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Sarkar K. Research progress on biodegradable magnesium phosphate ceramics in orthopaedic applications. J Mater Chem B 2024. [PMID: 39140212 DOI: 10.1039/d4tb01123f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
To overcome critical size bone defects, calcium phosphate (CaP)-based ceramics have been widely explored. The compositional similarity with bone matrix and degradability are the main reasons for their selection in orthopaedic biomaterials. However, the low solubility rate under in vivo conditions raises concerns about these CaP groups, particularly hydroxyapatite (HA) and tricalcium phosphate (TCP) ceramics. Therefore, reliable and suitable degradable ceramics for bone defect repair are always an important research direction for researchers. The magnesium phosphate (MgP) group of bioceramics has been studied for orthopaedic applications and is comparatively new compared to traditional CaP ceramics. The role of magnesium in different biochemical processes, such as DNA stabilization, bone density maintenance, regulating Ca and Na ion channels, and cell proliferation and differentiation enhancement, is a key parameter for the development of MgP bioceramics. This article aims to give a comprehensive review of MgP ceramics in bone tissue engineering. Here, we have highlighted several preparation techniques, the existence of porosity, and the impact of metal ion doping on MgP bioceramics. Finally, in vitro and in vivo responses of MgP bioceramics in bone formation are discussed.
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Affiliation(s)
- Kaushik Sarkar
- Department of Ceramic Engineering, Indian Institute of Technology (BHU), Varanasi 221005, India.
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2
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Steinacker VC, Weichhold J, Renner T, Gubik S, Vollmer A, Breitenbücher N, Fuchs A, Straub A, Hartmann S, Kübler AC, Gbureck U. Biological and mechanical performance of calcium phosphate cements modified with phytic acid. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:36. [PMID: 38900219 PMCID: PMC11189980 DOI: 10.1007/s10856-024-06805-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
Calcium phosphate cements, primarily brushite cements, require the addition of setting retarders to ensure adequate processing time and processability. So far, citric acid has been the primary setting retarder used in this context. Due to the poor biocompatibility, it is crucial to explore alternative options for better processing. In recent years, the setting retarder phytic acid (IP6) has been increasingly investigated. This study investigates the biological behaviour of calcium phosphate cements with varying concentrations of IP6, in addition to their physical properties. Therefore cytocompatibility in vitro testing was performed using osteoblastic (MG-63) and osteoclastic (RAW 264.7 differentiated with RANKL) cells. We could demonstrate that the physical properties like the compressive strength of specimens formed with IP6 (brushite_IP6_5 = 11.2 MPa) were improved compared to the reference (brushite = 9.8 MPa). In osteoblast and osteoclast assays, IP6 exhibited significantly better cytocompatibility in terms of cell activity and cell number for brushite cements up to 11 times compared to the brushite reference. In contrast, the calcium-deficient hydroxyapatite (CDHA) cements produced similar results for IP6 (CDHA_IP6_0.25 = 27.0 MPa) when compared to their reference (CDHA = 21.2 MPa). Interestingly, lower doses of IP6 were found to be more effective than higher doses with up to 3 times higher. Additionally, IP6 significantly increased degradation in both passive and active resorption. For these reasons, IP6 is emerging as a strong new competitor to established setting retarders such as citric acid. These cements have potential applications in bone augmentation, the stabilisation of non-load bearing fractures (craniofacial), or the cementation of metal implants.
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Affiliation(s)
- Valentin C Steinacker
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - Jan Weichhold
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Tobias Renner
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Sebastian Gubik
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Andreas Vollmer
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Niko Breitenbücher
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Andreas Fuchs
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Anton Straub
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Stefan Hartmann
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Alexander C Kübler
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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Rath P, Mandal S, Das P, Sahoo SN, Mandal S, Ghosh D, Nandi SK, Roy M. Effects of the multiscale porosity of decellularized platelet-rich fibrin-loaded zinc-doped magnesium phosphate scaffolds in bone regeneration. J Mater Chem B 2024; 12:5869-5883. [PMID: 38775079 DOI: 10.1039/d3tb02981f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
In recent years, metallic ion-doped magnesium phosphate (MgP)-based degradable bioceramics have emerged as alternative bone substitute materials owing to their excellent biocompatibility, bone-forming ability, bioactivity, and controlled degradability. Conversely, incorporating a biomolecule such as decellularized platelet-rich fibrin (d-PRF) on scaffolds has certain advantages for bone tissue regeneration, particularly in enhanced osteogenesis and angiogenesis. The present study focuses on the impact of d-PRF-loaded multiscale porous zinc-doped magnesium phosphate (Zn-MgP) scaffolds on biodegradability, biocompatibility, and bone regeneration. Scaffolds were fabricated through the powder-metallurgy route utilizing naphthalene as a porogen (porosity = 5-43%). With the inclusion of a higher porogen, a higher fraction of macro-porosity (>20 μm) and pore interconnectivity were observed. X-ray diffraction (XRD) studies confirmed the formation of the farringtonite phase. The developed scaffolds exhibited a minimum ultimate compressive strength (UCS) of 8.5 MPa (for 40 Naph), which lies within the range of UCS of the cancellous bone of humans (2-12 MPa). The in vitro assessment via immersion in physiological fluid yielded a higher deposition of the calcium phosphate (CaP) compound in response to increased macro-porosity and interconnectivity (40 Naph). Cytocompatibility assessed using MC3T3-E1 cells showed that the incorporation of d-PRF coupled with increased porosity resulted the highest cell attachment, proliferation, and viability. For further evaluation, the developed scaffolds were implanted in in vivo rabbit femur condylar defects. Radiography, SEM, OTC labelling, and histology analysis after 2 months of implantation revealed the better invasion of mature osteoblastic cells into the scaffolds with enhanced angiogenesis and superior and accelerated healing of bone defects in d-PRF-incorporated higher porosity scaffolds (40 Naph). Finally, it is hypothesized that the combination of d-PRF incorporation with multiscale porosity and increased interconnectivity facilitated better bone-forming ability, good biocompatibility, and controlled degradability within and around the Zn-doped MgP scaffolds.
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Affiliation(s)
- Pritish Rath
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India.
| | - Santanu Mandal
- School of Minerals, Metallurgical and Materials Engineering, Indian Institute of Technology Bhubaneswar, Argul, 752050, India
| | - Pratik Das
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India.
| | - Satyabrata Nigamananda Sahoo
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology - Kharagpur, Kharagpur, 721302, India.
| | - Samiran Mandal
- Department of Veterinary Pathology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India
| | - Debaki Ghosh
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India.
| | - Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India.
| | - Mangal Roy
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology - Kharagpur, Kharagpur, 721302, India.
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Martínková M, Zárybnická L, Viani A, Killinger M, Mácová P, Sedláček T, Oralová V, Klepárník K, Humpolíček P. Polyetheretherketone bioactivity induced by farringtonite. Sci Rep 2024; 14:12186. [PMID: 38806564 PMCID: PMC11133311 DOI: 10.1038/s41598-024-61941-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/12/2024] [Indexed: 05/30/2024] Open
Abstract
Polyetheretherketone (PEEK) is considered as an excellent biomaterial for bone grafting and connective tissue replacement. The clinical potential is, however, limited by its bioinertness, poor osteoconduction, and weak antibacterial activity. These disadvantages can be overcome by introducing suitable additives to produce mineral-polymer composites or coatings. In this work, a PEEK-based bioactive composite has been obtained by blending the polymer with magnesium phosphate (Mg3(PO4)2) particles in amounts ranging from 1 to 10 wt.% using the hot press technique. The obtained composite exhibited improved mechanical and physical properties, above the lower limits set for bone engineering applications. The tested grafts were found to not induce cytotoxicity. The presence of magnesium phosphate induced the mineralisation process with no adverse effects on the expression of the marker crucial for osteoblastic differentiation. The most promising results were observed in the grafts containing 1 wt.% of magnesium phosphate embedded within the PEEK matrix. The improved bioactivity of grafts, together with suitable physical-chemical and mechanical properties, indicate this composite as a promising orthopaedic implant material.
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Affiliation(s)
- Martina Martínková
- Centre of Polymer Systems, Tomas Bata University in Zlín, tř. Tomáše Bati 5678, 760 01, Zlín, Czech Republic
| | - Lucie Zárybnická
- Institute of Theoretical and Applied Mechanics of the Czech Academy of Sciences, Centre Telč, Prosecká 809/76, 190 00, Praha 9, Czech Republic.
| | - Alberto Viani
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Modena e Reggio Emilia, Via Campi, 103, 41125, Modena, Italy
| | - Michael Killinger
- Department of Bioanalytical Instrumentation, Institute of Analytical Chemistry, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Petra Mácová
- Institute of Theoretical and Applied Mechanics of the Czech Academy of Sciences, Centre Telč, Prosecká 809/76, 190 00, Praha 9, Czech Republic
| | - Tomáš Sedláček
- Centre of Polymer Systems, Tomas Bata University in Zlín, tř. Tomáše Bati 5678, 760 01, Zlín, Czech Republic
| | - Veronika Oralová
- Laboratory of Odontogenesis and Osteogenesis, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Karel Klepárník
- Department of Bioanalytical Instrumentation, Institute of Analytical Chemistry, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Petr Humpolíček
- Centre of Polymer Systems, Tomas Bata University in Zlín, tř. Tomáše Bati 5678, 760 01, Zlín, Czech Republic.
- Faculty of Technology, Tomas Bata University in Zlín, Vavrečkova 5669, 760 01, Zlín, Czech Republic.
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Kim JY, Kumar SB, Park CH, Kim CS. Development of cell-laden photopolymerized constructs with bioactive amorphous calcium magnesium phosphate for bone tissue regeneration via 3D bioprinting. Int J Biol Macromol 2024; 267:131412. [PMID: 38593894 DOI: 10.1016/j.ijbiomac.2024.131412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 04/11/2024]
Abstract
The synthesis of ideal bioceramics to guide the fate of cells and subsequent bone regeneration within the chemical, biological, and physical microenvironment is a challenging long-term task. This study developed amorphous calcium magnesium phosphate (ACMP) bioceramics via a simple co-precipitation method. The role of Mg2+ in the formation of ACMP is investigated using physicochemical and biological characterization at different Ca/Mg molar ratio of the initial reaction solution. Additionally, ACMP bioceramics show superior cytocompatibility and improved osteogenic differentiation of co-cultured MC3T3-E1 cells. Regulation of the microenvironment with Mg2+ can promote early-stage bone regeneration. For this, bioprinting technology is employed to prepare ACMP-modified 3D porous structures. Our hypothesis is that the incorporation of ACMP into methacrylated gelatin (GelMA) bioink can trigger the osteogenic differentiation of encapsulated preosteoblast and stimulate bone regeneration. The cell-laden ACMP composite structures display stable printability and superior cell viability and cell proliferation. Also, constructs loading the appropriate amount of ACMP bioceramic showed significant osteogenic differentiation activity compared to the pure GelMA. We demonstrate that the dissolved Mg2+ cation microenvironment in ACMP-modified composite constructs plays an effective biochemical role, and can regulate cell fate. Our results predict that GelMA/ACMP bioink has significant potential in patient-specific bone tissue regeneration.
