CNT and rGO reinforced PMMA based bone cement for fixation of load bearing implants: Mechanical property and biological response

Modification of polymethylmethacrylate bone cement with halloysite clay nanotubes

BACKGROUND

Polymethylmethacrylate (PMMA) bone cement is used in orthopedics and dentistry to get primary fixation to bone but doesn't provide a mechanically and biologically stable bone interface. Therefore, there was a great demand to improve the properties of the PMMA bone cement to reduce its clinical usage limitations and enhance its success rate. Recent studies demonstrated that the addition of halloysite nanotubes (HNTs) to a polymeric-based material can improve its mechanical and thermal characteristics.

OBJECTIVES

The purpose of the study is to assess the compressive strength, flexural strength, maximum temperature, and setting time of traditional PMMA bone cements that have been manually blended with 7 wt% HNT fillers.

METHODS

PMMA powder and monomer liquid were combined to create the control group, the reinforced group was made by mixing the PMMA powder with 7 wt% HNT fillers before liquid mixing. Chemical characterization of the HNT fillers was employed by X-ray fluorescence (XRF). The morphological examination of the cements was done using a scanning electron microscope (SEM). Analytical measurements were made for the compressive strength, flexural strength, maximum temperature, and setting time. Utilizing independent sample t-tests, the data was statistically assessed to compare mean values (p < 0.05).

RESULTS

The findings demonstrated that the novel reinforced PMMA-based bone cement with 7 wt% HNT fillers showed higher mean compressive strength values (93 MPa) and higher flexural strength (72 MPa). and lower maximum temperature values (34.8 °C) than the conventional PMMA bone cement control group, which was (76 MPa), (51 MPa), and (40 °C), respectively (P < 0.05). While there was no significant difference in the setting time between the control and the modified groups.

CONCLUSION

The novel PMMA-based bone cement with the addition of 7 wt% HNTs can effectively be used in orthopedic and dental applications, as they have the potential to enhance the compressive and flexural strength and reduce the maximum temperatures.

Composite Nanomaterials Based on Polymethylmethacrylate Doped with Carbon Nanotubes and Nanoparticles: A Review

Composite polymer materials have high strength and lightness, which makes them attractive for use in a variety of structures and products. The present article contains an overview of modern works devoted to the production of composite materials based on poly(methyl methacrylate) (PMMA) with improved characteristics. The possibility of obtaining such materials can be a key area for creating more efficient and durable products in various industries. Various methods were considered to improve the characteristics of PMMA by doping the polymer matrix with carbon nanotubes (CNTs), graphite, nanohydroxyapatite particles, micro-zirconia nanoparticles, titanium dioxide, etc. The possibilities of using the obtained composite materials in various industries such as aviation, automotive, construction, medical and others are discussed. This article also presents the results of our own research on the mechanisms of interaction of PMMA with single-layer CNTs, leading to the creation of a composite polymer system "PMMA+CNT", achieved using the modern quantum chemical method DFT. This article presents a review of the recent research on the effect of CNTs on the mechanical and electrically conductive properties of nanocomposite materials. The outcomes of this study can be important for the development of science and technology in various fields, from fundamental chemistry to applied scientific research.

Preparation and characterizations of antibacterial poly(methyl methacrylate) bone cement via copolymerization with a quaternary ammonium monomer of dimethylaminotriclosan methacrylate

