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Diederichs EV, Mondal D, Patil H, Gorbet M, Willett TL. The effect of triglycerol diacrylate on the printability and properties of UV curable, bio-based nanohydroxyapatite composites. J Mech Behav Biomed Mater 2024; 153:106499. [PMID: 38490049 DOI: 10.1016/j.jmbbm.2024.106499] [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: 01/11/2024] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/17/2024]
Abstract
3D printable biopolymer nanocomposites composed of hydroxyapatite nanoparticles and functionalized plant-based monomers demonstrate potential as sustainable and structural biomaterials. To increase this potential, their printability and performance must be improved. For extrusion-based 3D printing, such as Direct Ink Writing (DIW), printability is important for print fidelity. In this work, triglycerol diacrylate (TGDA) was added to an acrylated epoxidized soybean oil:polyethylene glycol diacrylate resin to increase hydrogen bonding. Greater hydrogen bonding was hypothesized to improve printability by increasing the ink's shear yield strength, and therefore shape holding after deposition. The effects of this additive on material and mechanical properties were quantified. Increased hydrogen bonding due to TGDA content increased the ink's shear yield stress and viscosity by 916% and 27.6%, respectively. This resulted in improved printability, with best performance at 3 vol% TGDA. This composition achieved an ultimate tensile strength (UTS) of 32.4 ± 2.1 MPa and elastic modulus of 1.15 ± 0.21 GPa. These were increased from the 0 vol% TGDA composite, which had an UTS of 24.8 ± 1.8 MPa and a modulus of 0.88 ± 0.06 GPa. This study demonstrates the development of bio-based additive manufacturing feedstocks for potential uses in sustainable manufacturing, rapid prototyping, and biomaterial applications.
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Affiliation(s)
- Elizabeth V Diederichs
- Composite Biomaterial Systems Laboratory, Department of Systems Design, University of Waterloo, Douglas Wright Engineering Building, 200 University Avenue West, Waterloo, Canada
| | - Dibakar Mondal
- Composite Biomaterial Systems Laboratory, Department of Systems Design, University of Waterloo, Douglas Wright Engineering Building, 200 University Avenue West, Waterloo, Canada
| | - Haresh Patil
- Composite Biomaterial Systems Laboratory, Department of Systems Design, University of Waterloo, Douglas Wright Engineering Building, 200 University Avenue West, Waterloo, Canada
| | - Maud Gorbet
- Material Interaction with Biological Systems Laboratory, Department of Systems Design, University of Waterloo, Carl A. Pollock Hall, 200 University Avenue West, Waterloo, Canada
| | - Thomas L Willett
- Composite Biomaterial Systems Laboratory, Department of Systems Design, University of Waterloo, Douglas Wright Engineering Building, 200 University Avenue West, Waterloo, Canada.
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2
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Moussa H, El Hadad A, Sarrigiannidis S, Saad A, Wang M, Taqi D, Al-Hamed FS, Salmerón-Sánchez M, Cerruti M, Tamimi F. High toughness resorbable brushite-gypsum fiber-reinforced cements. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 127:112205. [PMID: 34225857 DOI: 10.1016/j.msec.2021.112205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/18/2021] [Accepted: 05/19/2021] [Indexed: 12/27/2022]
Abstract
The ideal bone substitute material should be mechanically strong, biocompatible with a resorption rate matching the rate of new bone formation. Brushite (dicalcium phosphate dihydrate) cement is a promising bone substitute material but with limited resorbability and mechanical properties. To improve the resorbability and mechanical performance of brushite cements, we incorporated gypsum (calcium sulfate dihydrate) and diazonium-treated polyglactin fibers which are well-known for their biocompatibility and bioresorbability. Here we show that by combining brushite and gypsum, we were able to fabricate biocompatible composite cements with high fracture toughness (0.47 MPa·m1/2) and a resorption rate that matched the rate of new bone formation. Adding functionalized polyglactin fibers to this composite cement further improved the fracture toughness up to 1.00 MPa·m1/2. XPS and SEM revealed that the improvement in fracture toughness is due to the strong interfacial bonding between the functionalized fibers and the cement matrix. This study shows that adding gypsum and functionalized polyglactin fibers to brushite cements results in composite biomaterials that combine high fracture toughness, resorbability, and biocompatibility, and have great potential for bone regeneration.
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Affiliation(s)
- Hanan Moussa
- Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; Faculty of Dentistry, Benghazi University, Benghazi 9504, Libya
| | - Amir El Hadad
- Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; Physics Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt
| | | | - Ahmed Saad
- Department of Mining and Materials Engineering, McGill University, Montreal, QC H3A 0C5, Canada
| | - Min Wang
- Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Doaa Taqi
- Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada
| | | | | | - Marta Cerruti
- Department of Mining and Materials Engineering, McGill University, Montreal, QC H3A 0C5, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada; College of Dental Medicine, Qatar University, Doha 2713, Qatar.