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Affiliation(s)
- Ju Yeon Kim
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea; Department of Bionanotechnology and Bioconvergence Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea
| | - Shrestha Bishnu Kumar
- Department of Chemical, Biological, and Bioengineering, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Chan Hee Park
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea; Department of Bionanotechnology and Bioconvergence Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea; Department of Mechanical Design Engineering, Jeonbuk National University, Jeonju 561-756, Republic of Korea.
| | - Cheol Sang Kim
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea; Department of Bionanotechnology and Bioconvergence Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, Republic of Korea; Department of Mechanical Design Engineering, Jeonbuk National University, Jeonju 561-756, Republic of Korea.
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Schröter L, Kaiser F, Küppers O, Stein S, Krüger B, Wohlfahrt P, Geroneit I, Stahlhut P, Gbureck U, Ignatius A. Improving bone defect healing using magnesium phosphate granules with tailored degradation characteristics. Dent Mater 2024; 40:508-519. [PMID: 38199893 DOI: 10.1016/j.dental.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES Dental implant placement frequently requires preceding bone augmentation, for example, with hydroxyapatite (HA) or β-tricalcium phosphate (β-TCP) granules. However, HA is degraded very slowly in vivo and for β-TCP inconsistent degradation profiles from too rapid to rather slow are reported. To shorten the healing time before implant placement, rapidly resorbing synthetic materials are of great interest. In this study, we investigated the potential of magnesium phosphates in granular form as bone replacement materials. METHODS Spherical granules of four different materials were prepared via an emulsion process and investigated in trabecular bone defects in sheep: struvite (MgNH4PO4·6H2O), K-struvite (MgKPO4·6H2O), farringtonite (Mg3(PO4)2) and β-TCP. RESULTS All materials except K-struvite exhibited promising support of bone regeneration, biomechanical properties and degradation. Struvite and β-TCP granules degraded at a similar rate, with a relative granules area of 29% and 30% of the defect area 4 months after implantation, respectively, whereas 18% was found for farringtonite. Only the K-struvite granules degraded too rapidly, with a relative granules area of 2% remaining, resulting in initial fibrous tissue formation and intermediate impairment of biomechanical properties. SIGNIFICANCE We demonstrated that the magnesium phosphates struvite and farringtonite have a comparable or even improved degradation behavior in vivo compared to β-TCP. This emphasizes that magnesium phosphates may be a promising alternative to established calcium phosphate bone substitute materials.
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Affiliation(s)
- Lena Schröter
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Oliver Küppers
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Svenja Stein
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Benjamin Krüger
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Philipp Wohlfahrt
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Isabel Geroneit
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Philipp Stahlhut
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany.
| | - Anita Ignatius
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
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Zhao Q, Ni Y, Wei H, Duan Y, Chen J, Xiao Q, Gao J, Yu Y, Cui Y, Ouyang S, Miron RJ, Zhang Y, Wu C. Ion incorporation into bone grafting materials. Periodontol 2000 2024; 94:213-230. [PMID: 37823468 DOI: 10.1111/prd.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
The use of biomaterials in regenerative medicine has expanded to treat various disorders caused by trauma or disease in orthopedics and dentistry. However, the treatment of large and complex bone defects presents a challenge, leading to a pressing need for optimized biomaterials for bone repair. Recent advances in chemical sciences have enabled the incorporation of therapeutic ions into bone grafts to enhance their performance. These ions, such as strontium (for bone regeneration/osteoporosis), copper (for angiogenesis), boron (for bone growth), iron (for chemotaxis), cobalt (for B12 synthesis), lithium (for osteogenesis/cementogenesis), silver (for antibacterial resistance), and magnesium (for bone and cartilage regeneration), among others (e.g., zinc, sodium, and silica), have been studied extensively. This review aims to provide a comprehensive overview of current knowledge and recent developments in ion incorporation into biomaterials for bone and periodontal tissue repair. It also discusses recently developed biomaterials from a basic design and clinical application perspective. Additionally, the review highlights the importance of precise ion introduction into biomaterials to address existing limitations and challenges in combination therapies. Future prospects and opportunities for the development and optimization of biomaterials for bone tissue engineering are emphasized.
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Affiliation(s)
- Qin Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yueqi Ni
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Hongjiang Wei
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yiling Duan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Jingqiu Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Qi Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Jie Gao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yiqian Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Yu Cui
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Simin Ouyang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
- School of Medicine, Medical Research Institute, Wuhan University, Wuhan, China
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China
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8
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Schröter L, Kaiser F, Preißler AL, Wohlfahrt P, Küppers O, Gbureck U, Ignatius A. Ready-To-Use and Rapidly Biodegradable Magnesium Phosphate Bone Cement: In Vivo Evaluation in Sheep. Adv Healthc Mater 2023; 12:e2300914. [PMID: 37224104 DOI: 10.1002/adhm.202300914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Indexed: 05/26/2023]
Abstract
In clinical practice, hydroxyapatite (HA) cements for bone defect treatment are frequently prepared by mixing a powder component and a liquid component shortly before implantation in the operation theater, which is time-consuming and error-prone. In addition, HA cements are only slightly resorbed, that is, cement residues can still be found in the bone years after implantation. Here, these challenges are addressed by a prefabricated magnesium phosphate cement paste based on glycerol, which is ready-to-use and can be directly applied during surgery. By using a trimodal particle size distribution (PSD), the paste is readily injectable and exhibits a compressive strength of 9-14 MPa after setting. Struvite (MgNH4 PO4 ·6H2 O), dittmarite (MgNH4 PO4 ·H2 O), farringtonite (Mg3 (PO4 )2 ), and newberyite (MgHPO4 ·3H2 O) are the mineral phases present in the set cement. The paste developed here features a promising degradation of 37% after four months in an ovine implantation model, with 25% of the implant area being newly formed bone. It is concluded that the novel prefabricated paste improves application during surgery, has a suitable degradation rate, and supports bone regeneration.
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Affiliation(s)
- Lena Schröter
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
| | - Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Anna-Lena Preißler
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Philipp Wohlfahrt
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Oliver Küppers
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070, Würzburg, Germany
| | - Anita Ignatius
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081, Ulm, Germany
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Liu J, Hou W, Wei W, Peng J, Wu X, Lian C, Zhao Y, Tu R, Goto T, Dai H. Design and fabrication of high-performance injectable self-setting trimagnesium phosphate. Bioact Mater 2023; 28:348-357. [PMID: 37334067 PMCID: PMC10276258 DOI: 10.1016/j.bioactmat.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
Magnesium phosphate bone cement has become a widely used orthopedic implant due to the advantages of fast-setting and high early strength. However, developing magnesium phosphate cement possessing applicable injectability, high strength, and biocompatibility simultaneously remains a significant challenge. Herein, we propose a strategy to develop high-performance bone cement and establish a trimagnesium phosphate cement (TMPC) system. The TMPC exhibits high early strength, low curing temperature, neutral pH, and excellent injectability, overcoming the critical limitations of recently studied magnesium phosphate cement. By monitoring the hydration pH value and electroconductivity, we demonstrate that the magnesium-to-phosphate ratio could manipulate the components of hydration products and their transformation by adjusting the pH of the system, which will influence the hydration speed. Further, the ratio could regulate the hydration network and the properties of TMPC. Moreover, in vitro studies show that TMPC has outstanding biocompatibility and bone-filling capacity. The facile preparation properties and these advantages of TMPC render it a potential clinical alternative to polymethylmethacrylate and calcium phosphate bone cement. This study will contribute to the rational design of high-performance bone cement.
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Affiliation(s)
- Jiawei Liu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Wen Hou
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Wenying Wei
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Jian Peng
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Xiaopei Wu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Chenxi Lian
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Yanan Zhao
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
| | - Rong Tu
- Chaozhou Branch of Chemistry and Chemical Engineering Guangdong Laboratory, Chaozhou 521000, China
| | - Takashi Goto
- New Industry Creation Hatchery Center, Tohoku University, Sendai 980-8579, Japan
| | - Honglian Dai
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan 430070, China
- Chaozhou Branch of Chemistry and Chemical Engineering Guangdong Laboratory, Chaozhou 521000, China
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Hoelscher-Doht S, Heilig M, von Hertzberg-Boelch SP, Jordan MC, Gbureck U, Meffert RH, Heilig P. Experimental magnesium phosphate cement paste increases torque of trochanteric fixation nail advanced™ blades in human femoral heads. Clin Biomech (Bristol, Avon) 2023; 109:106088. [PMID: 37660575 DOI: 10.1016/j.clinbiomech.2023.106088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The use of polymethylmethacrylate cement for in-situ implant augmentation has considerable disadvantages: it is potentially cytotoxic, exothermic and non-degradable. Therefore, the primary aim of this study was to develop a magnesium phosphate cement which meets the requirements for in-situ implant augmentation as an alternative. Secondly, this experimental cement was compared to commercial bone cements in a biomechanical test set-up using augmented femoral head blades. METHODS A total of 40 human femoral heads were obtained from patients who underwent total hip arthroplasty. After bone mineral density was quantified, specimens were assigned to four treatment groups. A blade of the Trochanteric Fixation Nail Advanced™ was inserted into each specimen and augmented with either Traumacem™ V+, Paste-CPC, the experimental magnesium phosphate cement or no cement. A rotational load-to-failure-test (0° to 90°) was performed. FINDINGS A conventional two-component magnesium phosphate cement failed in-situ implant augmentation consistently due to filter pressing. Only a glycerol-based magnesium phosphate paste was suitable for the augmentation of femoral head blades. While the blades augmented with Traumacem™ V+ yielded the highest maximum torque overall (22.1 Nm), the blades augmented with Paste-CPC and the magnesium phosphate paste also showed higher maximum torque values (15.8 and 12.8 Nm) than the control group (10.8 Nm). INTERPRETATION This study shows for the first time the development of a degradable magnesium phosphate cement paste which fulfills the requirements for in-situ implant augmentation. Simultaneously, a 48% increase in stability is demonstrated for a scenario where implant anchorage is difficult in osteoporotic bone.
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Affiliation(s)
- Stefanie Hoelscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberdürrbacherstraße 6, 97080 Wuerzburg, Germany
| | - Maximilian Heilig
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberdürrbacherstraße 6, 97080 Wuerzburg, Germany
| | | | - Martin Cornelius Jordan
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberdürrbacherstraße 6, 97080 Wuerzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070, Wuerzburg, Germany
| | - Rainer Heribert Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberdürrbacherstraße 6, 97080 Wuerzburg, Germany
| | - Philipp Heilig
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberdürrbacherstraße 6, 97080 Wuerzburg, Germany.
