Effect of ball milling on the processing of bone substitutes with calcium phosphate powders

Multi-objective property optimisation of a phosphoserine-modified calcium phosphate cement for orthopaedic and dental applications using design of experiments methodology

Phosphoserine is a ubiquitous molecule found in numerous proteins and, when combined with alpha-tricalcium phosphate (α-TCP) powder, demonstrates the ability to generate an adhesive biomaterial capable of stabilising and repairing bone fractures. Design of Experiments (DoE) approach was able to optimise the composition of phosphoserine-modified calcium phosphate cement (PM-CPC) demonstrating that the liquid:powder ratio (LPR) and quantity of phosphoserine (wt%) significantly influenced the handling, mechanical, and adhesion properties. Subsequently, the DoE optimisation process identified the optimal PM-CPC formulation, exhibiting a compressive strength of 29.2 ± 4.9 MPa and bond/shear strength of 3.6 ± 0.9 MPa after a 24 h setting reaction. Moreover, the optimal PM-CPC composition necessitated a mixing time of 20 s and displayed an initial setting time between 3 and 4 min, thus enabling homogenous mixing and precise delivery within a surgical environment. Notably, the PM-CPC demonstrated a bone-to-bone bond strength of 1.05 ± 0.3 MPa under wet conditions, coupled with a slow degradation rate during the first five days. These findings highlight the ability of PM-CPC to effectively support and stabilise bone fragments during the initial stages of natural bone healing. The developed PM-CPC formulations fulfil the clinical requirements for working and setting times, static mechanical, degradation properties, and injectability, enabling surgeons to stabilise complex bone fractures. This innovative bioinspired adhesive represents a significant advancement in the treatment of challenging bone injuries, offering precise delivery within a surgical environment and the potential to enhance patient outcomes. STATEMENT OF SIGNIFICANCE: This manuscript presents a noteworthy contribution to the field of bone fracture healing and fixation by introducing a novel phosphoserine-modified calcium phosphate cement (PM-CPC) adhesive by incorporating phosphoserine and alpha-TCP. This study demonstrates the fabrication and extensive characterisation of this adhesive biomaterial that holds great promise for stabilising and repairing complex bone fractures. Design of Experiment (DoE) software was used to investigate the correlations between process, property, and structure of the adhesive, resulting in a cost-effective formulation with desirable physical and handling properties. The PM-CPC adhesive exhibited excellent adhesion and cohesion properties in wet-field conditions. This research offers significant potential for clinical translation and contributes to the ongoing advancements in bone tissue engineering.

Functionalized Porous Hydroxyapatite Scaffolds for Tissue Engineering Applications: A Focused Review

Biomaterials have been widely used in tissue engineering applications at an increasing rate in recent years. The increased clinical demand for safe scaffolds, as well as the diversity and availability of biomaterials, has sparked rapid interest in fabricating diverse scaffolds to make significant progress in tissue engineering. Hydroxyapatite (HAP) has drawn substantial attention in recent years owing to its excellent physical, chemical, and biological properties and facile adaptable surface functionalization with other innumerable essential materials. This focused review spotlights a brief introduction on HAP, scope, a historical outline, basic structural features/properties, various synthetic strategies, and their scientific applications concentrating on functionalized HAP in the diverse area of tissue engineering fields such as bone, skin, periodontal, bone tissue fixation, cartilage, blood vessel, liver, tendon/ligament, and corneal are emphasized. Besides clinical translation aspects, the future challenges and prospects of HAP based biomaterials involved in tissue engineering are also discussed. Furthermore, it is expected that researchers may find this review expedient in gaining an overall understanding of the latest advancement of HAP based biomaterials.

Solid-state MAS NMR, TEM, and TGA studies of structural hydroxyl groups and water in nanocrystalline apatites prepared by dry milling

A series of nanocrystalline calcium hydroxyapatites was prepared by dry milling and characterized using proton and ³¹P MAS NMR, TEM, and TGA methods. The samples contained stubby rod-shaped crystals, which length and width varied in the 130-30 and 95-20 nm ranges, respectively. It was confirmed that concentration of structural hydroxyl groups in nanocrystalline apatites decreases with the decreasing crystal size. In the series of the studied apatites, the decrease was from 86 to ca. 50 % in reference to stoichiometric apatite. Water was found in the surface hydrated layer and in the c-axis channels, in which compartments existed as adsorbed and structural, respectively. Molecules of the adsorbed water were capable of moving from the crystal surface into the lattice c-axis channels of apatite. This process introduced considerable structural disorder within and around those channels and reduced the content of the structural hydroxyl groups, particularly in the region underneath the apatite crystal surface.

Co-grinding significance for calcium carbonate-calcium phosphate mixed cement. Part I: effect of particle size and mixing on solid phase reactivity

In part I of this study we aim to evaluate and control the characteristics of the powders constituting the solid phase of a vaterite CaCO(3)-dicalcium phosphate dihydrate cement using a co-grinding process and to determine their impact on cement setting ability. An original methodology involving complementary analytical techniques was implemented to thoroughly investigate the grinding mechanism of separated or mixed reactive powders and the effects on solid phase reactivity. We showed that the association of both reactive powders during co-grinding improves the efficiency of this process in terms of the particle size decrease, thus making co-grinding adaptable to industrial development of the cement. For the first time the usefulness of horizontal attenuated total reflection Fourier transform infrared spectroscopy to follow the chemical setting reaction at 37°C in real time has been demonstrated. We point out the antagonist effects that co-grinding can have on cement setting: the setting time is halved; however, progress of the chemical reaction involving dissolution-reprecipitation is delayed by 30 min, probably due to the increased contact area between the reactive powders, limiting their hydration. More generally, we can take advantage of the co-grinding process to control powder mixing, size and reactivity and this original analytical methodology to better understand its effect on the phenomena involved during powder processing and cement setting, which is decisive for the development of multi-component cements.

