compared with plasma-sprayed hydroxyapatite (HAp) coating. Plasma-sprayed sphene coating supported human osteoblast-like cell (HOB) attachment and significantly enhanced HOB proliferation and differentiation compared with plasma-sprayed HAp coating and uncoated Ti-6Al-4V. Taken together, plasma-sprayed sphene coating on Ti-6Al-4V possessed excellent bonding strength, chemical stability and cellular bioactivity, indicating its potential application for orthopaedic implants.

Dissolution characteristics of extrusion freeformed hydroxyapatite-tricalcium phosphate scaffolds

The dissolution behaviour of calcium phosphate filaments made by extrusion freeforming for hard tissue scaffolds was measured. The solubility of filaments with different HA/beta-TCP ratios sintered at temperatures from 1,100 to 1,300 degrees C was measured under simulated physiological conditions (tris buffer solution: tris(hydroxyl) methyl-aminomethane-HCl), pH 7.4, 37 degrees C). Calcium and phosphate concentrations were measured separately by inductively coupled plasma (ICP) atomic emission spectroscopy. Surface morphologies and composition before and after immersion were analyzed by SEM and EDS. The results clearly show that as the beta-TCP content increased, the dissolution increased. Higher sintering temperatures, with consequent closure of surface pores, resulted in lower dissolution. Examination of the surface suggested dissolution on preferred sites by pitting.

Biomimetic formation of hydroxyapatite investigated by analytical techniques with high resolution

Morphology, phase and chemical compositions of atmospheric plasma-sprayed (APS) hydroxyapatite (HAp) coatings were investigated by scanning electron microscopy (SEM), X-ray powder diffraction (XRD), proton-induced X-ray emission (PIXE) and Rutherford backscattering spectrometry (RBS). The study involved as-sprayed coatings and coatings incubated in simulated body fluid (rSBF) for up to 56 days. The results obtained using combined contributions from three complementary analytical techniques confirm that secondary Ca-deficient defect hydroxyapatite precipitated by a biomimetic process from the simulated body fluid onto the HAp coating surface after a prolonged induction time. Owing to its sensitivity proton-induced X-ray emission (PIXE) provides information on in vitro resorption of calcium phosphate ceramics and dynamic dissolution/precipitation events occurring during the incubation process.

In vitro degradation, bioactivity, and cytocompatibility of calcium silicate, dimagnesium silicate, and tricalcium phosphate bioceramics

CaSiO3 (CS) ceramics have been regarded as a potential bioactive material for bone regeneration. Mg2SiO4 (M2S) ceramic has been reported as a novel bioceramic with higher mechanical properties and good biocompatibility recently. beta-Ca2(PO4)2 (beta-TCP) ceramic is a well-known bioactive and degradable material for bone repair. The aim of this study is to investigate and compare the effect of three bioceramics with different chemical composition on the in vitro degradation, apatite-forming ability in simulated body fluid (SBF) and cytocompatibility. The degradation was evaluated through the activation energy of Si or P ion released from ceramics and the weight loss of the ceramics in Tris-HCl buffer solution. Formation of bone-like apatite on different bioceramic surfaces was investigated in SBF. The presence of bone-like apatite layer on the material surface after soaking in SBF was demonstrated by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM). The effect of ionic products from the three kinds of material dissolution on osteoblast-like cell proliferation was investigated. The results showed that the degradation rate of CS was much faster than that of beta-TCP and M2S ceramics. Apatite formation occurred on the CS ceramics quickly. However, it was less likely to occur on the surfaces of beta-TCP and M2S ceramics. The ionic products from extracts of CS and M2S could stimulate osteoblast-like cell proliferation at certain concentration range throughout the 6-day culture period.