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11
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Gupta T, Ghosh SB, Bandyopadhyay-Ghosh S, Sain M. Is it possible to 3D bioprint load-bearing bone implants? A critical review. Biofabrication 2023; 15:042003. [PMID: 37669643 DOI: 10.1088/1758-5090/acf6e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/05/2023] [Indexed: 09/07/2023]
Abstract
Rehabilitative capabilities of any tissue engineered scaffold rely primarily on the triad of (i) biomechanical properties such as mechanical properties and architecture, (ii) chemical behavior such as regulation of cytokine expression, and (iii) cellular response modulation (including their recruitment and differentiation). The closer the implant can mimic the native tissue, the better it can rehabilitate the damage therein. Among the available fabrication techniques, only 3D bioprinting (3DBP) can satisfactorily replicate the inherent heterogeneity of the host tissue. However, 3DBP scaffolds typically suffer from poor mechanical properties, thereby, driving the increased research interest in development of load-bearing 3DBP orthopedic scaffolds in recent years. Typically, these scaffolds involve multi-material 3D printing, comprising of at-least one bioink and a load-bearing ink; such that mechanical and biological requirements of the biomaterials are decoupled. Ensuring high cellular survivability and good mechanical properties are of key concerns in all these studies. 3DBP of such scaffolds is in early developmental stages, and research data from only a handful of preliminary animal studies are available, owing to limitations in print-capabilities and restrictive materials library. This article presents a topically focused review of the state-of-the-art, while highlighting aspects like available 3DBP techniques; biomaterials' printability; mechanical and degradation behavior; and their overall bone-tissue rehabilitative efficacy. This collection amalgamates and critically analyses the research aimed at 3DBP of load-bearing scaffolds for fulfilling demands of personalized-medicine. We highlight the recent-advances in 3DBP techniques employing thermoplastics and phosphate-cements for load-bearing applications. Finally, we provide an outlook for possible future perspectives of 3DBP for load-bearing orthopedic applications. Overall, the article creates ample foundation for future research, as it gathers the latest and ongoing research that scientists could utilize.
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Affiliation(s)
- Tanmay Gupta
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Subrata Bandhu Ghosh
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Sanchita Bandyopadhyay-Ghosh
- Engineered Biomedical Materials Research and Innovation Centre (EnBioMatRIC), Department of Mechanical Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Mohini Sain
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
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12
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Kaiser F, Schröter L, Wohlfahrt P, Geroneit I, Murek J, Stahlhut P, Weichhold J, Ignatius A, Gbureck U. Exploring the potential of magnesium oxychloride, an amorphous magnesium phosphate, and newberyite as possible bone cement candidates. J Biomater Appl 2023; 38:438-454. [PMID: 37525613 PMCID: PMC10494481 DOI: 10.1177/08853282231190908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Magnesium phosphate-based bone cements, particularly struvite (MgNH4PO4∙6H2O)-forming cements, have attracted increased scientific interest in recent years because they exhibit similar biocompatibility to hydroxyapatite while degrading much more rapidly in vivo. However, other magnesium-based minerals which might be promising are, to date, little studied. Therefore, in this study, we investigated three magnesium-based bone cements: a magnesium oxychloride cement (Mg3(OH)5Cl∙4H2O), an amorphous magnesium phosphate cement based on Mg3(PO4)2, MgO, and NaH2PO4, and a newberyite cement (MgHPO4·3H2O). Because it is not sufficiently clear from the literature to what extent these cements are suitable for clinical use, all of them were characterized and optimized regarding setting time, setting temperature, compressive strength and passive degradation in phosphate-buffered saline. Because the in vitro properties of the newberyite cement were most promising, it was orthotopically implanted into a partially weight-bearing tibial bone defect in sheep. The cement exhibited excellent biocompatibility and degraded more rapidly compared to a hydroxyapatite reference cement; after 4 months, 18% of the cement was degraded. We conclude that the newberyite cement was the most promising candidate of the investigated cements and has clear advantages over calcium phosphate cements, especially in terms of setting time and degradation behavior.
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Affiliation(s)
- Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Lena Schröter
- Institute of Orthopedic Research and Biomechanics, Ulm University Medical Center, Ulm, Germany
| | - Philipp Wohlfahrt
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Isabel Geroneit
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Jérôme Murek
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Philipp Stahlhut
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Jan Weichhold
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Ulm University Medical Center, Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Würzburg, Germany
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13
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Gelli R, Ridi F. An Overview of Magnesium-Phosphate-Based Cements as Bone Repair Materials. J Funct Biomater 2023; 14:424. [PMID: 37623668 PMCID: PMC10455751 DOI: 10.3390/jfb14080424] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
In the search for effective biomaterials for bone repair, magnesium phosphate cements (MPCs) are nowadays gaining importance as bone void fillers thanks to their many attractive features that overcome some of the limitations of the well-investigated calcium-phosphate-based cements. The goal of this review was to highlight the main properties and applications of MPCs in the orthopedic field, focusing on the different types of formulations that have been described in the literature, their main features, and the in vivo and in vitro response towards them. The presented results will be useful to showcase the potential of MPCs in the orthopedic field and will suggest novel strategies to further boost their clinical application.
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Affiliation(s)
| | - Francesca Ridi
- Department of Chemistry “Ugo Schiff” and CSGI Consortium, University of Florence, Via della Lastruccia 3, 50019 Sesto Fiorentino, Italy;
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14
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Renner T, Otto P, Kübler AC, Hölscher-Doht S, Gbureck U. Novel adhesive mineral-organic bone cements based on phosphoserine and magnesium phosphates or oxides. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:14. [PMID: 36964421 PMCID: PMC10038963 DOI: 10.1007/s10856-023-06714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/15/2023] [Indexed: 05/03/2023]
Abstract
Present surgical situations require a bone adhesive which has not yet been developed for use in clinical applications. Recently, phosphoserine modified cements (PMC) based on mixtures of o-phosphoserine (OPLS) and calcium phosphates, such as tetracalcium phosphate (TTCP) or α-tricalcium phosphate (α-TCP) as well as chelate setting magnesium phosphate cements have gained increasing popularity for their use as mineral bone adhesives. Here, we investigated new mineral-organic bone cements based on phosphoserine and magnesium phosphates or oxides, which possess excellent adhesive properties. These were analyzed by X-ray diffraction, Fourier infrared spectroscopy and electron microscopy and subjected to mechanical tests to determine the bond strength to bone after ageing at physiological conditions. The novel biomineral adhesives demonstrate excellent bond strength to bone with approximately 6.6-7.3 MPa under shear load. The adhesives are also promising due to their cohesive failure pattern and ductile character. In this context, the new adhesive cements are superior to currently prevailing bone adhesives. Future efforts on bone adhesives made from phosphoserine and Mg2+ appear to be very worthwhile.
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Affiliation(s)
- Tobias Renner
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Paul Otto
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Alexander C Kübler
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Stefanie Hölscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Würzburg, Oberdürrbacherstraße 6, 97080, Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
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15
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Calcium phosphate bone cements as local drug delivery systems for bone cancer treatment. BIOMATERIALS ADVANCES 2023; 148:213367. [PMID: 36921461 DOI: 10.1016/j.bioadv.2023.213367] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/18/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
Bone cancer is usually a metastatic disease, affecting people of all ages. Its effective therapy requires a targeted drug administration locally at the cancer site so that the surrounding healthy organs and tissues stay unharmed. Upon a thorough literature search, a tremendous number of published articles are reporting on development of calcium phosphate cements (CPCs) for the treatment of a variety of diseases, such as osteoporosis, osteoarthritis, osteomyelitis, and other musculoskeletal disorders. However, just a limited number of research employs CPCs specifically for bone cancer treatment. In this review article, we study the factors influencing the local drug release from CPCs and particularly focus on bone cancer therapy. Finally, we locate the deficiencies in the literature regarding this specific topic and propose which other perspectives should be considered and discussed in future articles.
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16
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Biodegradable Cements for Bone Regeneration. J Funct Biomater 2023; 14:jfb14030134. [PMID: 36976058 PMCID: PMC10056236 DOI: 10.3390/jfb14030134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Bone cements such as polymethyl methacrylate and calcium phosphates have been widely used for the reconstruction of bone. Despite their remarkable clinical success, the low degradation rate of these materials hampers a broader clinical use. Matching the degradation rate of the materials with neo bone formation remains a challenge for bone-repairing materials. Moreover, questions such as the mechanism of degradation and how the composition of the materials contribute to the degradation property remain unanswered. Therefore, the review provides an overview of currently used biodegradable bone cements such as calcium phosphates (CaP), calcium sulfates and organic-inorganic composites. The possible degradation mechanism and clinical performance of the biodegradable cements are summarized. This paper reviews up-to-date research and applications of biodegradable cements, hoping to provide researchers in the field with inspirations and references.
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17
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Chen H, Shen M, Shen J, Li Y, Wang R, Ye M, Li J, Zhong C, Bao Z, Yang X, Li X, Gou Z, Xu S. A new injectable quick hardening anti-collapse bone cement allows for improving biodegradation and bone repair. BIOMATERIALS ADVANCES 2022; 141:213098. [PMID: 36063576 DOI: 10.1016/j.bioadv.2022.213098] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/26/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The development of injectable cement-like biomaterials via a minimally invasive approach has always attracted considerable clinical interest for modern bone regeneration and repair. Although α-tricalcium phosphate (α-TCP) powders may readily react with water to form hydraulic calcium-deficient hydroxyapatite (CDHA) cement, its long setting time, poor anti-collapse properties, and low biodegradability are suboptimal for a variety of clinical applications. This study aimed to develop new injectable α-TCP-based bone cements via strontium doping, α-calcium sulfate hemihydrate (CSH) addition and liquid phase optimization. A combination of citric acid and chitosan was identified to facilitate the injectable and anti-washout properties, enabling higher resistance to structure collapse. Furthermore, CSH addition (5 %-15 %) was favorable for shortening the setting time (5-20 min) and maintaining the compressive strength (10-14 MPa) during incubation in an aqueous buffer medium. These α-TCP-based composites could also accelerate the biodegradation rate and new bone regeneration in rabbit lateral femoral bone defect models in vivo. Our studies demonstrate that foreign ion doping, secondary phase addition and liquid medium optimization could synergistically improve the physicochemical properties and biological performance of α-TCP-based bone cements, which will be promising biomaterials for repairing bone defects in situations of trauma and diseased bone.
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Affiliation(s)
- Huaizhi Chen
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Miaoda Shen
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Jian Shen
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Yifan Li
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Ruo Wang
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Meihan Ye
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Jiafeng Li
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Cheng Zhong
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Zhaonan Bao
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Xigong Li
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China.
| | - Sanzhong Xu
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China.