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Paknahad A, Goudarzi M, Kucko NW, Leeuwenburgh SC, Sluys LJ. Calcium phosphate cement reinforced with poly (vinyl alcohol) fibers: An experimental and numerical failure analysis. Acta Biomater 2021; 119:458-471. [PMID: 33164819 DOI: 10.1016/j.actbio.2020.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Calcium phosphate cements (CPCs) have been widely used during the past decades as biocompatible bone substitution in maxillofacial, oral and orthopedic surgery. CPCs are injectable and are chemically resemblant to the mineral phase of native bone. Nevertheless, their low fracture toughness and high brittleness reduce their clinical applicability to weakly loaded bones. Reinforcement of CPC matrix with polymeric fibers can overcome these mechanical drawbacks and significantly enhance their toughness and strength. Such fiber-reinforced calcium phosphate cements (FRCPCs) have the potential to act as advanced bone substitute in load-bearing anatomical sites. This work achieves integrated experimental and numerical characterization of the mechanical properties of FRCPCs under bending and tensile loading. To this end, a 3-D numerical gradient enhanced damage model combined with a dimensionally-reduced fiber model are employed to develop a computational model for material characterization and to simulate the failure process of fiber-reinforced CPC matrix based on experimental data. In addition, an advanced interfacial constitutive law, derived from micromechanical pull-out tests, is used to represent the interaction between the polymeric fiber and CPC matrix. The presented computational model is successfully validated with the experimental results and offers a firm basis for further investigations on the development of numerical and experimental analysis of fiber-reinforced bone cements.
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Moussa H, Jiang W, El Hadad A, Alsheghri AA, Basiri T, Taqi D, Song J, Tamimi F. Selective Crystal Growth Regulation by Chiral α-Hydroxycarboxylic Acids Improves the Strength and Toughness of Calcium Sulfate Cements. ACS APPLIED BIO MATERIALS 2020; 3:8559-8566. [DOI: 10.1021/acsabm.0c00918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Hanan Moussa
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
- Faculty of Dentistry, Benghazi University, Benghazi 9504, Libya
| | - Wenge Jiang
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
- Department of Chemistry, Tianjin Key Laboratory of Molecular Optoelectronic Sciences, and Tianjin Collaborative Innovation Center of Chemical Science & Engineering, Tianjin University, Tianjin 300072, P. R. China
| | - Amir El Hadad
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
- Physics Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt
| | - Ammar A. Alsheghri
- Department of Mining and Materials Engineering, McGill University, Montreal, Quebec H3A 0C5, Canada
| | - Tayebeh Basiri
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
| | - Doaa Taqi
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
| | - Jun Song
- Department of Mining and Materials Engineering, McGill University, Montreal, Quebec H3A 0C5, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, Quebec H3A 0C7, Canada
- College of Dental Medicine, Qatar University, Doha, Qatar
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3D Bone Morphology Alters Gene Expression, Motility, and Drug Responses in Bone Metastatic Tumor Cells. Int J Mol Sci 2020; 21:ijms21186913. [PMID: 32967150 PMCID: PMC7555977 DOI: 10.3390/ijms21186913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Abstract
Patients with advanced skeletal metastases arising from primary cancers including breast, lung, and prostate suffer from extreme pain, bone loss, and frequent fractures. While the importance of interactions between bone and tumors is well-established, our understanding of complex cell–cell and cell–microenvironment interactions remains limited in part due to a lack of appropriate 3D bone models. To improve our understanding of the influence of bone morphometric properties on the regulation of tumor-induced bone disease (TIBD), we utilized bone-like 3D scaffolds in vitro and in vivo. Scaffolds were seeded with tumor cells, and changes in cell motility, proliferation, and gene expression were measured. Genes associated with TIBD significantly increased with increasing scaffold rigidity. Drug response differed when tumors were cultured in 3D compared to 2D. Inhibitors for Integrin β3 and TGF-β Receptor II significantly reduced bone-metastatic gene expression in 2D but not 3D, while treatment with the Gli antagonist GANT58 significantly reduced gene expression in both 2D and 3D. When tumor-seeded 3D scaffolds were implanted into mice, infiltration of myeloid progenitors changed in response to pore size and rigidity. This study demonstrates a versatile 3D model of bone used to study the influence of mechanical and morphometric properties of bone on TIBD.