Use of platelet-rich plasma in periodontal surgery--a prospective randomised double blind clinical trial

The aim of this prospective controlled randomized clinical trial was to evaluate the additional effect of platelet-rich plasma (PRP) in attachment gain. Twenty-two patients showing contralateral intrabony defects were included. Defects were randomized to beta-TCP (Cerasorb) in combination with PRP (test) or alone (control). Probing pocket depth (PPD), clinical attachment level (CAL), and relative AL (RAL) were assessed at the first, initial, re-evaluation (or basis examinations) and 6 months after surgery. Defect dimensions were recorded at baseline surgery (day 0) and during re-entry surgery (after 6 months), with vertical depth of the defect as primary outcome variable. An early healing index (EHI) was assessed 3 days, 1, 2 and 4 weeks after surgery. Both treatments led to clinical improvements. The median reduction of open vertical depth was 1.9 mm (interquartile intervals, 0.75 and 2.5 mm) at test sites, compared with 2.6 mm (1.8 and 3.5 mm) at control sites (p = 0.19, Wilcoxon). The median reductions of PPD and CAL at the four sites in close proximity to the defect in the interproximal area at test sites were 0.8 and 0.28 mm, and at control sites 0.4 and 0.13 mm, respectively. The EHI showed a reduction from grade 3 after 3 days to grade 1 after 4 weeks. PRP did not improve the results achieved with beta-TCP in the treatment of intrabony defects.

In vitro investigation of orthopedic titanium-coated and brushite-coated surfaces using human osteoblasts in the presence of gentamycin

Anti-infective coatings have been developed to protect the surfaces of cementless implants from bacterial colonization that is known to be a prerequisite for device-related infection. The aim of this study is to investigate the effect of brushite-coated arthroplasty surfaces on human osteoblasts and to evaluate the impact of concomitant exposure to gentamycin. We cultured human osteoblasts (hFOB 1.19) on brushite-coated and uncoated titanium alloy in the presence of gentamycin and analyzed cell function and vitality. Our results show that brushite-coated titanium alloy surfaces supported the function of osteoblasts and the expression of extracellular matrix even in the presence of highly dosed gentamycin. Brushite-coated titanium alloy surfaces supported osteogenic function, indicating that this coating could enhance implant osteointegration in vivo. Concomitant exposure to gentamycin slightly decreased osteoblastic activity in vitro, suggesting that there might also be negative effects in vivo. However, in vivo studies are necessary to validate these in vitro findings.

Review Paper: Behavior of Ceramic Biomaterials Derived from Tricalcium Phosphate in Physiological Condition

Various calcium phosphates are used for bone repair. Although hydroxyapatite (HA) sintered ceramics are widely used due to their osteoconductivity, its bioresorbability is so low that HA remains in the body for a long time after implantation. In contrast, tricalcium phosphate (TCP) ceramics show resorbable characters during bone regeneration, and can be completely substituted for the bone tissue after stimulation of bone formation. Therefore, much attention is paid to TCP ceramics for scaffold materials for supporting bone regeneration. This paper reviews bioresorbable properties of calcium phosphate ceramics derived from β-TCP and α-TCP.

Degradation, bioactivity, and cytocompatibility of diopside, akermanite, and bredigite ceramics

The aim of this study was to investigate the effect of three bioceramics in the CaO-SiO(2)-MgO systems with different composition on the in vitro degradation, bioactivity, and cytocompatibility. The degradation was evaluated through the activation energy of Si ion release from ceramics and the weight loss of the ceramics in Tris-HCl buffers. The in vitro bioactivity of the ceramics was investigated by analysis of apatite-formation ability in the simulated body fluid (SBF). The cytocompatibility was evaluated through osteoblast morphology and proliferation. The results showed that the activation energy of Si ion release increased and the degradation decreased from bredigite to diopside ceramics with the increase of Mg content, and the apatite-formation ability in SBF decreased. The Ca, Si, and Mg containing ionic products from three ceramics could stimulate cell proliferation at lower concentration, and inhibit cell proliferation with the increase of ion concentrations. Furthermore, osteoblasts could adhere, spread, and proliferate on three ceramic disks, and cell proliferation on diopside was more obvious than that on other two ceramic disks.

Histomorphometric evaluation of implants coated with enamel or dentine derived fluoride-substituted apatite

OBJECTIVES

The aim of this study was to compare osseous healing characteristics of titanium implants coated with enamel-derived fluoride-substituted apatite (EFSA) or dentin-derived fluoride-substituted apatite (DFSA).