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18
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Kowalewicz K, Waselau AC, Feichtner F, Schmitt AM, Brückner M, Vorndran E, Meyer-Lindenberg A. Comparison of degradation behavior and osseointegration of 3D powder-printed calcium magnesium phosphate cement scaffolds with alkaline or acid post-treatment. Front Bioeng Biotechnol 2022; 10:998254. [PMID: 36246367 PMCID: PMC9554004 DOI: 10.3389/fbioe.2022.998254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Due to the positive effects of magnesium substitution on the mechanical properties and the degradation rate of the clinically well-established calcium phosphate cements (CPCs), calcium magnesium phosphate cements (CMPCs) are increasingly being researched as bone substitutes. A post-treatment alters the materials’ physical properties and chemical composition, reinforcing the structure and modifying the degradation rate. By alkaline post-treatment with diammonium hydrogen phosphate (DAHP, (NH4)2HPO4), the precipitation product struvite is formed, while post-treatment with an acidic phosphate solution [e.g., phosphoric acid (PA, H3PO4)] results in precipitation of newberyite and brushite. However, little research has yet been conducted on newberyite as a bone substitute and PA post-treatment of CMPCs has not been described in the accessible literature so far. Therefore, in the present study, the influence of an alkaline (DAHP) or acid (PA) post-treatment on the biocompatibility, degradation behavior, and osseointegration of cylindrical scaffolds (h = 5.1 mm, Ø = 4.2 mm) produced from the ceramic cement powder Ca0.75Mg2.25(PO4)2 by the advantageous manufacturing technique of three-dimensional (3D) powder printing was investigated in vivo. Scaffolds of the material groups Mg225d (DAHP post-treatment) and Mg225p (PA post-treatment) were implanted into the cancellous part of the lateral femoral condyles in rabbits. They were evaluated up to 24 weeks by regular clinical, X-ray, micro-computed tomographic (µCT), and histological examinations as well as scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) analysis and compared with tricalcium phosphate (TCP). All materials showed excellent biocompatibility and rapid osseointegration. While TCP degraded only slightly, the CMPCs showed almost complete degradation. Mg225d demonstrated significantly faster loss of form and demarcability from surrounding bone, scaffold volume reduction, and significantly greater degradation on the side towards the bone marrow than to the cortex than Mg225p. Simultaneously, numerous bone trabeculae have grown into the implantation site. While these were mostly located on the side towards the cortex in Mg225d, they were more evenly distributed in Mg225p and showed almost the same structural characteristics as physiological bone after 24 weeks in Mg225p. Based on these results, the acid post-treated 3D powder-printed Mg225p is a promising degradable bone substitute that should be further investigated.
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Affiliation(s)
- Katharina Kowalewicz
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Anja-Christina Waselau
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Franziska Feichtner
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Anna-Maria Schmitt
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Manuel Brückner
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Elke Vorndran
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Würzburg, Germany
| | - Andrea Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University of Munich, Munich, Germany
- *Correspondence: Andrea Meyer-Lindenberg,
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19
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Kaiser F, Schröter L, Stein S, Krüger B, Weichhold J, Stahlhut P, Ignatius A, Gbureck U. Accelerated bone regeneration through rational design of magnesium phosphate cements. Acta Biomater 2022; 145:358-371. [PMID: 35443213 DOI: 10.1016/j.actbio.2022.04.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 12/17/2022]
Abstract
Results of several studies during past years suggested that magnesium phosphate cements (MPCs) not only show excellent biocompatibility and osteoconductivity, but they also provide improved regeneration capacity due to higher solubility compared to calcium phosphates. These findings also highlighted that chemical similarity of bone substitutes to the natural bone tissue is not a determinant factor in the success of regenerative strategies. The aim of this study was to further improve the degradation speed of MPCs for a fast bone ingrowth within a few months. We confirmed our hypothesis, that decreasing the powder-liquid ratio (PLR) of cement results in an increased content of highly soluble phases such as struvite (MgNH4PO4⋅6H2O) as well as K-struvite (MgKPO4⋅6H2O). Promising compositions with a low PLR of 1 g ml-1 were implanted in partially-loaded tibia defects in sheep. Both cements were partially degraded and replaced by bone tissue after 4 months. The degradation speed of the K-struvite cement was significantly higher compared to the struvite cement, initially resulting in the formation of a cell-rich resorption zone at the surface of some implants, as determined by histology. Overall, both MPCs investigated in this study seem to be promising as an alternative to the clinically well-established, but slowly degrading calcium phosphate cements, depending on defect size and desired degradation rate. Whereas the K-struvite cement might require further modification towards a slower resorption and reduced inflammatory response in vivo, the struvite cement appears promising for the treatment of bone defects due to its continuous degradation with simultaneous new bone formation. STATEMENT OF SIGNIFICANCE: Cold setting bone cements are used for the treatment of bone defects that exceed a critical size and cannot heal on their own. They are applied pasty into the bone defect and harden afterwards so that the shape adapts to the individual defect. Magnesium phosphates such as magnesium ammonium phosphate hexahydrate (struvite) belong to a new class of these cold setting bone cements. They degrade much faster than the clinically established calcium phosphates. In this study, a magnesium phosphate that has hardly been investigated so far was implanted into partially-loaded defects in sheeps: Potassium magnesium phosphate hexahydrate. This showed even faster resorption compared to the struvite cement: after 4 months, 63% of the cement was already degraded.
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Affiliation(s)
- Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Lena Schröter
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Svenja Stein
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Benjamin Krüger
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Jan Weichhold
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Philipp Stahlhut
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Anita Ignatius
- Institute for Orthopaedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstraße 14, D-89081 Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany.
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20
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Augmentation of suture anchors with magnesium phosphate cement – Simple technique with striking effect. J Mech Behav Biomed Mater 2022; 128:105096. [DOI: 10.1016/j.jmbbm.2022.105096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 11/20/2022]
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21
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Götz LM, Holeczek K, Groll J, Jüngst T, Gbureck U. Extrusion-Based 3D Printing of Calcium Magnesium Phosphate Cement Pastes for Degradable Bone Implants. MATERIALS 2021; 14:ma14185197. [PMID: 34576421 PMCID: PMC8472049 DOI: 10.3390/ma14185197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 01/07/2023]
Abstract
This study aimed to develop printable calcium magnesium phosphate pastes that harden by immersion in ammonium phosphate solution post-printing. Besides the main mineral compound, biocompatible ceramic, magnesium oxide and hydroxypropylmethylcellulose (HPMC) were the crucial components. Two pastes with different powder to liquid ratios of 1.35 g/mL and 1.93 g/mL were characterized regarding their rheological properties. Here, ageing over the course of 24 h showed an increase in viscosity and extrusion force, which was attributed to structural changes in HPMC as well as the formation of magnesium hydroxide by hydration of MgO. The pastes enabled printing of porous scaffolds with good dimensional stability and enabled a setting reaction to struvite when immersed in ammonium phosphate solution. Mechanical performance under compression was approx. 8-20 MPa as a monolithic structure and 1.6-3.0 MPa for printed macroporous scaffolds, depending on parameters such as powder to liquid ratio, ageing time, strand thickness and distance.
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Affiliation(s)
| | | | | | - Tomasz Jüngst
- Correspondence: (T.J.); (U.G.); Tel.: +49-931-201-73550 (U.G.)
| | - Uwe Gbureck
- Correspondence: (T.J.); (U.G.); Tel.: +49-931-201-73550 (U.G.)
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22
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Shi Y, Yu L, Gong C, Li W, Zhao Y, Guo W. A bioactive magnesium phosphate cement incorporating chondroitin sulfate for bone regeneration. Biomed Mater 2021; 16. [PMID: 33827063 DOI: 10.1088/1748-605x/abf5c4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/07/2021] [Indexed: 01/01/2023]
Abstract
Magnesium phosphate cement (MPC) has been evaluated as an inorganic bone filler due to its favorable biocompatibility, biodegradability, rapid setting, high initial strength, and osteogenic potential. However, the setting time of MPC is so rapid that it makes it difficult to use in practice, and the clinical properties of MPC could be further be improved by adding bioactive materials. Here we developed novel bioactive chondroitin sulfate (CS)-MPC composites (CS-MPCs) by incorporating different amounts of CS into MPC. The compositions, microstructures, and physiochemical properties of CS-MPCs and their inducedin vitrocellular responses andin vivobone regeneration properties were evaluated. CS-MPCs had a longer setting time, lower hydration temperature, higher compressive strength, and more neural pH than MPC. CS-MPCs demonstrated similar degradation ratios relative to MPC in Tris-HCl solution. CS-MPCs promoted pre-osteoblast cell proliferation, attachment, and differentiationin vitroand enhanced bone formation surrounding implantsin vivo. In conclusion, through CS modification, our novel CS-MPCs have improved physiochemical properties that enhance compatibilityin vitroand bone regenerationin vivo, making them attractive materials for bone regeneration.
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Affiliation(s)
- Yubo Shi
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
| | - Ling Yu
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
| | - Changtian Gong
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
| | - Wei Li
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
| | - Yingchun Zhao
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
| | - Weichun Guo
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People's Republic of China
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23
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Experimental Drillable Magnesium Phosphate Cement Is a Promising Alternative to Conventional Bone Cements. MATERIALS 2021; 14:ma14081925. [PMID: 33921373 PMCID: PMC8069694 DOI: 10.3390/ma14081925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
Clinically used mineral bone cements lack high strength values, absorbability and drillability. Therefore, magnesium phosphate cements have recently received increasing attention as they unify a high mechanical performance with presumed degradation in vivo. To obtain a drillable cement formulation, farringtonite (Mg3(PO4)2) and magnesium oxide (MgO) were modified with the setting retardant phytic acid (C6H18O24P6). In a pre-testing series, 13 different compositions of magnesium phosphate cements were analyzed concentrating on the clinical demands for application. Of these 13 composites, two cement formulations with different phytic acid content (22.5 wt% and 25 wt%) were identified to meet clinical demands. Both formulations were evaluated in terms of setting time, injectability, compressive strength, screw pullout tests and biomechanical tests in a clinically relevant fracture model. The cements were used as bone filler of a metaphyseal bone defect alone, and in combination with screws drilled through the cement. Both formulations achieved a setting time of 5 min 30 s and an injectability of 100%. Compressive strength was shown to be ~12–13 MPa and the overall displacement of the reduced fracture was <2 mm with and without screws. Maximum load until reduced fracture failure was ~2600 N for the cements only and ~3800 N for the combination with screws. Two new compositions of magnesium phosphate cements revealed high strength in clinically relevant biomechanical test set-ups and add clinically desired characteristics to its strength such as injectability and drillability.