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Moussa H, Jiang W, Alsheghri A, Mansour A, Hadad AE, Pan H, Tang R, Song J, Vargas J, McKee MD, Tamimi F. High strength brushite bioceramics obtained by selective regulation of crystal growth with chiral biomolecules. Acta Biomater 2020; 106:351-359. [PMID: 32035283 DOI: 10.1016/j.actbio.2020.01.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/27/2020] [Accepted: 01/30/2020] [Indexed: 01/03/2023]
Abstract
Chirality seems to play a key role in mineralization. Indeed, in biominerals, the biomolecules that guide the formation and organization of inorganic crystals and help construct materials with exceptional mechanical properties, are homochiral. Here, we show that addition of homochiral l-(+)-tartaric acid improved the mechanical properties of brushite bioceramics by decreasing their crystal size, following the classic Hall-Petch strengthening effect; d-(-)-tartaric acid had the opposite effect. Adding l-(+)-Tar increased both the compressive strength (26 MPa) and the fracture toughness (0.3 MPa m1/2) of brushite bioceramics, by 33% and 62%, respectively, compared to brushite bioceramics without additives. In addition, l-(+)-tartaric acid enabled the fabrication of cements with high powder-to-liquid ratios, reaching a compressive strength and fracture toughness as high as 32.2 MPa and 0.6 MPa m1/2, respectively, approximately 62% and 268% higher than that of brushite bioceramics prepared without additives, respectively. Characterization of brushite crystals from the macro- to the atomic-level revealed that this regulation is attributable to a stereochemical matching between l-(+)-tartaric acid and the chiral steps of brushite crystals, which results in inhibition of brushite crystallization. These findings provide insight into understanding the role of chirality in mineralization, and how to control the crystallographic structure of bioceramics to achieve high-performance mechanical properties. STATEMENT OF SIGNIFICANCE: Calcium-phosphate cements are promising bone repair materials. However, their suboptimal mechanical properties limit their clinical use. Natural biominerals have remarkable mechanical properties that are the result of controlled size, shape and organization of their inorganic crystals. This is achieved by biomineralization proteins that are homochiral, composed of l- amino acids. Despite the importance of chiral l-biomolecules in biominerals, using homochiral molecules to fabricate bone cements has not been studied yet. In this study, we showed that homochiral l-(+)-tartaric acid can regulate the crystal structure and improve the mechanical properties of a calcium-phosphate cement. Hence, these findings open the door for a new way of designing strong bone cement and highlight the importance of chirality in bioceramics.
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Affiliation(s)
- Hanan Moussa
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada; Faculty of Dentistry, Benghazi University, Benghazi, 9504, Libya
| | - Wenge Jiang
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada; Department of Chemistry, Tianjin Key Laboratory of Molecular Optoelectronic Sciences, and Tianjin Collaborative Innovation Center of Chemical Science & Engineering, Tianjin University, Tianjin, 300072, PR China
| | - Ammar Alsheghri
- Department of Mining and Materials Engineering, McGill University, Montreal, QC, H3A 0C5, Canada
| | - Alaa Mansour
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada
| | - Amir El Hadad
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada; Physics Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo, 11884, Egypt
| | - Haihua Pan
- Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, Zhejiang, 310027, PR China
| | - Ruikang Tang
- Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, Zhejiang, 310027, PR China; Center for Biomaterials and Biopathways, Zhejiang University, Hangzhou, Zhejiang, 310027, PR China
| | - Jun Song
- Department of Mining and Materials Engineering, McGill University, Montreal, QC, H3A 0C5, Canada
| | - Javier Vargas
- Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, QC, H3A 0C7, Canada
| | - Marc D McKee
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada; Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, QC, H3A 0C7, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, H3A 0C7, Canada.
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Mondal D, Willett TL. Mechanical properties of nanocomposite biomaterials improved by extrusion during direct ink writing. J Mech Behav Biomed Mater 2020; 104:103653. [PMID: 32174411 DOI: 10.1016/j.jmbbm.2020.103653] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/17/2020] [Accepted: 01/23/2020] [Indexed: 11/16/2022]
Abstract
In this study, single filaments of acrylated epoxidized soybean oil (AESO)/polyethylene glycol diacrylate (PEGDA)/nanohydroxyapatite (nHA)-based nanocomposites intended for bone defect repair have displayed significant improvement of their mechanical properties when extruded through smaller needle gauges before UV curing. These nanocomposite inks can be deposited layer-by-layer during direct ink writing (DIW) - a form of additive manufacturing. Single filaments were prepared by extruding the nanocomposite ink through needles with varying diameters from 0.21 mm to 0.84 mm and then UV cured. Filaments and cast specimens were tensile tested to determine elastic modulus, strength and toughness. The cured nanocomposite filaments were further characterized using thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Fourier-transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). SEM confirmed that the hydroxyapatite nanoparticles were well dispersed in the polymer matrices. The ultimate tensile strength and moduli increased as the diameter of the extrusion needle was decreased. These correlated with increased matrix crystallinity and fewer defects. For instance, filaments extruded through 0.84 mm diameter needles had ultimate tensile stress and modulus of 26.3 ± 2.8 MPa and 885 ± 100 MPa, respectively, whereas, filaments extruded through 0.21 mm needles had ultimate tensile stress and modulus of 48.9 ± 4.0 MPa and 1696 ± 172 MPa, respectively. This study has demonstrated enhanced mechanical properties resulting from extrusion-based direct ink writing of a new AESO-PEGDA-nHA nanocomposite biomaterial intended for biomedical applications. These enhanced properties are the result of fewer defects and increased crystallinity. A means of achieving mechanical properties suitable for repairing bone defects is apparent.
