In vitro interaction between tetracalcium phosphate-based cement and calvarial osteogenic cells

Biofunctionalization of metallic implants by calcium phosphate coatings

Metallic materials have been extensively applied in clinical practice due to their unique mechanical properties and durability. Recent years have witnessed broad interests and advances on surface functionalization of metallic implants for high-performance biofunctions. Calcium phosphates (CaPs) are the major inorganic component of bone tissues, and thus owning inherent biocompatibility and osseointegration properties. As such, they have been widely used in clinical orthopedics and dentistry. The new emergence of surface functionalization on metallic implants with CaP coatings shows promise for a combination of mechanical properties from metals and various biofunctions from CaPs. This review provides a brief summary of state-of-art of surface biofunctionalization on implantable metals by CaP coatings. We first glance over different types of CaPs with their coating methods and in vitro and in vivo performances, and then give insight into the representative biofunctions, i.e. osteointegration, corrosion resistance and biodegradation control, and antibacterial property, provided by CaP coatings for metallic implant materials.

In Vivo Evaluation of S-Chitosan Enhanced Calcium Phosphate Cements

Calcium phosphate cements (CPC), made from dicalcium phosphate dihydrate and calcium hydroxide and reinforced with water soluble S-chitosan, were investigated in vivo. Cylinders of these cements were prepared and prehardened before implantation into preformed radial defects in rabbits. Histological observations after 1, 4, 14 and 22 weeks, respectively, were performed on thin decalcified sections. No inflammation or other negative response was found in the S-chitosan containing cements (S-CPCs). After 4 weeks, newly formed trabeculae contacted with the implant directly in the lower S-chitosan sample, while a thin layer of fibers had formed between the newly formed bone and the implant in the higher S-chitosan samples. The degradation rates of the S-CPCs were significantly lower than the original CPC cement alone. Most of the S-chitosan cements were still present at the end of the 22 weeks. The implant material and the surrounding infiltrated fluid layer were examined by back scattered scanning electron microscopy and X-ray energy-dispersive spectrometry.

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.

Skeletal repair in rabbits with calcium phosphate cements incorporated phosphorylated chitin

The effects of phosphorylated chitin (P-chitin) on the tissue responses to two kinds of calcium phosphate cements (CPCs) were investigated using experimental rabbits. One of them consisting of monocalcium phosphate monohydrate, calcium oxide, 1 M phosphate buffer (pH: 7.4) and different amounts of P-chitin (CPC-I or P-CPC-I) with relatively neutral initial pH was filled as paste into tibial defects of the rabbits for 1, 4, 12 and 22 weeks. The other kind of cement made from dicacium phosphate dihydrate/calcium hydroxide/1 M Na2HPO4/different amounts of P-chitin (CPC-II or P-CPC-II) with relatively higher initial pH was implanted as prehardened cylinders into the radial defects of the rabbits for the same periods. Pure CPC-I and CPC-II were used as controls. Histological and histomorphological studies were performed on thin un-decalcified and decalcified sections. Three different bone formation types in the resorption lacuna of the P-CPCs were found during this study. The biodegradation rate of the P-CPCs had a negative relationship with the P-chitin content. Most of the low P-chitin-containing samples were bioabsorbed in 16 weeks, while the high P-chitin-containing samples disappeared in 22 weeks. The newly formed bone was identified with back scattered scanning electron microscopy and X-ray energy-dispersive spectrometry. The results show that with P-chitin component in a certain range, the P-CPCs are biocompatible, bioabsorbable and osteoinductive and could be used as promising candidates of bone repair materials.

Bone repair in radii and tibias of rabbits with phosphorylated chitosan reinforced calcium phosphate cements

Biocompatibility of two calcium phosphate cements (CPCs), reinforced with phosphorylated chitosan (P-chitosan), was investigated in rabbits in present study. The two CPCs are monocalcium phosphate monohydrate (MPCM) with calcium oxide (CaO) in 1 M phosphate buffer (i.e. MCPM/CaO/1 M phosphate buffer cement, CPC-I) and dicalcium phosphate dihydrate (DCPD) with calcium hydroxide [Ca(OH)2] in 1 M Na2HPO4 solution (i.e. DCPD/Ca(OH)2/1 M Na2HPO4 cement, CPC-II). Different amount of P-chitosan was added to the liquid phase before the power phase was mixed with the liquid phase. The MCPM/CaO/1 M phosphate buffer/P-chitosan cements (P-CPC-I) with neutral pH were filled into the holey defects of rabbit tibias. While the DCPD/Ca(OH)2/1 M Na2HPO4/P-chitosan cements (P-CPC-II) shaped as prehardened cylinders were implanted into rabbit radial defects. After operation, the two serial groups and CPC-II controls were observed for 1, 4, 12 and 22 weeks, respectively. Histological and histomorphological studies proved that P-chitosan containing cements are biocompatible, bioabsorbable and osteoinductive. The biodegradation rate has a negative relationship with the P-chitosan content. Progressive substitution took place at the interface of implants and host bones. No adverse effects were found in tissues around the bone defects. Thus, they could be used as bone substitutes in clinic.