METHODS

Fluoride-substituted apatite was derived from extracted human teeth with calcination method at 850 degrees C. DFSA and EFSA were separated and carefully ground with a blade grinder. Twenty-four titanium implants were prepared from a 99.99% pure titanium bar. EFSA and DFSA powders were sprayed separately on implants. As control group, unsprayed and sandblasted pure titanium implants were used. Eight adult rams were used in the study. One EFSA coated, 1 DFSA coated and 1 control implants were placed into right tibia of each rams. The rams were sacrificed after 6 months of healing. Undecalcified sections were prepared according to Donath's method and histomorphometric evaluation of implants was made.

RESULTS

The mean bone contact percentage of DFSA-coated, EFSA-coated and control implants was 89.88%+/-2.34, 70.19%+/-13.11 and 53.12%+/-5.76 respectively. This study suggests that DFSA-coated implants achieved better bone contact than EFSA-coated implants (P<0.05). Also study groups presented better bone contact than control group (P<0.05).

CONCLUSIONS

The results of this study show that although DFSA-coated implants achieved better bone contact, both DFSA and EFSA can be considered as appropriate coating materials.

Mechanical properties of calcium phosphate scaffolds fabricated by robocasting

The mechanical behavior under compressive stresses of beta-tricalcium phosphate (beta-TCP) and hydroxyapatite (HA) scaffolds fabricated by direct-write assembly (robocasting) technique is analyzed. Concentrated colloidal inks prepared from beta-TCP and HA commercial powders were used to fabricate porous structures consisting of a 3-D tetragonal mesh of interpenetrating ceramic rods. The compressive strength and elastic modulus of these model scaffolds were determined by uniaxial testing to compare the relative performance of the selected materials. The effect of a 3-week immersion in simulated body fluid (SBF) on the strength of the scaffolds was also analyzed. The results are compared with those reported in the literature for calcium phosphate scaffolds and human bone. The robocast calcium phosphate scaffolds were found to exhibit excellent mechanical performances in terms of strength, especially the HA structures after SBF immersion, indicating a great potential of this type of scaffolds for use in load-bearing bone tissue engineering applications.

β-CaSiO3/β-Ca3(PO4)2 composite materials for hard tissue repair:In vitro studies

In this study, a series of beta-CaSiO(3) (CS)/beta-Ca(3)(PO(4))(2) (TCP) composites with different ratios were prepared to produce new bioactive and biodegradable biomaterials for potential bone repair. The mechanical properties of CS-TCP composites increased steadily with the increase of TCP amounts in composites. Formation of bone-like apatite on a range of CS-TCP composites with CS weight percentage ranging from 0 to 100 has been investigated in simulated body fluid (SBF). The presence of bone-like apatite layer on the composite surface after soaking in SBF was demonstrated by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and fourier transform infrared reflection spectroscopy (FTIR). The results showed that the apatite formation ability of the CS-TCP composite was enhanced with increasing CS content in the composites. For composites with more than 50% CS contents, the samples were completely covered by a layer of dense bone-like apatite just after 3 days immersion. Dissolution tests in Tris-HCl buffer solution showed obvious differences with different CS contents in composites. The dissolution rate increased with the increase of CS content, which suggested that the solubility of biphasic composites could be tailored by adjusting the initial CS/TCP ratio. In vitro cell experiments showed that higher content of CS phase in composites promoted cell proliferation and differentiation. When the CS amount in the composite increased to 50%, the proliferation rate and ALP activities of osteoblast-like cells showed significant difference compared with pure TCP (p < 0.05). Results of the study suggested that the CS-TCP composites with more than 50% CS content might be promising bone repair materials.

In vitro studies of novel CaO-SiO2-MgO system composite bioceramics

In this study, a series of CaO-SiO(2)-MgO composites with different beta-CaSiO(3) (CS)/Mg(2)SiO(4) (M(2)S) composite ratios were prepared to produce new bioactive and biodegradable biomaterials for potential bone repair. The mechanical properties of CS-M(2)S composites increased steadily with the increase of M(2)S ratios in composites. Dissolution tests in Tris-HCl buffer solution showed obvious differences with different CS initial composite ratio in composites. The dissolution rate increased with the increase of CS composite ratio, which suggested that the solubility of composites could be tailored by adjusting the initial CS/M(2)S composite ratio. Formation of bone-like apatite on a range of CS-M(2)S composites with CS weight percentage ranging from 0 to 100 has been investigated in simulated body fluid (SBF). The presence of bone-like apatite layer on the composite surface after soaking in SBF was demonstrated by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM). The results showed that the apatite formation ability of the CS-M(2)S composite with 70% CS was detected after 10 days immersion. In vitro cell experiments showed that the 50 and 70% CS composites supported greater osteoblast-like cell proliferation as compared with pure M(2)S (p<0.05). The results of this study suggested that the CS-M(2)S composites with 50 and 70% initial CS composite amount might be more suitable for preparation of bone repair materials.