Poly (methyl methacrylate) (PMMA) bone cement relies on the loaded antibiotic to realize the antibacterial purpose. But the exothermic behavior during setting often makes temperature-sensitive antibiotics inactivated. It is necessary to develop new material candidates to replace antibiotics. In this study, a new quaternary ammonium methacrylate (QAM) monomer called dimethylaminetriclosan methacrylate (DMATCM) was designed by the quaternization between 2-(Dimethylamino)ethyl methacrylate and triclosan, then employed as the modifier to explore the feasibility of equipping bone cement with antibacterial activity, and to investigate the variations on the physical and biological performances brought by the substitution ratio of DMATCM to MMA. Results showed that DMATCM opened its C=C bonding to participate in the MMA polymerization, and the quaternary ammonium group helped it to perform broad-spectrum antibacterial property against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. With an increased substitution ratio of DMATCM to MMA, the glass transition temperatures, the maximum exothermic temperatures, and the contact angles of bone cements declined, but the residual monomer contents, the fluid uptakes, and the setting times under Vical indentation increased. Long-term soaking made almost no changes to the weight loss and the mechanical properties of DMATCM-modified cements with lower substitution ratios of 0∼20%, and the activation rather enhanced the strengths of uncured AMBC-4 and AMBC-5 samples. Owing to more DMATCM exposed on the cement surface, the inhibition ring diameter produced by modified cement was improved to a maximum of 28.09 mm, and MC3T3-E1 cells performed the cell viabilities all beyond 70% and healthy adhesion after 72 h co-culturing. Taking all measured properties and ISO standards into account, the antibacterial bone cement under the ratio of 10% performed better, besides its good bactericidal effect, the other properties satisfied the requirements for clinical application.

Fabrication of magnetic nanocomposite scaffolds based on polyvinyl alcohol-chitosan containing hydroxyapatite and clay modified with graphene oxide: Evaluation of their properties for bone tissue engineering applications

One of the most common systems for bone tissue engineering is polymeric scaffolds. However, the low mechanical properties of polymeric scaffolds, considering the properties required for bone replacement tissue, are the main challenge for researchers in this field. For bone tissue engineering, this research prepared nanocomposite scaffolds based on polyvinyl alcohol-chitosan containing modified clay and hydroxyapatite (HAp). HAp used in these 3D scaffolds was synthesized from a chicken femur, and Cloisite 30B clay nanoparticles were modified by graphene oxide and Fe3O4 nanoparticles to strengthen their mechanical properties. Sample characteristics were determined using FT-IR, XRD, SEM, TGA, swelling rate, laboratory degradation, and biological and mechanical properties. These analyses showed that 2% of modified clay (C30B/GO/Fe3O4, CGF) inside the nanocomposite scaffold increased the compressive strength 23 times compared to the pristine polymer scaffold. Also, adding HAp particles and modified clay simultaneously increased the mineralization on the surface of the scaffolds. Final nanocomposite scaffolds were found to have a compressive strength of 9.31 MPa, a porosity of 75 %, and a porosity size of 50 nm and were in the range of cancellous bone. The final swelling amount is 1790 %, which is the amount that is Favorable for bone scaffold. Finally, the analysis results to determine the samples' toxicity showed that none of the prepared scaffolds were toxic and showed good cell viability.

Study on the poly(methyl methacrylate-acrylic acid)/calcium phosphate cement composite bound by chelation with enhanced water absorption and biomechanical properties

Polymethylmethacrylate (PMMA) bone cement has been widely used as a critical material for fixing prostheses and filling bone defects. The shrinkage of PMMA bone cement was addressed by the additives, however, the uneven integral water absorption and expansion performance as well as the deteriorated mechanical properties of the modified bone cement after immersion in phosphate buffered saline (PBS) and simulation body fluid (SBF) affected the long-term stability after implantation. Calcium phosphate cement (CPC) is a biomaterial with promising applications in orthopedics, whose hydration reaction provides an important driving force for the transfer of water. Besides, the mechanical properties of CPC can be enhanced with the curing process. In this study, CPC was utilized to modify the poly(methyl methacrylate-acrylic acid) [P(MMA-AA)] bone cement. The results demonstrated the successful construction of interconnected CPC water delivery networks in the P(MMA-AA)/CPC composite, the water absorption ratio and expansion ratio of the composite were up to 131.18 ± 9.14% and 168.19 ± 5.44%, respectively. Meanwhile, the transformation of CPC water delivery networks into rigid mechanical support networks as well as the chelation interaction between organic-inorganic enhanced the mechanical properties of the composite after immersion, the compressive strength after immersion reached 62.97 ± 0.97 MPa, which was 27.65% higher than that before immersion. The degradation ratio of the composite was up to 13.76 ± 0.23% after 9 days of immersion, which was 16.4% higher than that of CPC. Furthermore, composites exhibited superior biocompatibility as the release of Ca2+. Therefore, P(MMA-AA)/CPC composite serves as a promising medical filling material for clinical use.

