The effect of ball milling grinding pathways on the bulk and reactivity properties of calcium phosphate cements

Nanostructured Strontium-Doped Calcium Phosphate Cements: A Multifactorial Design

Calcium phosphate cements (CPCs) have been extensively studied in last decades as nanostructured biomaterials for the regeneration of bone defects, both for dental and orthopedic applications. However, the precise control of their handling properties (setting time, viscosity, and injectability) still represents a remarkable challenge because a complicated adjustment of multiple correlated processing parameters is requested, including powder particle size and the chemical composition of solid and liquid components. This study proposes, for the first time, a multifactorial investigation about the effects of powder and liquid variation on the final performance of Sr-doped apatitic CPCs, based on the Design of Experiment approach. In addition, the effects of two mixing techniques, hand spatula (low-energy) and planetary shear mixing (high-energy), on viscosity and extrusion force were compared. This work aims to shed light on the various steps involved in the processing of CPCs, thus enabling a more precise and tailored design of the device, based on the clinical need.

High-scale yield of nano hydroxyapatite through combination of mechanical activation and chemical dispersion

The aim of this study is to develop a simple, convenient and effective approach to synthesize nano-sized hydroxyapatite (nano-HA) at high-scale yield. Nano-HA was wet synthesized in the presence or absence of alendronate sodium (ALN), one of bisphosphonates for anti-osteoporotic. Then aged and washed nano-HA precipitate was directly treated by mechanical activation combined with the chemical dispersion of ALN to prevent the agglomeration of nano-HA. ALN acted not only as a chemical dispersant but also as an orthopedic drug. In vitro release showed that ALN was released slowly from nano-HA. Transmission electron microscopy (TEM) revealed that nano-HA with size less than 100 nm appeared as single particle after being treated by mechanical activation combined with the dispersion of ALN (AMA-HA and MA-HA). High resolution transmission electron microscopy (HRTEM) and X-ray diffraction (XRD) confirmed that as-prepared nanoparticles were HA with low crystallinity and crystallite size. Fourier transform infrared spectroscopy (FTIR) indicated that the phosphonate groups in ALN were introduced to bond with the Ca²⁺ of HA to impede the growth of HA crystal. Zeta potential illustrated that the absolute value of surface negative charge of nano-HA increased significantly with the addition of ALN, which inhibited the agglomeration of nano-HA. The present approach makes it feasible to produce nano-HA at high-scale yield, which provide the possibility to construct bone graft.

Phytic acid as alternative setting retarder enhanced biological performance of dicalcium phosphate cement in vitro

Dicalcium phosphate cement preparation requires the addition of setting retarders to meet clinical requirements regarding handling time and processability. Previous studies have focused on the influence of different setting modifiers on material properties such as mechanical performance or injectability, while ignoring their influence on biological cement properties as they are used in low concentrations in the cement pastes and the occurrence of most compounds in human tissues. Here, analyses of both material and biological behavior were carried out on samples with common setting retardants (citric acid, sodium pyrophosphate, sulfuric acid) and novel (phytic acid). Cytocompatibility was evaluated by in vitro tests with osteoblastic (hFOB 1.19) and osteoclastic (RAW 264.7) cells. We found cytocompatibility was better for sodium pyrophosphate and phytic acid with a three-fold cell metabolic activity by WST-1 test, whereas samples set with citric acid showed reduced cell number as well as cell activity. The compressive strength (CS) of cements formed with phytic acid (CS = 13 MPa) were nearly equal to those formed with citric acid (CS = 15 MPa) and approximately threefold higher than for other setting retardants. Due to a proven cytocompatibility and high mechanical strength, phytic acid seems to be a candidate replacement setting retardant for dicalcium phosphate cements.

Crystallized nano-sized alpha-tricalcium phosphate from amorphous calcium phosphate: microstructure, cementation and cell response

New insight on the conversion of amorphous calcium phosphate (ACP) to nano-sized alpha tricalcium phosphate (α-TCP) provides a faster pathway to calcium phosphate bone cements. In this work, synthesized ACP powders were treated with either water or ethanol, dried, crystallized between 700 and 800 °C, and then cooled at different cooling rates. Particle size was measured in a scanning electron microscope, but crystallite size calculated by Rietveld analysis. Phase composition and bonding in the crystallized powder was assessed by x-ray diffraction and Fourier-transform infrared spectroscopy. Results showed that 50 nm sized α-TCP formed after crystallization of lyophilized powders. Water treated ACP retained an unstable state that may allow ordering to nanoapatite, and further transition to β-TCP after crystallization and subsequent decomposition. Powders treated with ethanol, favoured the formation of pure α-TCP. Faster cooling limited the growth of β-TCP. Both the initial contact with water and the cooling rate after crystallization dictated β-TCP formation. Nano-sized α-TCP reacted faster with water to an apatite bone cement than conventionally prepared α-TCP. Water treated and freeze-dried powders showed faster apatite cement formation compared to ethanol treated powders. Good biocompatibility was found in pure α-TCP nanoparticles made from ethanol treatment and with a larger crystallite size. This is the first report of pure α-TCP nanoparticles with a reactivity that has not required additional milling to cause cementation.