Dissolution of human teeth-derived hydroxyapatite

We have been interested in human teeth which consist of hydroxyapatite (HA), but do not degrade for a long time. In order to overcome dissolution and mechanical degradation of man-made HA, biologically derived hydroxyapatite (BHA) ceramics were prepared from human teeth and their dissolving behavior was investigated in distilled water for 3-14 days and compared with an artificial HA made of synthetic HA powder. BHA ceramics were prepared by calcining freshly extracted human teeth at 900 degrees C and followed by sintering at 1200 degrees C for 2 h. All detectable peaks in the artificial HA are identical to HA lattice planes, whereas BHA consisted of a mixture of HA and beta-tricalcium phosphate (TCP). Although the artificial HA was expected to be stable in water, the surface dissolution initiated at grain boundaries followed by generated many separated grains and their associated pores. On the other hand, BHA showed that definite grains considered as beta-TCP were predominantly dissolved and the grains were separated from the matrix leaving pores. In the mean time, the rest region, mainly consisting of HA, did not show any evidence of dissolution. It indicates that BHA showed rather stable grain boundaries and lack of excessive dissolution in liquid environment.

CaTiO(3) coating on titanium for biomaterial application--optimum thickness and tissue response

The objectives of this study were to determine the optimum thickness of a CaTiO(3) film for biomaterial applications and to investigate the biocompatibility and bone formation of titanium with a CaTiO(3) film. First, CaTiO(3) films of 10, 20, 30, and 50 nm in thickness were deposited on titanium substrates using radiofrequency magnetron sputtering followed by annealing at 873 K in air for 7.2 ks. The optimum thickness of the CaTiO(3) film for bone formation was determined by comparison with its performance regarding calcium phosphate formation in Hanks' balanced saline solution (HBSS). Regarding calcium phosphate formation, the performance of the specimen with a 50-nm-thick CaTiO(3) film was superior to those of specimens with other thicknesses. A titanium prism with a CaTiO(3) film of 50-nm in thickness was surgically inserted in both soft and hard rat tissues. The biocompatibility of CaTiO(3)-deposited titanium and bone formation on it was investigated by histological observations. A slight inflammatory reaction was observed around the titanium with the 50-nm-thick CaTiO(3) film, while no severe response, such as degeneration and necrosis, was observed in either soft or hard rat tissue. New bone formation on the titanium plate with the CaTiO(3) film was more active than that without the film. The 50-nm-thick CaTiO(3) film has biocompatibility and can facilitate new bone formation in vivo, and, consequently, it is an excellent surface modification method for biomaterial applications.

No migration of acetabular cups after prophylaxis for heterotopic ossification

The possibility of migration of cementless cups in total joints after prophylaxis of heterotopic ossification with irradiation or nonsteroidal antiinflammatory drugs is a concern. Data investigating component stability with digital methods are lacking. This prospective study analyzed the migration of cementless cups after indomethacin and irradiation prophylaxis with the digital Einzel-Bild-Röntgen-Analyse tool. The irradiation group (106 hips) and the indomethacin group (98 hips) were compared with 82 hips that did not receive any prophylaxis. The same cementless acetabular implants were used in all cases, and patients were observed clinically and radiographically at 2 and 5 years. At the 5-year followup, the number of cups that showed migration greater than 1 mm in the irradiation group (five), the indomethacin group (three), and the control group (four) were not different. No cup was considered loose on the radiographs and no patient underwent revision surgery. The results of our study indicate irradiation or short-course use of indomethacin for prophylaxis of heterotopic ossification did not negatively affect the stability of cementless cups in primary total hip arthroplasties.