The practical process of manufacturing poly(methyl methacrylate)-based scaffolds having high porosity and high strength

Poly(methyl methacrylate) (PMMA)-based scaffolds have been produced using the granule casting method with grain sizes M80-100 and M100-140. The novelty of this study was the application of the cold-cutting method (CCm) to reduce the PMMA granule size. PMMA granule shape, granule size (mesh), and sintering temperature were the primary variables in manufacturing PMMA scaffolds. CCm was applied to reduce the granule size of commercial PMMA, which was originally solid cylindrical, by lowering the temperature to 3.5 °C, 0 °C, and-8.3 °C. PMMA granules that had been reduced were sieved with mesh sizes M80-100 and M100-140. Green bodies were made by the granule casting method using an aluminum mold measuring 8 × 8 × 8 mm³. The sintering process was carried out at temperatures varying from 115 °C to 140 °C, a heating rate of 5 °C/min, and a holding time of 2 h, the cooling process was carried out in a furnace. The characterization of the PMMA-based scaffolds' properties was carried out by observing the microstructure with SEM, analyzing the distribution of pore sizes with ImageJ software, and testing the porosity, the phase, with XRD, and the compressive strength. The best results from the overall analysis were the M80-100 PMMA scaffold treated at a sintering temperature of 130 °C with compressive strength, porosity, and pore size distribution values of 8.2 MPa, 62.0%, and 121-399 μm, respectively, and the M100-140 one treated at a sintering temperature of 135 °C with compressive strength, porosity, and pore size distribution values of 12.1 MPa, 61.2%, and 140-366 μm, respectively. There were interconnected pores in the PMMA scaffolds, as evidenced by the SEM images. There was no PMMA phase change between before and after the sintering process.

Thermal insulation properties of lightweight, self-healing, and mesoporous carrageenan/PMMA cryogels

The development of new bio-based cryogel materials with low environmental impact and various properties such as self-healing, flame-retardancy, low thermal conductivity has emerged as a cutting-edge research topic in special-purpose materials and a significant challenge. Herein, we report a simple processing methodology for preparing new mesoporous light weight thermal insulation biomass hybrid cryogels based on natural and biocompatible polymers, including marine glycosaminoglycan carrageenan moss (CM) and polymethyl methacrylate (PMMA) abbreviated as CM/PMMA under cryo conditions. The mechanical, thermal, and physicochemical characterization of the obtained hybrid cryogel was studied. The effect of increasing thickness on thermal conductivity and compressive strength was investigated. The results show that the thermal conductivity increases from 0.068 W m-1 K-1 to 0.124 W m-1 K-1 with increasing thickness. Also, the compressive strength changed from 89.5% MPa to 95.4% MPa. The results revealed that cryogel has a wrinkled surface and interconnected pores and exhibits high flexibility, self-healing ability, flame retardancy, and low thermal conductivity.

Influence of Initiator Concentration on the Polymerization Course of Methacrylate Bone Cement