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Affiliation(s)
- Dibakar Mondal
- Composite Biomaterial Systems Laboratory, Department of Systems Design Engineering, University of Waterloo, 200 University Ave. West, Waterloo, N2L 3G1, Canada
| | - Thomas L Willett
- Composite Biomaterial Systems Laboratory, Department of Systems Design Engineering, University of Waterloo, 200 University Ave. West, Waterloo, N2L 3G1, Canada.
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Paknahad A, Kucko NW, Leeuwenburgh SC, Sluys LJ. Experimental and numerical analysis on bending and tensile failure behavior of calcium phosphate cements. J Mech Behav Biomed Mater 2020; 103:103565. [DOI: 10.1016/j.jmbbm.2019.103565] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
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McGough MA, Boller LA, Groff DM, Schoenecker JG, Nyman JS, Wenke JC, Rhodes C, Shimko D, Duvall CL, Guelcher SA. Nanocrystalline hydroxyapatite-poly(thioketal urethane) nanocomposites stimulate a combined intramembranous and endochondral ossification response in rabbits. ACS Biomater Sci Eng 2020; 6:564-574. [PMID: 32405537 PMCID: PMC7220073 DOI: 10.1021/acsbiomaterials.9b01378] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Resorbable bone cements are replaced by bone osteoclastic resorption and osteoblastic new bone formation near the periphery. However, the ideal bone cement would be replaced by new bone through processes similar to fracture repair, which occurs through a variable combination of endochondral and intramembranous ossification. In this study, nanocrystalline hydroxyapatite (nHA)-poly(thioketal urethane) (PTKUR) cements were implanted in femoral defects in New Zealand White rabbits to evaluate ossification at 4, 12, and 18 months. Four formulations were tested: an injectable, flowable cement and three moldable putties with varying ratios of calcium phosphate to sucrose granules. New bone formation and resorption of the cement by osteoclasts occurred near the periphery. Stevenel's Blue and Safranin O staining revealed infiltration of chondrocytes into the cements and ossification of the cartilaginous intermediate. These findings suggest that nHA-PTKUR cements support combined intramembranous and endochondral ossification, resulting in enhanced osseointegration of the cement that could potentially improve patient outcomes.
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Affiliation(s)
- Madison A.P. McGough
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Lauren A. Boller
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Dustin M. Groff
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Jonathan G. Schoenecker
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
- Department of Orthopaedics, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
| | - Jeffry S. Nyman
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
- Department of Orthopaedics, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
| | - Joseph C. Wenke
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234
| | - Cheyenne Rhodes
- Medtronic Spinal & Biologics, 1800 Pyramid Pl, Memphis, TN 38132
| | - Dan Shimko
- Medtronic Spinal & Biologics, 1800 Pyramid Pl, Memphis, TN 38132
| | - Craig L. Duvall
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Scott A. Guelcher
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
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Panpisut P, Khan MA, Main K, Arshad M, Xia W, Petridis H, Young AM. Polymerization kinetics stability, volumetric changes, apatite precipitation, strontium release and fatigue of novel bone composites for vertebroplasty. PLoS One 2019; 14:e0207965. [PMID: 30883564 PMCID: PMC6422261 DOI: 10.1371/journal.pone.0207965] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/26/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The aim was to determine effects of diluent monomer and monocalcium phosphate monohydrate (MCPM) on polymerization kinetics and volumetric stability, apatite precipitation, strontium release and fatigue of novel dual-paste composites for vertebroplasty. MATERIALS AND METHODS Polypropylene (PPGDMA) or triethylene (TEGDMA) glycol dimethacrylates (25 wt%) diluents were combined with urethane dimethacrylate (70 wt%) and hydroxyethyl methacrylate (5 wt%). 70 wt% filler containing glass particles, glass fibers (20 wt%) and polylysine (5 wt%) was added. Benzoyl peroxide and MCPM (10 or 20 wt%) or N-tolyglycine glycidyl methacrylate and tristrontium phosphate (15 wt%) were included to give initiator or activator pastes. Commercial PMMA (Simplex) and bone composite (Cortoss) were used for comparison. ATR-FTIR was used to determine thermal activated polymerization kinetics of initiator pastes at 50-80°C. Paste stability, following storage at 4-37°C, was assessed visually or through mixed paste polymerization kinetics at 25°C. Polymerization shrinkage and heat generation were calculated from final monomer conversions. Subsequent expansion and surface apatite precipitation in simulated body fluid (SBF) were assessed gravimetrically and via SEM. Strontium release into water was assessed using ICP-MS. Biaxial flexural strength (BFS) and fatigue properties were determined at 37°C after 4 weeks in SBF. RESULTS Polymerization profiles all exhibited an inhibition time before polymerization as predicted by free radical polymerization mechanisms. Initiator paste inhibition times and maximum reaction rates were described well by Arrhenius plots. Plot extrapolation, however, underestimated lower temperature paste stability. Replacement of TEGDMA by PPGDMA, enhanced paste stability, final monomer conversion, water-sorption induced expansion and strontium release but reduced polymerization shrinkage and heat generation. Increasing MCPM level enhanced volume expansion, surface apatite precipitation and strontium release. Although the experimental composite flexural strengths were lower compared to those of commercially available Simplex, the extrapolated low load fatigue lives of all materials were comparable. CONCLUSIONS Increased inhibition times at high temperature give longer predicted shelf-life whilst stability of mixed paste inhibition times is important for consistent clinical application. Increased volumetric stability, strontium release and apatite formation should encourage bone integration. Replacing TEGDMA by PPGDMA and increasing MCPM could therefore increase suitability of the above novel bone composites for vertebroplasty. Long fatigue lives of the composites may also ensure long-term durability of the materials.