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24
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In-Vivo Degradation Behavior and Osseointegration of 3D Powder-Printed Calcium Magnesium Phosphate Cement Scaffolds. MATERIALS 2021; 14:ma14040946. [PMID: 33671265 PMCID: PMC7923127 DOI: 10.3390/ma14040946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 02/07/2023]
Abstract
Calcium magnesium phosphate cements (CMPCs) are promising bone substitutes and experience great interest in research. Therefore, in-vivo degradation behavior, osseointegration and biocompatibility of three-dimensional (3D) powder-printed CMPC scaffolds were investigated in the present study. The materials Mg225 (Ca0.75Mg2.25(PO4)2) and Mg225d (Mg225 treated with diammonium hydrogen phosphate (DAHP)) were implanted as cylindrical scaffolds (h = 5 mm, Ø = 3.8 mm) in both lateral femoral condyles in rabbits and compared with tricalcium phosphate (TCP). Treatment with DAHP results in the precipitation of struvite, thus reducing pore size and overall porosity and increasing pressure stability. Over 6 weeks, the scaffolds were evaluated clinically, radiologically, with Micro-Computed Tomography (µCT) and histological examinations. All scaffolds showed excellent biocompatibility. X-ray and in-vivo µCT examinations showed a volume decrease and increasing osseointegration over time. Structure loss and volume decrease were most evident in Mg225. Histologically, all scaffolds degraded centripetally and were completely traversed by new bone, in which the remaining scaffold material was embedded. While after 6 weeks, Mg225d and TCP were still visible as a network, only individual particles of Mg225 were present. Based on these results, Mg225 and Mg225d appear to be promising bone substitutes for various loading situations that should be investigated further.
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25
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Schröter L, Kaiser F, Stein S, Gbureck U, Ignatius A. Biological and mechanical performance and degradation characteristics of calcium phosphate cements in large animals and humans. Acta Biomater 2020; 117:1-20. [PMID: 32979583 DOI: 10.1016/j.actbio.2020.09.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/21/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022]
Abstract
Calcium phosphate cements (CPCs) have been used to treat bone defects and support bone regeneration because of their good biocompatibility and osteointegrative behavior. Since their introduction in the 1980s, remarkable clinical success has been achieved with these biomaterials, because they offer the unique feature of being moldable and even injectable into implant sites, where they harden through a low-temperature setting reaction. However, despite decades of research efforts, two major limitations concerning their biological and mechanical performance hamper a broader clinical use. Firstly, achieving a degradation rate that is well adjusted to the dynamics of bone formation remains a challenging issue. While apatite-forming CPCs frequently remain for years at the implant site without major signs of degradation, brushite-forming CPCs are considered to degrade to a greater extent. However, the latter tend to convert into lower soluble phases under physiological conditions, which makes their degradation behavior rather unpredictable. Secondly, CPCs exhibit insufficient mechanical properties for load bearing applications because of their inherent brittleness. This review places an emphasis on these limitations and provides an overview of studies that have investigated the biological and biomechanical performance as well as the degradation characteristics of different CPCs after implantation into trabecular bone. We reviewed studies performed in large animals, because they mimic human bone physiology more closely in terms of bone metabolism and mechanical loading conditions compared with small laboratory animals. We compared the results of these studies with clinical trials that have dealt with the degradation behavior of CPCs after vertebroplasty and kyphoplasty.
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Affiliation(s)
- Lena Schröter
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
| | - Friederike Kaiser
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany
| | - Svenja Stein
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, Pleicherwall 2, D-97070 Würzburg, Germany.
| | - Anita Ignatius
- Institute for Orthopedic Research and Biomechanics, Ulm University Medical Center, Helmholtzstrasse 14, D-89081 Ulm, Germany
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26
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Gelli R, Di Pompo G, Graziani G, Avnet S, Baldini N, Baglioni P, Ridi F. Unravelling the Effect of Citrate on the Features and Biocompatibility of Magnesium Phosphate-Based Bone Cements. ACS Biomater Sci Eng 2020; 6:5538-5548. [PMID: 33320576 PMCID: PMC8011797 DOI: 10.1021/acsbiomaterials.0c00983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
![]()
In
the framework of new materials for orthopedic applications,
Magnesium Phosphate-based Cements (MPCs) are currently the focus of
active research in biomedicine, given their promising features; in
this field, the loading of MPCs with active molecules to be released
in the proximity of newly forming bone could represent an innovative
approach to enhance the in vivo performances of the biomaterial. In
this work, we describe the preparation and characterization of MPCs
containing citrate, an ion naturally present in bone which presents
beneficial effects when released in the proximity of newly forming
bone tissue. The cements were characterized in terms of handling properties,
setting time, mechanical properties, crystallinity, and microstructure,
so as to unravel the effect of citrate concentration on the features
of the material. Upon incubation in aqueous media, we demonstrated
that citrate could be successfully released from the cements, while
contributing to the alkalinization of the surroundings. The cytotoxicity
of the materials toward human fibroblasts was also tested, revealing
the importance of a fine modulation of released citrate to guarantee
the biocompatibility of the material.
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Affiliation(s)
- Rita Gelli
- Department of Chemistry "Ugo Schiff" and CSGI, University of Florence, via della Lastruccia 3-13, 50019 Sesto Fiorentino, Italy
| | - Gemma Di Pompo
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Gabriela Graziani
- Laboratory of Nanobiotechnology (NaBi), IRCSS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Sofia Avnet
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Nicola Baldini
- BST Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, 40127 Bologna, Italy
| | - Piero Baglioni
- Department of Chemistry "Ugo Schiff" and CSGI, University of Florence, via della Lastruccia 3-13, 50019 Sesto Fiorentino, Italy
| | - Francesca Ridi
- Department of Chemistry "Ugo Schiff" and CSGI, University of Florence, via della Lastruccia 3-13, 50019 Sesto Fiorentino, Italy
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27
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Boehm AV, Meininger S, Gbureck U, Müller FA. Self-healing capacity of fiber-reinforced calcium phosphate cements. Sci Rep 2020; 10:9430. [PMID: 32523063 PMCID: PMC7287135 DOI: 10.1038/s41598-020-66207-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/15/2020] [Indexed: 11/23/2022] Open
Abstract
A major problem concerning the mechanical properties of calcium phosphate cements (CPC) is related to their inherent brittleness, which limits their applicability to non-load bearing bone defects. In this work the preparation of a damage tolerant CPC is presented, where the incorporation of functionalized carbon fibers facilitates steady state flat crack propagation with crack openings below 10 µm. A subsequent self-healing process in simulated body fluid, that mimics the in vivo mineralization of bioactive surfaces, closes the cracks and completely restores the mechanical properties. Hereby, two pathways of self-healing are presented: i) intrinsic healing that bases on the inherent bioactive properties of the cement matrix and chemically treated fibers, and ii) capsule based extrinsic healing, where H2PO4- is released as an initiator for the apatite formation. Such damage tolerant CPCs with self-healing capacity are of particular interest to increase the lifetime of implants as well as in the field of load-bearing bioceramics.
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Affiliation(s)
- Anne V Boehm
- Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743, Jena, Germany
| | - Susanne Meininger
- Department for Functional Materials in Medicine and Dentistry (FMZ), University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry (FMZ), University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Frank A Müller
- Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743, Jena, Germany.
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28
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Dubey N, Ferreira JA, Malda J, Bhaduri SB, Bottino MC. Extracellular Matrix/Amorphous Magnesium Phosphate Bioink for 3D Bioprinting of Craniomaxillofacial Bone Tissue. ACS APPLIED MATERIALS & INTERFACES 2020; 12:23752-23763. [PMID: 32352748 PMCID: PMC7364626 DOI: 10.1021/acsami.0c05311] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Bioprinting, a promising field in regenerative medicine, holds great potential to create three-dimensional, defect-specific vascularized bones with tremendous opportunities to address unmet craniomaxillofacial reconstructive challenges. A cytocompatible bioink is a critical prerequisite to successfully regenerate functional bone tissue. Synthetic self-assembling peptides have a nanofibrous structure resembling the native extracellular matrix (ECM), making them an excellent bioink component. Amorphous magnesium phosphates (AMPs) have shown greater levels of resorption while maintaining high biocompatibility, osteoinductivity, and low inflammatory response, as compared to their calcium phosphate counterparts. Here, we have established a novel bioink formulation (ECM/AMP) that combines an ECM-based hydrogel containing 2% octapeptide FEFEFKFK and 98% water with AMP particles to realize high cell function with desirable bioprintability. We analyzed the osteogenic differentiation of dental pulp stem cells (DPSCs) encapsulated in the bioink, as well as in vivo bone regeneration, to define the potential of the formulated bioink as a growth factor-free bone-forming strategy. Cell-laden AMP-modified bioprinted constructs showed an improved cell morphology but similar cell viability (∼90%) compared to their AMP-free counterpart. In functional assays, the cell-laden bioprinted constructs modified with AMP exhibited a high level of mineralization and osteogenic gene expression without the use of growth factors, thus suggesting that the presence of AMP-triggered DPSCs' osteogenic differentiation. Cell-free ECM-based bioprinted constructs were implanted in vivo. In comparison with the ECM group, bone volume per total volume for ECM/1.0AMP was approximately 1.7- and 1.4-fold higher at 4 and 8 weeks, respectively. Further, a significant increase in the bone density was observed in ECM/1.0AMP from 4 to 8 weeks. These results demonstrate that the presence of AMP in the bioink significantly increased bone formation, thus showing promise for in situ bioprinting strategies. We foresee significant potential in translating this innovative bioink toward the regeneration of patient-specific bone tissue for regenerative dentistry.
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Affiliation(s)
- Nileshkumar Dubey
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Jessica A Ferreira
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Jos Malda
- Regenerative Medicine Center, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands
- Department of Orthopedics, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht 3584 CL, The Netherlands
| | - Sarit B Bhaduri
- Department of Mechanical, Industrial and Manufacturing Engineering and Surgery (Dentistry), University of Toledo, Toledo, Ohio 43606, United States
- EEC Division, Directorate of Engineering, The National Science Foundation, Alexandria, Virginia 22314, United States
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
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29
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Yousefi AM. A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation. J Appl Biomater Funct Mater 2020; 17:2280800019872594. [PMID: 31718388 DOI: 10.1177/2280800019872594] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Treatment of bone defects caused by trauma or disease is a major burden on human healthcare systems. Although autologous bone grafts are considered as the gold standard, they are limited in availability and are associated with post-operative complications. Minimally invasive alternatives using injectable bone cements are currently used in certain clinical procedures, such as vertebroplasty and balloon kyphoplasty. Nevertheless, given the high incidence of fractures and pathologies that result in bone voids, there is an unmet need for injectable materials with desired properties for minimally invasive procedures. This paper provides an overview of the most common injectable bone cement materials for clinical use. The emphasis has been placed on calcium phosphate cements and acrylic bone cements, while enabling the readers to compare the opportunities and challenges for these two classes of bone cements. This paper also briefly reviews antibiotic-loaded bone cements used in bone repair and implant fixation, including their efficacy and cost for healthcare systems. A summary of the current challenges and recommendations for future directions has been brought in the concluding section of this paper.