Nanostructured bioceramics for maxillofacial applications

Biomaterials science and technology have been expanding tremendously the recent years. The results of this evolution are obvious in maxillofacial applications especially with the contemporary development of Nanotechnology. Among biomaterials, bioceramics possess a specific field due to various interactions with the biological tissues. The combination of bioceramics and nanotechnology has resulted in enhanced skeletal interactions in maxillofacial applications. Nanotechnology secures better mechanical properties and more effective biological interactions with jaws. The main production methods for the synthesis of nanostructured materials include plasma arcing, chemical vapour deposition, sol-gel and precipitation. The bioceramics in Dentistry comprise inert, bioactive, resorbable and composite systems. The purpose of the present article is to describe the available nanotechnology methods and how these could be addressed to synthesise maxillofacial bioceramics with advanced properties for better biological applications. Additionally, it describes specific clinical applications in maxillofacial surgery of these biomaterials--either by themselves or in combination with others--that can be promising candidates for bone tissue engineering. Such applications include replacement of lost teeth, filling of jaws defects or reconstruction of mandible and temporomandibular joint.

Interaction of a blood coagulation factor on electrically polarized hydroxyapatite surfaces

Although the polarization treatment of hydroxyapatite (HA) remarkably enhances the osteoconductivity, the mechanisms have not yet been completely understood. The interaction of proteins in blood and tissue fluids with biomaterials are reportedly triggers for later cellular responses and played a major role in osteoconductive processes. Considering this, we disclosed the interaction of polarized HA surface with a coagulation factor, fibrin stabilizing factor XIII (FXIII). The HA activated FXIII even in Ca2+ free buffer, based on the SDS-PAGE detections of alpha-polymer and gamma-dimer bands assigned to stabilized fibrin. The Ca2+ ions, possibly released from the HA surfaces, were examined whether they initiate the activation of the FXIII. It was experimentally proved by ICP analysis that the induced large negative charges on the electrically polarized HA significantly increased the released Ca2+ concentration for the short pre-incubation time of 3 min. The more Ca2+ ions released from the negatively charged HA (N-HA) surfaces were more effective in the activation of the FXIII, resulting in the rapider disappearance of the gamma-chain bands in fibrin. The slightly lower Ca2+ concentration in the positively charged HA, compared to the nonpolarized HA activated the FXIII at an almost equal rate. The accelerated activation contributed to the stabilization of fibrin scaffold. Therefore, the polarity difference of the induced charges of the polarized HA surface altered the rate of the FXIII activation. The early stage interaction of the HA surfaces with blood proteins was considered to be an essential process of the accelerated new bone formation near implanted N-HA surface.

The influence of discharge power and heat treatment on calcium phosphate coatings prepared by RF magnetron sputtering deposition

Ca-P coatings with different Ca/P ratio and composition were successfully prepared by RF magnetron sputtering deposition. The Ca/P ratio, phase composition, structure and morphological properties were characterized by XRD, FTIR, EDS and SEM analyses. All the as-sputtered coatings were amorphous and after IR-irradiation the coatings altered into a crystalline phase. The obtained coatings had a Ca/P ratio that varied from 0.55 to 2.10 and different phase compositions or mixtures of apatite, beta-pyrophosphate and beta-tricalciumphosphate structures were formed. Evidently, the phase compositions of the sputtered coatings are determined not only by the discharge power ratio of the hydroxylapatite and calcium pyrophosphate targets but also by the annealing temperature.

Silicon substitution in the calcium phosphate bioceramics

Silicon (Si) substitution in the crystal structures of calcium phosphate (CaP) ceramics such as hydroxyapatite (HA) and tricalcium phosphate (TCP) generates materials with superior biological performance to stoichiometric counterparts. Si, an essential trace element required for healthy bone and connective tissues, influences the biological activity of CaP materials by modifying material properties and by direct effects on the physiological processes in skeletal tissue. The synthesis of Si substituted HA (Si-HA), Si substituted alpha-TCP (Si-alpha-TCP), and multiphase systems are reviewed. The biological performance of these Si substituted CaP materials in comparison to stoichiometric counterparts is discussed. Si substitution promotes biological activity by the transformation of the material surface to a biologically equivalent apatite by increasing the solubility of the material, by generating a more electronegative surface and by creating a finer microstructure. When Si is included in the TCP structure, recrystallization to a carbonated HA is mediated by serum proteins and osteoblast-like cells. Release of Si complexes to the extracellular media and the presence of Si at the material surface may induce additional dose-dependent stimulatory effects on cells of the bone and cartilage tissue systems.