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Affiliation(s)
- Piyaphong Panpisut
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
| | - Muhammad Adnan Khan
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
| | - Kirsty Main
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
| | - Mayda Arshad
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
| | - Wendy Xia
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
| | - Haralampos Petridis
- Department of Restorative Dentistry, Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Anne Margaret Young
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, United Kingdom
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11
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McGough MAP, Shiels SM, Boller LA, Zienkiewicz KJ, Duvall CL, Wenke JC, Guelcher SA. Poly(Thioketal Urethane) Autograft Extenders in an Intertransverse Process Model of Bone Formation. Tissue Eng Part A 2019; 25:949-963. [PMID: 30398387 DOI: 10.1089/ten.tea.2018.0223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
IMPACT STATEMENT The development of autograft extenders is a significant clinical need in bone tissue engineering. We report new settable poly(thioketal urethane)-based autograft extenders that have bone-like mechanical properties and handling properties comparable to calcium phosphate bone cements. These settable autograft extenders remodeled to form new bone in a biologically stringent intertransverse process model of bone formation that does not heal when treated with calcium phosphate bone void fillers or cements alone. This is the first study to report settable autograft extenders with bone-like strength and handling properties comparable to ceramic bone cements, which have the potential to improve treatment of bone fractures and other orthopedic conditions.
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Affiliation(s)
- Madison A P McGough
- 1Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,2Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Lauren A Boller
- 1Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,2Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katarzyna J Zienkiewicz
- 4Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee
| | - Craig L Duvall
- 1Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Joseph C Wenke
- 3U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas
| | - Scott A Guelcher
- 1Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,2Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee.,4Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee
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12
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Lu S, McGough MAP, Shiels SM, Zienkiewicz KJ, Merkel AR, Vanderburgh JP, Nyman JS, Sterling JA, Tennent DJ, Wenke JC, Guelcher SA. Settable polymer/ceramic composite bone grafts stabilize weight-bearing tibial plateau slot defects and integrate with host bone in an ovine model. Biomaterials 2018; 179:29-45. [PMID: 29960822 PMCID: PMC6065109 DOI: 10.1016/j.biomaterials.2018.06.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 11/16/2022]
Abstract
Bone fractures at weight-bearing sites are challenging to treat due to the difficulty in maintaining articular congruency. An ideal biomaterial for fracture repair near articulating joints sets rapidly after implantation, stabilizes the fracture with minimal rigid implants, stimulates new bone formation, and remodels at a rate that maintains osseous integrity. Consequently, the design of biomaterials that mechanically stabilize fractures while remodeling to form new bone is an unmet challenge in bone tissue engineering. In this study, we investigated remodeling of resorbable bone cements in a stringent model of mechanically loaded tibial plateau defects in sheep. Nanocrystalline hydroxyapatite-poly(ester urethane) (nHA-PEUR) hybrid polymers were augmented with either ceramic granules (85% β-tricalcium phosphate/15% hydroxyapatite, CG) or a blend of CG and bioactive glass (BG) particles to form a settable bone cement. The initial compressive strength and fatigue properties of the cements were comparable to those of non-resorbable poly(methyl methacrylate) bone cement. In animals that tolerated the initial few weeks of early weight-bearing, CG/nHA-PEUR cements mechanically stabilized the tibial plateau defects and remodeled to form new bone at 16 weeks. In contrast, cements incorporating BG particles resorbed with fibrous tissue filling the defect. Furthermore, CG/nHA-PEUR cements remodeled significantly faster at the full weight-bearing tibial plateau site compared to the mechanically protected femoral condyle site in the same animal. These findings are the first to report a settable bone cement that remodels to form new bone while providing mechanical stability in a stringent large animal model of weight-bearing bone defects near an articulating joint.
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Affiliation(s)
- Sichang Lu
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Madison A P McGough
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Stefanie M Shiels
- Extremity Trauma and Regenerative Medicine Task Area, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - Katarzyna J Zienkiewicz
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Alyssa R Merkel
- Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37235, USA; Department of Veterans Affairs, Nashville, TN, USA
| | - Joseph P Vanderburgh
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Jeffry S Nyman
- Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37235, USA; Department of Orthopedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Julie A Sterling
- Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37235, USA; Department of Veterans Affairs, Nashville, TN, USA
| | - David J Tennent
- Extremity Trauma and Regenerative Medicine Task Area, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - Joseph C Wenke
- Extremity Trauma and Regenerative Medicine Task Area, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA; Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37235, USA.