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Affiliation(s)
- Azizeh-Mitra Yousefi
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, USA
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30
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Swetha S, Lavanya K, Sruthi R, Selvamurugan N. An insight into cell-laden 3D-printed constructs for bone tissue engineering. J Mater Chem B 2020; 8:9836-9862. [DOI: 10.1039/d0tb02019b] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In this review, we have spotlighted various combinations of bioinks to optimize the biofabrication of 3D bone constructs.
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Affiliation(s)
- S. Swetha
- Department of Biotechnology, College of Engineering and Technology
- SRM Institute of Science and Technology
- Kattankulathur 603 203
- India
| | - K. Lavanya
- Department of Biotechnology, College of Engineering and Technology
- SRM Institute of Science and Technology
- Kattankulathur 603 203
- India
| | - R. Sruthi
- Department of Biotechnology, College of Engineering and Technology
- SRM Institute of Science and Technology
- Kattankulathur 603 203
- India
| | - N. Selvamurugan
- Department of Biotechnology, College of Engineering and Technology
- SRM Institute of Science and Technology
- Kattankulathur 603 203
- India
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31
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Brückner T, Meininger M, Groll J, Kübler AC, Gbureck U. Magnesium Phosphate Cement as Mineral Bone Adhesive. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3819. [PMID: 31766321 PMCID: PMC6926875 DOI: 10.3390/ma12233819] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022]
Abstract
Mineral bone cements were actually not developed for their application as bone-bonding agents, but as bone void fillers. In particular, calcium phosphate cements (CPC) are considered to be unsuitable for that application, particularly under moist conditions. Here, we showed the ex vivo ability of different magnesium phosphate cements (MPC) to adhere on bovine cortical bone substrates. The cements were obtained from a mixture of farringtonite (Mg3(PO4)2) with different amounts of phytic acid (C6H18O24P6, inositol hexaphosphate, IP6), whereas cement setting occurred by a chelation reaction between Mg2+ ions and IP6. We were able to show that cements with 25% IP6 and a powder-to-liquid ratio (PLR) of 2.0 g/mL resulted in shear strengths of 0.81 ± 0.12 MPa on bone even after 7 d storage in aqueous conditions. The samples showed a mixed adhesive-cohesive failure with cement residues on the bone surface as indicated by scanning electron microscopy and energy-dispersive X-ray analysis. The presented material demonstrated appropriate bonding characteristics, which could enable a broadening of the mineral bone cements' application field to bone adhesives.
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Affiliation(s)
- Theresa Brückner
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Markus Meininger
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Jürgen Groll
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
| | - Alexander C. Kübler
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany;
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (T.B.); (M.M.); (J.G.)
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32
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Sikder P, Bhaduri SB, Ong JL, Guda T. Silver (Ag) doped magnesium phosphate microplatelets as next‐generation antibacterial orthopedic biomaterials. J Biomed Mater Res B Appl Biomater 2019; 108:976-989. [DOI: 10.1002/jbm.b.34450] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/06/2019] [Accepted: 07/11/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Prabaha Sikder
- Department of Mechanical Industrial and Manufacturing Engineering The University of Toledo Toledo Ohio
| | - Sarit B. Bhaduri
- Department of Mechanical Industrial and Manufacturing Engineering The University of Toledo Toledo Ohio
| | - Joo L. Ong
- Department of Biomedical Engineering The University of Texas at San Antonio San Antonio Texas
| | - Teja Guda
- Department of Biomedical Engineering The University of Texas at San Antonio San Antonio Texas
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33
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Cao X, Lu H, Liu J, Lu W, Guo L, Ma M, Zhang B, Guo Y. 3D plotting in the preparation of newberyite, struvite, and brushite porous scaffolds: using magnesium oxide as a starting material. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:88. [PMID: 31325082 DOI: 10.1007/s10856-019-6290-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- Xiaofeng Cao
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Haojun Lu
- Hangzhou Branch of Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Zhejiang, 310018, Hangzhou, PR China
| | - Junli Liu
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Weipeng Lu
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Lin Guo
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Ming Ma
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Bing Zhang
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China
| | - Yanchuan Guo
- Key Laboratory of Photochemical Conversion and Optoelectronic Material, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 100190, Beijing, PR China.
- Hangzhou Branch of Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Zhejiang, 310018, Hangzhou, PR China.
- University of Chinese Academy of Sciences, 100049, Beijing, PR China.
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Ewald A, Kreczy D, Brückner T, Gbureck U, Bengel M, Hoess A, Nies B, Bator J, Klammert U, Fuchs A. Development and Bone Regeneration Capacity of Premixed Magnesium Phosphate Cement Pastes. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E2119. [PMID: 31266228 PMCID: PMC6651064 DOI: 10.3390/ma12132119] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- Andrea Ewald
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany.
| | - Dorothea Kreczy
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Theresa Brückner
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Melanie Bengel
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Andreas Hoess
- INNOTERE GmbH, Meissner Strasse 191, 01445 Radebeul, Germany
| | - Berthold Nies
- INNOTERE GmbH, Meissner Strasse 191, 01445 Radebeul, Germany
| | - Julia Bator
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Klammert
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Andreas Fuchs
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
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Weichhold J, Gbureck U, Goetz-Neunhoeffer F, Hurle K. Setting Mechanism of a CDHA Forming α-TCP Cement Modified with Sodium Phytate for Improved Injectability. MATERIALS 2019; 12:ma12132098. [PMID: 31261865 PMCID: PMC6651550 DOI: 10.3390/ma12132098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 02/02/2023]
Abstract
A calcium deficient hydroxyapatite (CDHA) forming cement with a bimodal grain size distribution, composed of α-TCP and fine grained CDHA at a weight ratio of 9:1, was modified by the addition of sodium phytate (IP6) in variable amounts ranging from 0.25 to 2 wt.%, related to the powder content. The injectability of the cement paste was drastically increased by the IP6 addition, independent of the amount of added IP6. Additionally, the cement paste viscosity during the first minutes decreased. These effects could be clearly related to a slightly more negative zeta potential. Furthermore, IP6 was shown to strongly retard the setting reaction, as can be seen both in the calorimetry and X-ray diffraction measurements. In addition, octacalcium phosphate (OCP) was identified as a further setting product. All measurements were performed at 23 °C and 37 °C to assess the effect of temperature on the setting reaction for both clinical handling by the surgeon and the final hardening in the bone defect.
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Affiliation(s)
- Jan Weichhold
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Würzburg, Germany.
| | - Friedlinde Goetz-Neunhoeffer
- GeoZentrum Nordbayern-Mineralogy, Friedrich-Alexander-University of Erlangen-Nuernberg, Schlossgarten 5a, 91054 Erlangen, Germany
| | - Katrin Hurle
- GeoZentrum Nordbayern-Mineralogy, Friedrich-Alexander-University of Erlangen-Nuernberg, Schlossgarten 5a, 91054 Erlangen, Germany.
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Effect of Baghdadite Substitution on the Physicochemical Properties of Brushite Cements. MATERIALS 2019; 12:ma12101719. [PMID: 31137837 PMCID: PMC6566396 DOI: 10.3390/ma12101719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 11/16/2022]
Abstract
Brushite cements have been clinically used for irregular bone defect filling applications, and various strategies have been previously reported to modify and improve their physicochemical properties such as strength and injectability. However, strategies to address other limitations of brushite cements such as low radiopacity or acidity without negatively impacting mechanical strength have not yet been reported. In this study, we report the effect of substituting the beta-tricalcium phosphate reactant in brushite cement with baghdadite (Ca3ZrSi2O9), a bioactive zirconium-doped calcium silicate ceramic, at various concentrations (0, 5, 10, 20, 30, 50, and 100 wt%) on the properties of the final brushite cement product. X-ray diffraction profiles indicate the dissolution of baghdadite during the cement reaction, without affecting the crystal structure of the precipitated brushite. EDX analysis shows that calcium is homogeneously distributed within the cement matrix, while zirconium and silicon form cluster-like aggregates with sizes ranging from few microns to more than 50 µm. X-ray images and µ-CT analysis indicate enhanced radiopacity with increased incorporation of baghdadite into brushite cement, with nearly a doubling of the aluminium equivalent thickness at 50 wt% baghdadite substitution. At the same time, compressive strength of brushite cement increased from 12.9 ± 3.1 MPa to 21.1 ± 4.1 MPa with 10 wt% baghdadite substitution. Culture medium conditioned with powdered brushite cement approached closer to physiological pH values when the cement is incorporated with increasing amounts of baghdadite (pH = 6.47 for pure brushite, pH = 7.02 for brushite with 20 wt% baghdadite substitution). Baghdadite substitution also influenced the ionic content in the culture medium, and subsequently affected the proliferative activity of primary human osteoblasts in vitro. This study indicates that baghdadite is a beneficial additive to enhance the radiopacity, mechanical performance and cytocompatibility of brushite cements.
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Brueckner T, Heilig P, Jordan MC, Paul MM, Blunk T, Meffert RH, Gbureck U, Hoelscher-Doht S. Biomechanical Evaluation of Promising Different Bone Substitutes in a Clinically Relevant Test Set-Up. MATERIALS 2019; 12:ma12091364. [PMID: 31035473 PMCID: PMC6540007 DOI: 10.3390/ma12091364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 12/02/2022]
Abstract
(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 (ChronOSTM 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.
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Affiliation(s)
- Theresa Brueckner
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany.
| | - Philipp Heilig
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Martin Cornelius Jordan
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Mila Marie Paul
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Torsten Blunk
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Rainer Heribert Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University of Wuerzburg, Pleicherwall 2, 97070 Wuerzburg, Germany.
| | - Stefanie Hoelscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany.