Effect of methotrexate on the mechanical properties and microstructure of calcium phosphate cement

Calcium phosphate cement (CPC) is widely used as an antitumor bone-filling material. Methotrexate (MTX) is recognized as an effective chemotherapy medicine. The current study examined the effects of MTX on the mechanical properties and microstructure of CPC. Methotrexate-loaded CPC at mass ratios of 0%, 0.1%, 0.2%, and 0.5% were designated as groups A, B, C, and D, respectively, and were pressed into precast cylindrical molds. Solidification time, axial compressive strength, transverse compressive strength, and rotational tensile strength were measured, and scanning electron microscopy images were captured before and after MTX-CPC microstructure changes occurred. Average initial and final setting times increased gradually with increasing drug concentration, but this increase was not significant among the groups. Average axial transverse compressive strength and rotational tensile strength of groups B and C were not significantly different from those of group A (P>.05); however, there was a significant difference in these properties between groups A and D (P<.05). Scanning electron microscopy observations showed a porous crystalline structure. The addition of MTX to CPC does not significantly affect the basic crystal structure and setting time of CPC. Adding MTX at mass ratios of 0.1% and 0.2% to CPC does not lead to a significant difference in mechanical strength and can therefore be applied in clinical practice. This study may shed some light on the future application of MTX-loaded CPC in the treatment of bone defects after tumor excision.

Development and Characterization of Biphasic Hydroxyapatite/β-TCP Cements

Biphasic calcium phosphate bioceramics composed of hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) have relevant properties as synthetic bone grafts, such as tunable resorption, bioactivity, and intrinsic osteoinduction. However, they have some limitations associated to their condition of high-temperature ceramics. In this work self-setting Biphasic Calcium Phosphate Cements (BCPCs) with different HA/β-TCP ratios were obtained from self-setting α-TCP/β-TCP pastes. The strategy used allowed synthesizing BCPCs with modulated composition, compressive strength, and specific surface area. Due to its higher solubility, α-TCP was fully hydrolyzed to a calcium-deficient HA (CDHA), whereas β-TCP remained unreacted and completely embedded in the CDHA matrix. Increasing amounts of the non-reacting β-TCP phase resulted in a linear decrease of the compressive strength, in association to the decreasing amount of precipitated HA crystals, which are responsible for the mechanical consolidation of apatitic cements. Ca²⁺ release and degradation in acidic medium was similar in all the BCPCs within the timeframe studied, although differences might be expected in longer term studies once β-TCP, the more soluble phase was exposed to the surrounding media.

Processing and in vivo evaluation of multiphasic calcium phosphate cements with dual tricalcium phosphate phases

Calcium phosphate cements (CPCs) use the simultaneous presence of several calcium phosphates phases. This is done to generate specific bulk and in vivo properties. This work has processed and evaluated novel multiphasic CPCs containing dual tricalcium phosphate (TCPs) phases. Dual TCPs containing α- and β-TCP phases were obtained by thermal treatment. Standard CPC (S-CPC) was composed of α-TCP, anhydrous dicalcium phosphate and precipitated hydroxyapatite, while modified CPC (DT-CPC) included both α- and β-TCP. Physicochemical characterization of these CPCs was based on scanning electron microscopy, X-ray diffraction, specific surface area (SSA) and particle size (PS) analysis and mechanical properties. This characterization allowed the selection of one DT-CPC for setting time, cohesion and biological assessment compared with S-CPC. Biological assessment was carried out using a tibial intramedullary cavity model and subcutaneous pouches in guinea pigs. Differences in the surface morphology and crystalline phases of the treated TCPs were detected, although PS analysis of the milled CPC powders produced similar results. SSA analysis was significantly higher for DT-CPC with α-TCP treated at 1100°C for 5h. Poorer mechanical properties were found for DT-CPC with α-TCP treated at 1000°C. Setting time and cohesion, as well as the in vivo performance, were similar in the selected DT-CPC and the S-CPC. Both CPCs created the desired host reactions in vivo.

Bulk properties and bioactivity assessment of porous polymethylmethacrylate cement loaded with calcium phosphates under simulated physiological conditions

Polymethylmethacrylate (PMMA) cements are widely used in spinal surgery. Nevertheless, these types of cements present some documented drawbacks. Therefore, efforts have been made to improve the properties and biological performance of solid PMMA. A porous structure would seem to be advantageous for anchoring purposes. This work studied the bulk physicochemical, mechanical and interconnectivity properties of porous PMMA cements loaded with various amounts of calcium phosphate (CaP). As a measure of bioactivity, changes of PMMA cements under simulated physiological conditions were studied in a calcium phosphate solution for 0, 3, 7, 14, 21 and 28 days. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), micro-computed tomography (μ-CT) and mechanical compression tests were performed to characterize the morphology, crystallographic and chemical composition, interconnectivity and mechanical properties, respectively. SEM allowed observing the result of loading CaP into the porous PMMA, which was corroborated by XRD, FTIR and μ-CT. No interference of the CaP with the PMMA was detected. μ-CT described similar interconnectivity and pore distribution for all CaP percentages. Mechanical properties were not significantly altered by the CaP percentages or the immersion time. Hence, porous PMMA was effectively loaded with CaP, which provided the material with properties for potential osteoconductivity.