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13
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Robo C, Öhman-Mägi C, Persson C. Compressive fatigue properties of commercially available standard and low-modulus acrylic bone cements intended for vertebroplasty. J Mech Behav Biomed Mater 2018; 82:70-76. [PMID: 29571115 DOI: 10.1016/j.jmbbm.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
Abstract
Vertebroplasty (VP) is a minimally invasive surgical procedure commonly used to relieve severe back pain associated with vertebral compression fractures. The poly(methyl methacrylate) bone cement used during this procedure is however presumed to facilitate the occurrence of additional fractures next to the treated vertebrae. A reason for this is believed to be the difference in stiffness between the bone cement and the surrounding trabecular bone. The use of bone cements with lower mechanical properties could therefore reduce the risk of complications post-surgery. While intensive research has been performed on the quasi-static mechanical properties of these cements, there is no data on their long-term mechanical properties. In the present study, the in vitro compressive fatigue performance as well as quasi-static mechanical properties of two commercially available acrylic bone cements - a low-modulus cement (Resilience®) and a standard cement (F20) from the same manufacturer - were determined. The quasi-static mechanical properties of the low-modulus and standard cements after 24 h of setting were in the range of other vertebroplastic cements (σ = 70-75 MPa; E= 1600-1900 MPa). F20 displayed similar mechanical properties over time in 37 °C phosphate buffered saline solution, while the mechanical properties of the Resilience® cement decreased gradually due to an increased porosity in the polymeric matrix. The standard cement exhibited a fatigue limit of approx. 47 MPa, whereas the low-modulus cement showed a fatigue limit of approx. 31 MPa. In summary, the low-modulus bone cement had a lower fatigue limit than the standard cement, as expected. However, this fatigue limit is still substantially higher than the stresses experienced by vertebral trabecular bone.
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Affiliation(s)
- Céline Robo
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - Caroline Öhman-Mägi
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - Cecilia Persson
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden.
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14
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Ajaxon I, Holmberg A, Öhman-Mägi C, Persson C. Fatigue performance of a high-strength, degradable calcium phosphate bone cement. J Mech Behav Biomed Mater 2018; 79:46-52. [DOI: 10.1016/j.jmbbm.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 01/18/2023]
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15
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DANESI VALENTINA, FALDINI CESARE, CRISTOFOLINI LUCA. METHODS FOR THE CHARACTERIZATION OF THE LONG-TERM MECHANICAL PERFORMANCE OF CEMENTS FOR VERTEBROPLASTY AND KYPHOPLASTY: CRITICAL REVIEW AND SUGGESTIONS FOR TEST METHODS. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519417300022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is a growing interest towards bone cements for use in vertebroplasty and kyphoplasty, as such spine procedures are becoming more and more common. Such cements feature different compositions, including both traditional acrylic cements and resorbable and bioactive materials. Due to the different compositions and intended use, the mechanical requirements of cements for spinal applications differ from those of traditional cements used in joint replacement. Because of the great clinical implications, it is very important to assess their long-term mechanical competence in terms of fatigue strength and creep. This paper aims at offering a critical overview of the methods currently adopted for such mechanical tests. The existing international standards and guidelines and the literature were searched for publications relevant to fatigue and creep of cements for vertebroplasty and kyphoplasty. While standard methods are available for traditional bone cements in general, no standard indicates specific methods or acceptance criteria for fatigue and creep of cements for vertebroplasty and kyphoplasty. Similarly, a large number of papers were published on cements for joint replacements, but only few cover fatigue and creep of cements for vertebroplasty and kyphoplasty. Furthermore, the literature was analyzed to provide some indications of tests parameters and acceptance criteria (number of cycles, duration in time, stress levels, acceptable amount of creep) for possible tests specifically relevant to cements for spinal applications.