Evaluation of calcium phosphates and experimental calcium phosphate bone cements using osteogenic cultures

In this study, rat bone marrow cells (RBM) were used to evaluate two biodegradable calcium phosphate bone cements and bioactive calcium phosphate ceramics. The substances investigated were: two novel calcium phosphate cements, Biocement F and Biocement H, tricalcium phosphate (TCP), surface-modified alpha-tricalcium phosphate [TCP (s)] and a rapid resorbable calcium phosphate ceramic consisting of CaKPO(4) (sample code R5). RBM cells were cultured on disc-shaped test substrates for 14 days. The culture medium was changed daily and also examined for calcium, phosphate, and potassium concentrations. Specimens were evaluated using light microscopy, and morphometry of the cell-covered substrate surface, scanning electron microscopy, and energy dispersive X-ray analysis and morphometry of the cell-covered substrate surface. Areas of mineralization were identified by tetracyline labeling. Except for R 5, rat bone-marrow cells attached and grew on all substrate surfaces. Of the different calcium phosphate materials tested, TCP and TCP (s) facilitated osteoblast growth and extracellular matrix elaboration to the highest degree, followed by Biocements H and F. The inhibition of cell growth encountered with R 5 seems to be related to its high phosphate and potassium ion release.

An osteogenic cell culture system to evaluate the cytocompatibility of Osteoset, a calcium sulfate bone void filler

The purpose of the study was to describe a convenient, reliable and quantitative in vitro assay system to assess the cytocompatibility of a calcium sulfate bone filler on two osteogenic cell lines and primary osteoblasts. The hypothesis was that the bone void filler, OsteoSet pellets, would not impact adversely on cell proliferation kinetics or osteogenic potential of selected cells. The hypothesis was tested by standard in vitro methodology of placing OsteoSet pellets either directly in contact with osteogenic cells, or by compartmentalizing within transwell - clear microporous membrane inserts. Data analyses were accomplished with appropriate post hoc statistics (p < or = 0.05). In the presence of the OsteoSet pellets, the cell lines exhibited a decrease in cell proliferation at days 4 and 7, independent of either cell type or tissue culture medium. A decrease in the alkaline phosphatase enzyme activity occurred in the osteogenic cell lines maintained for 9 and 16 days in the presence of the OsteoSet pellets. However, with the exception of the MC3T3E-1 line, no differences were observed with respect to calcium deposition (mineralization) by day 16. Intact human osteocalcin release data for the human-derived OPC1 line and the primary osteoblasts was inconclusive as the OsteoSet pellets may interact with the osteocalcin secreted into the tissue culture medium. The present studies describe a cell culture system to assess the cytocompatibility of bone-graft substitutes with osteogenic cells by compartmentalizing material from direct cell contact (in transwells), and additionally, by evaluating direct cell/biomaterial interactions.

The effects of calcium phosphate cement particles on osteoblast functions

Calcium phosphate cements (CPC) are increasingly used in the orthopedic field. This kind of cement has potential applications in bone defect replacements, osteosynthetic screw reinforcements or drug delivery. In vivo studies have demonstrated a good osteointegration of CPC. However, it was also observed that the resorption of CPC could create particles. It is known from orthopedic implant studies that particles can be responsible for the peri-implant osteolysis. Biocompatibility assessment of CPC should then be performed with particles. In this study, we quantified the functions of osteoblasts in the presence of beta-TCP, brushite and cement particles. Two particle sizes were prepared. The first one corresponded to the critical diameter range 1-10 microm and the second one had a diameter larger than 10 microm. We found that CPC particles could adversely affect the osteoblast functions. A decrease in viability, proliferation and production of extracellular matrix was measured. A dose effect was also observed. A ratio of 50 CPC particles per osteoblast could be considered as the maximum number of particles supported by an osteoblast. The smaller particles had stronger negative effects on osteoblast functions than the larger ones. Future CPC development should minimize the generation of particles smaller than 10 microm.

Osteotransductive bone cements

Calcium phosphate bone cements (CPBCs) are osteotransductive, i.e. after implantation in bone they are transformed into new bone tissue. Furthermore, due to the fact that they are mouldable, their osteointegration is immediate. Their chemistry has been established previously. Some CPBCs contain amorphous calcium phosphate (ACP) and set by a sol-gel transition. The others are crystalline and can give as the reaction product dicalcium phosphate dihydrate (DCPD), calcium-deficient hydroxyapatite (CDHA), carbonated apatite (CA) or hydroxyapatite (HA). Mixed-type gypsum-DCPD cements are also described. In vivo rates of osteotransduction vary as follows: gypsum-DCPD > DCPD > CDHA approximately CA > HA. The osteotransduction of CDHA-type cements may be increased by adding dicalcium phosphate anhydrous (DCP) and/or CaCO3 to the cement powder. CPBCs can be used for healing of bone defects, bone augmentation and bone reconstruction. Incorporation of drugs like antibiotics and bone morphogenetic protein is envisaged. Load-bearing applications are allowed for CHDA-type, CA-type and HA-type CPBCs as they have a higher compressive strength than human trabecular bone (10 MPa).