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Tuning the properties of magnesium phosphate-based bone cements: Effect of powder to liquid ratio and aqueous solution concentration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 95:248-255. [DOI: 10.1016/j.msec.2018.10.083] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023]
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Kucko NW, Li W, García Martinez MA, Rehman IU, Ulset AST, Christensen BE, Leeuwenburgh SCG, Herber RP. Sterilization effects on the handling and degradation properties of calcium phosphate cements containing poly (D,L
-lactic-co-glycolic acid) porogens and carboxymethyl cellulose. J Biomed Mater Res B Appl Biomater 2019; 107:2216-2228. [DOI: 10.1002/jbm.b.34306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/07/2018] [Accepted: 12/19/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Nathan W. Kucko
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
- CAM Bioceramics B.V.; Zernikedreef 6, 2333 CL, Leiden The Netherlands
| | - Wenliang Li
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
| | - Marcela A. García Martinez
- Department of Materials Science and Engineering; The Kroto Research Institute, The University of Sheffield; North Campus, Broad Lane, S3 7HQ, Sheffield UK
| | - Ihtesham ur Rehman
- Department of Materials Science and Engineering; The Kroto Research Institute, The University of Sheffield; North Campus, Broad Lane, S3 7HQ, Sheffield UK
| | - Ann-Sissel Teialeret Ulset
- NOBIPOL, Department of Biotechnology and Food Science; Norwegian University of Science and Technology; Sem Saeland veg 6/8, NO-7491, Trondheim Norway
| | - Bjørn E. Christensen
- NOBIPOL, Department of Biotechnology and Food Science; Norwegian University of Science and Technology; Sem Saeland veg 6/8, NO-7491, Trondheim Norway
| | - Sander C. G. Leeuwenburgh
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
| | - Ralf-Peter Herber
- CAM Bioceramics B.V.; Zernikedreef 6, 2333 CL, Leiden The Netherlands
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Mocanu AC, Stan GE, Maidaniuc A, Miculescu M, Antoniac IV, Ciocoiu RC, Voicu ȘI, Mitran V, Cîmpean A, Miculescu F. Naturally-Derived Biphasic Calcium Phosphates through Increased Phosphorus-Based Reagent Amounts for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E381. [PMID: 30691077 PMCID: PMC6384751 DOI: 10.3390/ma12030381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 01/11/2023]
Abstract
Calcium carbonate from marble and seashells is an eco-friendly, sustainable, and largely available bioresource for producing natural bone-like calcium phosphates (CaPs). Based on three main objectives, this research targeted the: (i) adaptation of an indirect synthesis route by modulating the amount of phosphorus used in the chemical reaction, (ii) comprehensive structural, morphological, and surface characterization, and (iii) biocompatibility assessment of the synthesized powdered samples. The morphological characterization was performed on digitally processed scanning electron microscopy (SEM) images. The complementary 3D image augmentation of SEM results also allowed the quantification of roughness parameters. The results revealed that both morphology and roughness were modulated through the induced variation of the synthesis parameters. Structural investigation of the samples was performed by Fourier transform infrared spectroscopy and X-ray diffraction. Depending on the phosphorus amount from the chemical reaction, the structural studies revealed the formation of biphasic CaPs based on hydroxyapatite/brushite or brushite/monetite. The in vitro assessment of the powdered samples demonstrated their capacity to support MC3T3-E1 pre-osteoblast viability and proliferation at comparable levels to the negative cytotoxicity control and the reference material (commercial hydroxyapatite). Therefore, these samples hold great promise for biomedical applications.
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Affiliation(s)
- Aura-Cătălina Mocanu
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
- Department of Research, Development and Innovation, S.C. Nuclear NDT Research & Services S.R.L, 104 Berceni Str., Central Laboratory Building, District 4, 041919 Bucharest, Romania.
| | - George E Stan
- National Institute of Materials Physics, Laboratory of Multifunctional Materials and Structures, 405A Atomistilor Str., 077125 Măgurele-Ilfov, Romania.
| | - Andreea Maidaniuc
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
- Destructive and Nondestructive Testing Laboratory,S.C. Nuclear NDT Research & Services S.R.L, 104 Berceni Str., Central Laboratory Building, District 4, 041919 Bucharest, Romania.
| | - Marian Miculescu
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
| | - Iulian Vasile Antoniac
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
| | - Robert-Cătălin Ciocoiu
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
| | - Ștefan Ioan Voicu
- Department of Analytical Chemistry and Environmental Engineering, University Politehnica of Bucharest, 1-7 Gh. Polizu Str., Polizu campus, L 015 Building, District 1, 011061 Bucharest, Romania.
| | - Valentina Mitran
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania.
| | - Anișoara Cîmpean
- Department of Biochemistry and Molecular Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania.
| | - Florin Miculescu
- Department of Metallic Materials Science, Physical Metallurgy, University Politehnica of Bucharest, 313 Splaiul Independentei, J Building, District 6, 060042 Bucharest, Romania.
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Xu C, Ma B, Peng J, Gao L, Xu Y, Huan Z, Chang J. Tricalcium silicate/graphene oxide bone cement with photothermal properties for tumor ablation. J Mater Chem B 2019; 7:2808-2818. [DOI: 10.1039/c9tb00246d] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Illustration of the Tricalcium silicate/graphene oxide bone cement for bone tumor ablation.
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Affiliation(s)
- Chen Xu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics, Chinese Academy of Sciences
- Shanghai
- People's Republic of China
| | - Bing Ma
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics, Chinese Academy of Sciences
- Shanghai
- People's Republic of China
| | - Jinliang Peng
- School of Pharmacy
- Shanghai Jiaotong University
- Shanghai
- People's Republic of China
| | - Long Gao
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics, Chinese Academy of Sciences
- Shanghai
- People's Republic of China
| | - Yuhong Xu
- School of Pharmacy
- Shanghai Jiaotong University
- Shanghai
- People's Republic of China
| | - Zhiguang Huan
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics, Chinese Academy of Sciences
- Shanghai
- People's Republic of China
| | - Jiang Chang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure
- Shanghai Institute of Ceramics, Chinese Academy of Sciences
- Shanghai
- People's Republic of China
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Devi KB, Tripathy B, Roy A, Lee B, Kumta PN, Nandi SK, Roy M. In Vitro Biodegradation and In Vivo Biocompatibility of Forsterite Bio-Ceramics: Effects of Strontium Substitution. ACS Biomater Sci Eng 2018; 5:530-543. [DOI: 10.1021/acsbiomaterials.8b00788] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- K. Bavya Devi
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology−Kharagpur, Kharagpur 721302, India
| | - Bipasa Tripathy
- Department of Veterinary Surgery & Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | | | | | | | - Samit Kumar Nandi
- Department of Veterinary Surgery & Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Mangal Roy
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology−Kharagpur, Kharagpur 721302, India
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He F, Lu T, Fang X, Qiu C, Tian Y, Li Y, Zuo F, Ye J. Study on Mg xSr 3-x(PO 4) 2 bioceramics as potential bone grafts. Colloids Surf B Biointerfaces 2018; 175:158-165. [PMID: 30530001 DOI: 10.1016/j.colsurfb.2018.11.085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
Magnesium (Mg) and strontium (Sr), which are essential nutrient elements in the natural bone, positively affect the osteogenic activity even in wide ranges of ion concentrations. However, it remains unknown whether magnesium-strontium phosphates [MgxSr3-x(PO4)2] are potential bone grafts for accelerating bone regeneration. Herein, a serial of MgxSr3-x(PO4)2, including Mg3(PO4)2, Mg2Sr(PO4)2, Mg1.5Sr1.5(PO4)2, MgSr2(PO4)2 and Sr3(PO4)2, were synthesized using a solid-state reaction approach. The physicochemical properties and cell behaviors of MgxSr3-x(PO4)2 bioceramics were characterized and compared with the common bone graft β-tricalcium phosphate (β-TCP). The results indicated that various MgxSr3-x(PO4)2 bioceramics differed in compressive strength and in vitro degradation rate. All the MgxSr3-x(PO4)2 bioceramics had excellent biocompatibility. In contrast to β-TCP, the MgxSr3-x(PO4)2 enhanced alkaline phosphatase activity of mouse bone mesenchymal stem cells (mBMSCs), and inhibited osteoclastogenesis-related gene expression of RAW264.7 cells, but did not enhance osteogenesis-related gene expression of mBMSCs which were treated with osteogenesis induction supplements. However, Mg3(PO4)2 stimulated osteogenesis-related gene expression of mBMSCs without the treatment of osteogenesis induction supplements. This work contributes to the design of bone graft and may open a new avenue for the bone regeneration field.
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Affiliation(s)
- Fupo He
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China.
| | - Teliang Lu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, People's Republic of China
| | - Xibo Fang
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Chao Qiu
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Ye Tian
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Yanhui Li
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Fei Zuo
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Jiandong Ye
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, People's Republic of China.
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44
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Rödel M, Teßmar J, Groll J, Gbureck U. Highly flexible and degradable dual setting systems based on PEG-hydrogels and brushite cement. Acta Biomater 2018; 79:182-201. [PMID: 30149213 DOI: 10.1016/j.actbio.2018.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/21/2023]
Abstract
With respect to the composition of natural bone, we established a degradable dual setting system of different poly(ethylene glycol) (PEG)-based hydrogels combined with a brushite cement. The idea was to reinforce the inorganic calcium phosphate mineral phase with an organic, polymeric phase to alter the cement's properties towards ductility and elasticity. Extremely flexible samples were produced via this dual setting approach with a fully reversible elasticity of the samples containing high molecular weight PEG-based hydrogel precursors. Using the decalcifying agent EDTA, the whole inorganic phase was dissolved due to Ca2+-complexation and dimensionally stable hydrogels were obtained, indicating a homogenous polymeric phase within the composites. This was also confirmed by SEM-analysis, where no discontinuities or agglomerations of the phase were observed. Additional XRD-measurements proved a significant influence of the coherent polymeric matrix on the conversion from β-TCP/MCPA to brushite with a decrease in signal intensity. The results confirmed a parallelly running process of setting reaction and gelation without an inhibition of the conversion to brushite and the formation of interpenetrating networks of hydrogel and cement. The strengths of this newly developed dual setting system are based on the material degradability as well as flexibility, which can be a promising tool for bone regeneration applications in non-load bearing craniomaxillofacial defects. STATEMENT OF SIGNIFICANCE Brushite based calcium phosphate cements (CPCs) are known as bone replacement materials, which degrade in vivo and are replaced by native bone. However, the pure inorganic material shows a brittle fracture behavior. Here, the addition of a polymeric phase can influence the mechanical properties to create more ductile and flexible materials. This polymeric phase should ideally form during cement setting by a polymerization reaction to achieve high polymer loads without altering cement viscosity and it should be degradable in vivo similar to the cement itself. Therefore, we developed a dual setting system based on simultaneous cement setting of brushite and lactide modified poly(ethylene glycol) dimethacrylate (PEG-PLLA-DMA)-based hydrogel. It was evident that the gels form a continuous phase within the cement after radical polymerization with a strong reduction of cement brittleness.
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Affiliation(s)
- Michaela Rödel
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Jörg Teßmar
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Jürgen Groll
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry and Bavarian Polymer Institute (BPI), Julius Maximilians University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany.