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Affiliation(s)
- VALENTINA DANESI
- Department of Industrial Engineering, Alma Mater Studiorum — Università di Bologna, Italy
| | - CESARE FALDINI
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum — Università di Bologna, Italy
- Department of Orthopaedics and Trauma Surgery, Università di Bologna — Istituto Ortopedico Rizzoli, Bologna, Italy
| | - LUCA CRISTOFOLINI
- Department of Industrial Engineering, Alma Mater Studiorum — Università di Bologna, Italy
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16
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Saji GS, Shamnadh M, Varma S, Amanulla S, Bharath R, Oommen C. Experimental Evaluation of Compressive Strength of PMMA-Seashell based Biocomposites for Orthopedic Applications. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.matpr.2018.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Liang T, Gao CX, Yang L, Saijilafu, Yang HL, Luo ZP. Deterioration of the mechanical properties of calcium phosphate cements with Poly (γ-glutamic acid) and its strontium salt after in vitro degradation. J Mech Behav Biomed Mater 2017; 75:190-196. [PMID: 28750300 DOI: 10.1016/j.jmbbm.2017.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/16/2017] [Accepted: 07/19/2017] [Indexed: 10/19/2022]
Abstract
The mechanical reliability of calcium phosphate cements has restricted their clinical application in load-bearing locations. Although their mechanical strength can be improved using a variety of strategies, their fatigue properties are still unclear, especially after degradation. The evolutions of uniaxial compressive properties and the fatigue behavior of calcium phosphate cements incorporating poly (γ-glutamic acid) and its strontium salt after different in vitro degradation times were investigated in the present study. Compressive strength decreased from the 61.2±5.4MPa of the original specimen, to 51.1±4.4, 42.2±3.8, 36.8±2.4 and 28.9±3.2MPa following degradation for one, two, three and four weeks, respectively. Fatigue life under same loading condition also decreased with increasing degradation time. The original specimens remained intact for one million cycles (run-out) under a maximum stress of 30MPa. After degradation for one to four weeks, the specimens were able to withstand maximum stress of 20, 15, 10 and 10MPa, respectively until run-out. Defect volume fraction within the specimens increased from 0.19±0.021% of the original specimen to 0.60±0.19%, 1.09±0.04%, 2.68±0.64% and 7.18±0.34% at degradation time of one, two, three and four weeks, respectively. Therefore, we can infer that the primary cause of the deterioration of the mechanical properties was an increasing in micro defects induced by degradation, which promoted crack initiation and propagation, accelerating the final mechanical failure of the bone cement. This study provided the data required for enhancing the mechanical reliability of the calcium phosphate cements after different degradation times, which will be significant for the modification of load-bearing biodegradable bone cements to match clinical application.
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Affiliation(s)
- Ting Liang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Chun-Xia Gao
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Lei Yang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Saijilafu
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Hui-Lin Yang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Zong-Ping Luo
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China.
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18
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Lu S, McEnery MAP, Rogers BR, Wenke JC, Shimko D, Guelcher SA. Resorbable Nanocomposites with Bone-Like Strength and Enhanced Cellular Activity. J Mater Chem B 2017; 5:4198-4206. [PMID: 30101031 PMCID: PMC6086367 DOI: 10.1039/c7tb00657h] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bone cements for treatment of fractures at weight-bearing sites are subjected to dynamic physiological loading from daily activities. An ideal bone cement rapidly sets after injection, exhibits bone-like strength, stimulates osteogenic differentiation of endogenous cells, and resorbs at a rate aligned with patient biology. However, currently available materials fall short of these targeted properties. Nanocrystalline hydroxyapatite (nHA) enhances osteogenic differentiation, new bone formation, and osteoclast differentiation activity compared to amorphous or micron-scale crystalline hydroxyapatite. However, the brittle mechanical properties of nHA precludes its use in treatment of weight-bearing bone defects. In this study, we report settable nHA-poly(ester urethane) (PEUR) nanocomposites synthesized from nHA, lysine triisocyanate (LTI), and poly(caprolactone) triol via a solvent-free process. The nanocomposites are easily mixed and injected using a double-barrel syringe, exhibit mechanical properties exceeding those of conventional bone cements, enhance mineralization of osteoprogenitor cells in vitro, and undergo osteoclast-mediated degradation in vitro. This combination of properties cannot be achieved using other technologies, which underscores the potential of nHA-PEUR nanocomposites as a new approach for promoting bone healing at weight-bearing sites.
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Affiliation(s)
- S Lu
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - M A P McEnery
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - B R Rogers
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - J C Wenke
- Orthopaedic Task Area, U.S. Army Institute of Surgical Research, San Antonio, TX, USA
| | - D Shimko
- Medtronic Spine and Biologics, Memphis, TN, 38132, USA
| | - S A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
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19
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Ajaxon I, Öhman Mägi C, Persson C. Compressive fatigue properties of an acidic calcium phosphate cement-effect of phase composition. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:41. [PMID: 28144853 PMCID: PMC5285421 DOI: 10.1007/s10856-017-5851-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
Calcium phosphate cements (CPCs) are synthetic bone grafting materials that can be used in fracture stabilization and to fill bone voids after, e.g., bone tumour excision. Currently there are several calcium phosphate-based formulations available, but their use is partly limited by a lack of knowledge of their mechanical properties, in particular their resistance to mechanical loading over longer periods of time. Furthermore, depending on, e.g., setting conditions, the end product of acidic CPCs may be mainly brushite or monetite, which have been found to behave differently under quasi-static loading. The objectives of this study were to evaluate the compressive fatigue properties of acidic CPCs, as well as the effect of phase composition on these properties. Hence, brushite cements stored for different lengths of time and with different amounts of monetite were investigated under quasi-static and dynamic compression. Both storage and brushite-to-monetite phase transformation was found to have a pronounced effect both on quasi-static compressive strength and fatigue performance of the cements, whereby a substantial phase transformation gave rise to a lower mechanical resistance. The brushite cements investigated in this study had the potential to survive 5 million cycles at a maximum compressive stress of 13 MPa. Given the limited amount of published data on fatigue properties of CPCs, this study provides an important insight into the compressive fatigue behaviour of such materials.