In situ apatite forming injectable hydrogel

Injectable polymers are attractive materials for tissue augmentation or replacement. Thermosensitive hydrogels, especially poly(N-isopropylacryamide), have been investigated for these applications to exploit the lower critical solution temperature (LCST) which falls between room and body temperatures. Some practical limitations to the material are the load-bearing capabilities and the ability to bond to the host tissue. In this work, we evaluated a novel, injectable apatite-forming material system: poly(N-isopropylacryamide)-co-poly(ethyleneglycol) dimethacrylate, with the addition of tri-methacryloxypropyltrimethoxysilane (MPS). We have previously reported that MPS concentration permits the material system to be tuned to different compressive moduli ranging from 50-700 kPa without altering the LCST of the material. Here, we explore the apatite formation of this material system in protein-free and protein-containing SBF. The MPS-containing hydrogel system exhibited apatite formation throughout the gel thickness. The apatite formation was inhibited by the presence of proteins. This mechanism is likely controlled by the silanol groups (Si-OH) in MPS, which provided attachment sites for calcium and initiated mineral dissolution from the simulated biological environments. The challenge of this material system is to balance the network-forming and modulus-enhancing MPS while maintaining an injectable hydrogel for potential tissue regeneration.

Control of bisphosphonate release using hydroxyapatite granules

The efficacy of hydroxyapatite (HAp) as a carrier was investigated to establish a method of local administration of bisphosphonates (Bps), which has currently been administered systemically. HAp granules (300-500 microm in size) with different physicochemical features were prepared by altering the sintering temperature. To ascertain the physicochemical properties of the HAp granules, their crystallinity was assessed using X-ray diffraction, the surface morphology was examined under scanning electron microscopy, and the specific surface area and calcium dissolution were evaluated. Different Bps-HAp composites were subsequently prepared and the concentration of Bps released from these composites was measured. The influence of Bps-HAp composites on the rate of osteoclast survival was also evaluated. The results revealed that (1) HAp solubility depends on the sintering temperature; (2) The concentration of released Bps could be controlled by regulating the sintering temperature of HAp as a carrier; and (3) Bps released from Bps-HAp composites reduced the number of osteoclasts. These findings indicated that Bps-HAp composites could be locally administered as a drug delivery system to areas with bone resorption.

Growth behavior of rat bone marrow cells on RF magnetron sputtered hydroxyapatite and dicalcium pyrophosphate coatings

The aim of this study was to evaluate the osteogenic properties of magnetron sputtered dicalcium pyrophaosphate (DCPP) and hydroxylapatite (HA) coatings. Therefore, DCPP and HA coatings were deposited on grit-blasted titanium discs. The substrates were used as-prepared or received an additional heat treatment which changed the amorphous coating structure to a crystalline structure. Subsequently, rat bone marrow stromal cells were cultured for 1-24 days on the various substrates. DNA and alkaline phosphatase activity was determined after 1, 3, 5, 8, and 12 days of incubation. Osteocalcin expression was evaluated after 8, 12, 16, and 24 days of incubation. Scanning electron microscopical analysis of cell morphology and coating characteristics was done after 8 and 16 days of incubation. All assays were done in duplicate and in each assay all specimens were present in fourfold. Results demonstrated that the cells did not proliferate and differentiate on all amorphous coatings. SEM revealed that the amorphous coatings showed significant dissolution. On the crystalline DCPP and HA coatings an increase in DNA and alkaline phosphatase activity was seen starting at day 8 of incubation. Osteocalcin expression on the crystalline coatings started to increase at day 16 of incubation. SEM showed that the growth and differentiation of the cells was associated with extensive collagen fiber formation and surface mineralization in the form of globular accretions. Further, statistical testing revealed that proliferation and differentiation of the rat bone marrow stromal cells started significantly earlier on the crystalline HA coatings than that on the crystalline DCPP coatings. These results demonstrate that the rat bone marrow stromal cells proliferated and differentiated only on crystalline magnetron sputtered DCPP as well as HA coatings, which warrants the further in vivo analysis of the bone healing supporting properties of these coatings.