Viscoelastic properties of composites of calcium alginate and hydroxyapatite

Calcium alginate was reinforced with hydroxyapatite (HA) particles, whose dimensions were a few micrometres, with mass fraction, mf, values in the range 0-0.8. Cylindrical samples of these composite materials were subjected to cyclic compression in the frequency range f = 0.001-20 Hz; in these tests a sinusoidal load of amplitude 1 N was applied either side of a static compression of 2 N. Storage and loss moduli, E' and E'', respectively, were found to be independent of particle size; however, E' increased with frequency consistent with the materials undergoing a glass transition. Above frequencies of about 0.05 Hz, E' > E'' for all materials. For each frequency, the dependence of the moduli on log10f could be represented by a third order polynomial; these equations can be used to calculate E' and E'' for a range of compositions. Approximate values of (E*) = square root of E'2 + E''2 are predicted by a Reuss model.

Phase conversion of tricalcium phosphate into Ca-deficient apatite during sintering of hydroxyapatite–tricalcium phosphate biphasic ceramics

In this study, we report a new observation on the phase conversion that occurs during the sintering of hydroxyapatite (HA)-tricalcium phosphate (TCP) biphasic ceramics. During the sintering of the HA-TCP mixture powders, a large amount of TCP was converted into HA, as detected by X-ray diffraction. The amount of TCP transformed into HA was approximately 10-90% of that initially added. From the electron probe microscopy analysis, the HA transformed from TCP was found to be Ca-deficient with Ca/P ratios of 1.62-1.64. The dissolution behavior and osteoblastic responses in a series of HA-TCP biphasic ceramics (10-90% TCP) were assessed. The solubility of the HA-TCP biphasic ceramics was intermediate between that of the HA and TCP pure ceramics. However, in the case of the HA-90% TCP biphasic ceramic, the solubility was even higher than that of pure TCP. The cell proliferation and alkaline phosphatase activity of the cells on the biphasic ceramics were lower than those on pure HA, but higher than those on pure TCP. However, particularly in the HA-50% TCP biphasic composition, the cellular responses were significantly higher than those on pure HA. It is considered that the Ca-deficient apatite newly formed from the TCP may affect in some way the solubility and biological properties of the HA-TCP biphasic ceramics.

Injectable bone cements for use in vertebroplasty and kyphoplasty: State-of-the-art review

Vertebroplasty (VP) and kyphoplasty (KP) are minimally invasive surgical procedures that have recently been introduced for the medical management of osteoporosis-induced vertebral compression fractures. The aim of VP is to stabilize the fractured vertebral body, while the goals of KP are to stabilize the fractured vertebral body and to restore its height to as near its prefracture level as possible. Both procedures involve injection of the setting dough of an injectable bone cement (IBC) into the fractured vertebral body, thereby highlighting the indispensable role that the IBC plays. Although there is a very large literature on IBCs, no detailed critical review of it has been published. Such a review is the subject of the present work, which is in seven parts. The review opens with a succinct introduction to VP and KP. The topics covered in the parts that follow are: (1) a listing of the 18 most desirable properties of an IBC (e.g., easy injectability, high radiopacity, and a resorption rate that is neither too high nor too low); (2) descriptions of the four classes of IBCs (calcium phosphates, acrylic bone cements, calcium sulfates, and composites); (3) concerns that have been raised with regard to the use of IBCs (such as the potential for thermal necrosis of tissue at the peri-augmentation site, when an acrylic bone cement is used); (4) explicative summaries of the main findings of literature studies on the influence of nine factors (such as powder particle size, powder-to-liquid ratio, and the method used to mix the powder and the liquid) on the values of various properties of IBCs; (5) explicative summaries of the main findings of literature studies on five fundamental matters, such as the aging mechanism of the powder, the thermokinetics of a setting dough, and the influence of the type of IBC used on various ex vivo biomechanical performance measures of VP- and KP-augmented vertebral bodies; and (6) descriptions of topics in six areas for future research, such as the determination of an overall index of the fatigue performance of an IBC and the development of internationally recognized standardized testing protocols to employ when a synthetic cancellous bone void model is used in the rapid in vitro screening of IBCs. The review ends with a summary of the most salient points and observations made.

Sintered hydroxyfluorapatites. Part I: Sintering ability of precipitated solid solution powders

The presence of fluoride within apatites occurring naturally within the body provides the basis for investigating the sintering ability of fluoride containing hydroxyapatites for use as biomaterials. Hydroxyfluorapatites were synthesized and then calcined to produce a 0%, 20%, 40%, 60%, 80% and 100% replacement of the hydroxyl ions with fluoride in the hydroxyapatite structure. Fluoride ion occupancy within the apatites was found to be about 90% of the anticipated value. Pycnometry results revealed a constant true density for powders of low to medium fluoride content followed by a rapid increase to the fluorapatite composition. Powders were uniaxially pressed, cold-isostatically pressed and sintered at 1150 degrees C, 1200 degrees C and 1250 degrees C. All hydroxyfluorapatite powders displayed a comparable ability for densification except when hydroxyl groups and fluoride ions were present at a comparable concentration. The grain size revealed that this composition also exhibited the smallest grain size and displayed the highest activation energy for grain growth. The lower diffusion created by similar amounts of fluoride and hydroxide within the lattice decreases grain growth and densification.