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Affiliation(s)
- Ingrid Ajaxon
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden
| | - Caroline Öhman Mägi
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden
| | - Cecilia Persson
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden.
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20
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O'Neill R, McCarthy HO, Montufar EB, Ginebra MP, Wilson DI, Lennon A, Dunne N. Critical review: Injectability of calcium phosphate pastes and cements. Acta Biomater 2017; 50:1-19. [PMID: 27838464 DOI: 10.1016/j.actbio.2016.11.019] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 12/26/2022]
Abstract
Calcium phosphate cements (CPC) have seen clinical success in many dental and orthopaedic applications in recent years. The properties of CPC essential for clinical success are reviewed in this article, which includes properties of the set cement (e.g. bioresorbability, biocompatibility, porosity and mechanical properties) and unset cement (e.g. setting time, cohesion, flow properties and ease of delivery to the surgical site). Emphasis is on the delivery of calcium phosphate (CaP) pastes and CPC, in particular the occurrence of separation of the liquid and solid components of the pastes and cements during injection; and established methods to reduce this phase separation. In addition a review of phase separation mechanisms observed during the extrusion of other biphasic paste systems and the theoretical models used to describe these mechanisms are discussed. STATEMENT OF SIGNIFICANCE Occurrence of phase separation of calcium phosphate pastes and cements during injection limits their full exploitation as a bone substitute in minimally invasive surgical applications. Due to lack of theoretical understanding of the phase separation mechanism(s), optimisation of an injectable CPC that satisfies clinical requirements has proven difficult. However, phase separation of pastes during delivery has been the focus across several research fields. Therefore in addition to a review of methods to reduce phase separation of CPC and the associated constraints, a review of phase separation mechanisms observed during extrusion of other pastes and the theoretical models used to describe these mechanisms is presented. It is anticipated this review will benefit future attempts to develop injectable calcium phosphate based systems.
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Affiliation(s)
- R O'Neill
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - H O McCarthy
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - E B Montufar
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - M-P Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - D I Wilson
- Department of Chemical Engineering and Biotechnology, New Museums Site, Pembroke Street, University of Cambridge, CB2 3RA, United Kingdom
| | - A Lennon
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - N Dunne
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom; Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland; Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
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21
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McEnery MAP, Lu S, Gupta MK, Zienkiewicz KJ, Wenke JC, Kalpakci KN, Shimko D, Duvall CL, Guelcher SA. Oxidatively Degradable Poly(thioketal urethane)/Ceramic Composite Bone Cements with Bone-Like Strength. RSC Adv 2016; 6:109414-109424. [PMID: 27895899 PMCID: PMC5123593 DOI: 10.1039/c6ra24642g] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Synthetic bone cements are commonly used in orthopaedic procedures to aid in bone regeneration following trauma or disease. Polymeric cements like PMMA provide the mechanical strength necessary for orthopaedic applications, but they are not resorbable and do not integrate with host bone. Ceramic cements have a chemical composition similar to that of bone, but their brittle mechanical properties limit their use in weight-bearing applications. In this study, we designed oxidatively degradable, polymeric bone cements with mechanical properties suitable for bone tissue engineering applications. We synthesized a novel thioketal (TK) diol, which was crosslinked with a lysine triisocyanate (LTI) prepolymer to create hydrolytically stable poly(thioketal urethane)s (PTKUR) that degrade in the oxidative environment associated with bone defects. PTKUR films were hydrolytically stable for up to 6 months, but degraded rapidly (<1 week) under simulated oxidative conditions in vitro. When combined with ceramic micro- or nanoparticles, PTKUR cements exhibited working times comparable to calcium phosphate cements and strengths exceeding those of trabecular bone. PTKUR/ceramic composite cements supported appositional bone growth and integrated with host bone near the bone-cement interface at 6 and 12 weeks post-implantation in rabbit femoral condyle plug defects. Histological evidence of osteoclast-mediated resorption of the cements was observed at 6 and 12 weeks. These findings demonstrate that a PTKUR bone cement with bone-like strength can be selectively resorbed by cells involved in bone remodeling, and thus represent an important initial step toward the development of resorbable bone cements for weight-bearing applications.
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Affiliation(s)
- Madison A P McEnery
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Sichang Lu
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA
| | - Mukesh K Gupta
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Katarzyna J Zienkiewicz
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA
| | - Joseph C Wenke
- U.S. Army Institute of Surgical Research, San Antonio, TX, USA
| | | | | | - Craig L Duvall
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Scott A Guelcher
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN
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