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Esnaashary MH, Rezaie HR, Khavandi A, Javadpour J. Evaluation of setting time and compressive strength of a new bone cement precursor powder containing Mg–Na–Ca. Proc Inst Mech Eng H 2018; 232:1017-1024. [DOI: 10.1177/0954411918796048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Taking the advantage of a novel magnesium phosphate precursor containing Na and Ca, the cementation rate of the cement, including only Mg/Mg–Na–Ca, was studied. Besides, two effective parameters, that is, calcination temperature, 650 °C and 800 °C, and powder-to-cement liquid ratio, 1 and 1.5 g/mL, were assessed. X-ray diffraction, scanning electron microscopy, ion chromatography, particle size analyser, Vicat needle and compression test were used to characterize the powders and obtained cements. The sample containing Mg–Na–Ca, calcined at 800 °C with powder-to-cement liquid ratio of 1.5, obtained the highest compressive strength, 20 MPa, but set fast. To control the kinetics of cementation, the powder containing Mg–Na–Ca calcined at 950 °C with powder-to-cement liquid ratio of 1.5 and 2 g/mL was assessed and the one with 2 g/mL set in 9 min possessing 22 MPa compressive strength was selected as optimal condition to be used as a candidate, injectable bone cement.
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Affiliation(s)
| | - Hamid Reza Rezaie
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Alireza Khavandi
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Jafar Javadpour
- School of Metallurgy and Materials Engineering, Iran University of Science and Technology, Tehran, Iran
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Oesterle A, Boehm AV, Müller FA. Photoluminescent Eu 3+-Doped Calcium Phosphate Bone Cement and Its Mechanical Properties. MATERIALS 2018; 11:ma11091610. [PMID: 30181495 PMCID: PMC6163723 DOI: 10.3390/ma11091610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/16/2018] [Accepted: 09/03/2018] [Indexed: 12/30/2022]
Abstract
Calcium phosphate cements (CPC) are well-established bone replacement materials that have been used in dentistry and orthopedics for more than 25 years. The monitoring of bone cements and the associated healing processes in the human body is difficult and so far has often been achieved using cytotoxic X-ray contrast agent additives. These additives have a negative effect on the mechanical properties and setting time of the bone cement. In this paper, we present a novel approach to prepare contrastive CPC by the incorporation of luminescent Eu3+-doped hydroxyapatite (Eu:HAp) nanoparticles. Eu-doped CPC (Eu:CPC) exhibited enhanced mechanical properties compared to pure CPC. Furthermore, the red photoluminescence of Eu:CPC may allow the observation of CPC-related healing processes without the use of harmful ionizing radiation.
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Affiliation(s)
- Annemarie Oesterle
- Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany.
| | - Anne V Boehm
- Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany.
| | - Frank A Müller
- Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany.
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Sikder P, Grice CR, Lin B, Goel VK, Bhaduri SB. Single-Phase, Antibacterial Trimagnesium Phosphate Hydrate Coatings on Polyetheretherketone (PEEK) Implants by Rapid Microwave Irradiation Technique. ACS Biomater Sci Eng 2018; 4:2767-2783. [PMID: 33435002 DOI: 10.1021/acsbiomaterials.8b00594] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This Article reports the fabrication and evaluation of single-phase, silver-doped trimagnesium phosphate hydrate (Ag-TMPH) nanosheet coatings on polyetheretherketone (PEEK), a well-known material used to fabricate orthopedic and spinal implants. While PEEK has better biomechanical compatibility with bone compared to metallic implants, it is also quite inert. Therefore, it is a common practice to coat PEEK implants with conventional calcium phosphates (CaPs) to enhance cell attachment, proliferation and differentiation. As opposed to well-studied CaP compounds, relatively less-explored magnesium phosphates (MgPs) are also becoming interesting orthopedic biomaterials and is the prime focus in this research. The novel aspects of this paper are as follows. First, we report developing TMPH coatings within minutes with the help of microwave irradiation technology. Microwave irradiation plays an important role in the coating formation with accelerated kinetics. Scanning electron microscopy (SEM) confirmed the fabrication of approximately 650 nm thick TMPH coatings. The coatings resulted in submicron level surface roughness and in vitro cell studies confirmed enhanced MC3T3 cell adhesion within 4 h on such surfaces. The coatings also resulted in significant apatite formation after immersing in simulated body fluid for 7 days. Second, multifunctionality was achieved by doping TMPH coatings with Ag, thus rendering the coatings antibacterial. The antibacterial properties were evaluated against two most common infection-causing bacterial strains-Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus. The results indicated good bacterial resistance and bactericidal properties of the Ag-TMPH coatings. Third, in spite of Ag doping, the single-phase nature of the coatings were retained (without forming composite systems) with the help of the low-processing temperature of the microwave irradiation. The inductive coupled plasma technique confirmed that the doped single-phase TMPH coatings supported a uniform and controlled release of Ag+ ions over a period of 3 weeks. MTT assay evaluations and SEM micrographs confirmed no signs of cytotoxicity and healthy proliferation of cells in all cases. Quantitative real time PCR (qRT-PCR) indicated a significant rise in collagen (Col1) and osteocalcin (OCN) gene expression levels in the case of TMPH coated PEEK. Thus, microwave irradiation was successfully employed in forming multifunctional, that is, bioactive, cytocompatible, and antibacterial MgP coatings on PEEK.
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Affiliation(s)
- Prabaha Sikder
- Department of Mechanical, Industrial and Manufacturing Engineering, The University of Toledo, Toledo, Ohio 43606, United States
| | - Corey R Grice
- Department of Physics & Astronomy, The University of Toledo, Toledo, Ohio 43606, United States
| | - Boren Lin
- Department of Bioengineering, The University of Toledo, Toledo, Ohio 43606, United States
| | - Vijay K Goel
- Department of Bioengineering, The University of Toledo, Toledo, Ohio 43606, United States
| | - Sarit B Bhaduri
- Department of Mechanical, Industrial and Manufacturing Engineering, The University of Toledo, Toledo, Ohio 43606, United States
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Qi P, Ohba S, Hara Y, Fuke M, Ogawa T, Ohta S, Ito T. Fabrication of calcium phosphate-loaded carboxymethyl cellulose non-woven sheets for bone regeneration. Carbohydr Polym 2018; 189:322-330. [DOI: 10.1016/j.carbpol.2018.02.050] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/16/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
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Bone regeneration capacity of magnesium phosphate cements in a large animal model. Acta Biomater 2018; 69:352-361. [PMID: 29409867 DOI: 10.1016/j.actbio.2018.01.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/18/2018] [Accepted: 01/23/2018] [Indexed: 12/21/2022]
Abstract
Magnesium phosphate minerals have captured increasing attention during the past years as suitable alternatives for calcium phosphate bone replacement materials. Here, we investigated the degradation and bone regeneration capacity of experimental struvite (MgNH4PO4·6H2O) forming magnesium phosphate cements in two different orthotopic ovine implantation models. Cements formed at powder to liquid ratios (PLR) of 2.0 and 3.0 g ml-1 were implanted into trabecular bone using a non-load-bearing femoral drill-hole model and a load-bearing tibial defect model. After 4, 7 and 10 months the implants were retrieved and cement degradation and new bone formation was analyzed by micro-computed tomography (µCT) and histomorphometry. The results showed cement degradation in concert with new bone formation at both defect locations. Both cements were almost completely degraded after 10 months. The struvite cement formed with a PLR of 2.0 g ml-1 exhibited a slightly accelerated degradation kinetics compared to the cement with a PLR of 3.0 g ml-1. Tartrat-resistant acid phosphatase (TRAP) staining indicated osteoclastic resorption at the cement surface. Energy dispersive X-ray analysis (EDX) revealed that small residual cement particles were mostly accumulated in the bone marrow in between newly formed bone trabeculae. Mechanical loading did not significantly increase bone formation associated with cement degradation. Concluding, struvite-forming cements might be promising bone replacement materials due to their good degradation which is coupled with new bone formation. STATEMENT OF SIGNIFICANCE Recently, the interest in magnesium phosphate cements (MPC) for bone substitution increased, as they exhibit high initial strength, comparably elevated degradation potential and the release of valuable magnesium ions. However, only few in vivo studies, mostly including non-load-bearing defects in small animals, have been performed to analyze the degradation and regeneration capability of MPC derived compounds. The present study examined the in vivo behavior of magnesiumammoniumphosphate hexahydrate (struvite) implants with different porosity in both mechanically loaded and non-loaded defects of merino sheep. For the first time, the effect of mechanical stimuli on the biological outcome of this clinically relevant replacement material is shown and directly compared to the conventional unloaded defect situation in a large animal model.
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Rentsch B, Bernhardt A, Henß A, Ray S, Rentsch C, Schamel M, Gbureck U, Gelinsky M, Rammelt S, Lode A. Trivalent chromium incorporated in a crystalline calcium phosphate matrix accelerates materials degradation and bone formation in vivo. Acta Biomater 2018; 69:332-341. [PMID: 29355718 DOI: 10.1016/j.actbio.2018.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/19/2017] [Accepted: 01/10/2018] [Indexed: 01/23/2023]
Abstract
Remodeling of calcium phosphate bone cements is a crucial prerequisite for their application in the treatment of large bone defects. In the present study trivalent chromium ions were incorporated into a brushite forming calcium phosphate cement in two concentrations (10 and 50 mmol/mol β-tricalcium phosphate) and implanted into a femoral defect in rats for 3 and 6 month, non-modified brushite was used as reference. Based on our previous in vitro findings indicating both an enhanced osteoclastic activity and cytocompatibility towards osteoprogenitor cells we hypothesized a higher in vivo remodeling rate of the Cr3+ doped cements compared to the reference. A significantly enhanced degradation of the modified cements was evidenced by micro computed tomography, X-ray and histological examinations. Furthermore the formation of new bone tissue after 6 month of implantation was significantly increased from 29% to 46% during remodeling of cements, doped with the higher Cr3+ amount. Time of flight secondary ion mass spectrometry (ToF-SIMS) of histological sections was applied to investigate the release of Cr3+ ions from the cement after implantation and to image their distribution in the implant region and the surrounding bone tissue. The relatively weak incorporation of chromium into the newly formed bone tissue is in agreement to the low chromium concentrations which were released from the cements in vitro. The faster degradation of the Cr3+ doped cements was also verified by ToF-SIMS. The positive effect of Cr3+ doping on both degradation and new bone formation is discussed as a synergistic effect of Cr3+ bioactivity on osteoclastic resorption on one hand and improvement of cytocompatibility and solubility by structural changes in the calcium phosphate matrix on the other hand. STATEMENT OF SIGNIFICANCE While biologically active metal ions like strontium, magnesium and zinc are increasingly applied for the modification of ceramic bone graft materials, the present study is the first report on the incorporation of low doses of trivalent chromium ions into a calcium phosphate based biomaterial and testing of its performance in bone defect regeneration in vivo. Chromium(III)-doped calcium phosphate bone cements show improved cytocompatibility and both degradation rate and new bone formation in vivo are significantly increased compared to the reference cement. This important discovery might be the starting point for the application of trivalent chromium salts for the modification of bone graft materials to increase their remodelling rate.
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