Background: The amount of oxidant (initiator) and reductant (co-initiator) and their ratio have a significant effect on the properties of polymethacrylate bone cement, such as maximum temperature (T_max), setting time (t_set) and compressive strength (σ). The increase in the initiating system concentration causes an increase in the number of generated radicals and a faster polymerization rate, which shortens the setting time. The influence of the redox-initiating composition on the course of polymerization (rate of polymerization and degree of double bond conversion) and the mechanical properties of bone cement will be analyzed. Methods: Bone cements were synthesized by mixing a powder phase composed of two commercially available methacrylate copolymers (Evonic) and a liquid phase containing 2-hydroxyethyl methacrylate (HEMA), methyl methacrylate (MMA), and triethylene glycol dimethacrylate (D3). As an initiating system, the benzoyl peroxide (BPO) as an oxidant (initiator) in combination with a reducing agent (co-initiator), N,N-dimethylaniline (DMA), was used. Samples were prepared with various amounts of peroxide BPO (0.05%, 0.1%, 0.2%, 0.3%, 0.5% and 0.7% by weight) with a constant amount of reducing agent DMA (0.5 wt.%), and various amounts of DMA (0.25%, 0.35% and 0.5% by weight) with a constant amount of BPO (0.3 wt.%). The polymerization kinetics were studied by differential scanning calorimetry (DSC). Doughing time and compressive strength tests were carried out according to the requirements of the ISO 5833:2002 standard. Results: The increase in polymerization rate was due to the increase in the amount of BPO. In addition, the curing time was shortened, as well as the time needed to achieve the maximum polymerization rate. The final conversion of the double bonds in the studied compositions was in the range 74-100%, and the highest value of this parameter was obtained by the system with 0.3 wt.% of BPO. The doughing times for each BPO concentration were in the range of 90-140 s. The best mechanical properties were obtained for the cement following the initiating system concentrations: 0.3 wt.% of BPO and 0.5 wt.% of DMA. Nevertheless, all tested cements met the requirements of the ISO 5833:2002 standard. Conclusions: Based on the conducted polymerization kinetic studies, the best reaction conditions are provided by an initiating system containing 0.3 wt.% of BPO oxidant (initiator) and 0.5 wt.% of DMA reductant (co-initiator). A decrease in the DMA amount caused a decrease in the polymerization rate and the amount of heat released during the reaction. The change in BPO and DMA concentrations in the composition had little effect on the doughing time of the studied bone cement. The cements showed similar doughing times, ranging from 90-225 s, which is comparable to the bone cement available on the market.

Cutting-Edge Progress in Stimuli-Responsive Bioadhesives: From Synthesis to Clinical Applications

With the advent of "intelligent" materials, the design of smart bioadhesives responding to chemical, physical, or biological stimuli has been widely developed in biomedical applications to minimize the risk of wounds reopening, chronic pain, and inflammation. Intelligent bioadhesives are free-flowing liquid solutions passing through a phase shift in the physiological environment due to stimuli such as light, temperature, pH, and electric field. They possess great merits, such as ease to access and the ability to sustained release as well as the spatial transfer of a biomolecule with reduced side effects. Tissue engineering, wound healing, drug delivery, regenerative biomedicine, cancer therapy, and other fields have benefited from smart bioadhesives. Recently, many disciplinary attempts have been performed to promote the functionality of smart bioadhesives and discover innovative compositions. However, according to our knowledge, the development of multifunctional bioadhesives for various biomedical applications has not been adequately explored. This review aims to summarize the most recent cutting-edge strategies (years 2015-2021) developed for stimuli-sensitive bioadhesives responding to external stimuli. We first focus on five primary categories of stimuli-responsive bioadhesive systems (pH, thermal, light, electric field, and biomolecules), their properties, and limitations. Following the introduction of principal criteria for smart bioadhesives, their performances are discussed, and certain smart polymeric materials employed in their creation in 2015 are studied. Finally, advantages, disadvantages, and future directions regarding smart bioadhesives for biomedical applications are surveyed.

Novel Trends into the Development of Natural Hydroxyapatite-Based Polymeric Composites for Bone Tissue Engineering

In recent years, the number of people needing bone replacements for the treatment of defects caused by chronic diseases or accidents has continuously increased. To solve these problems, tissue engineering has gained significant attention in the biomedical field, by focusing on the development of suitable materials that improve osseointegration and biologic activity. In this direction, the development of an ideal material that provides good osseointegration, increased antimicrobial activity and preserves good mechanical properties has been the main challenge. Currently, bone tissue engineering focuses on the development of materials with tailorable properties, by combining polymers and ceramics to meet the necessary complex requirements. This study presents the main polymers applied in tissue engineering, considering their advantages and drawbacks. Considering the potential disadvantages of polymers, improving the applicability of the material and the combination with a ceramic material is the optimum pathway to increase the mechanical stability and mineralization process. Thus, ceramic materials obtained from natural sources (e.g., hydroxyapatite) are preferred to improve bioactivity, due to their similarity to the native hydroxyapatite found in the composition of human bone.

Influence of Different Nanometals Implemented in PMMA Bone Cement on Biological and Mechanical Properties

Cemented arthroplasty is a common process to fix prostheses when a patient becomes older and his/her bone quality deteriorates. The applied cements are biocompatible, can transfer loads, and dampen vibrations, but do not provide antibacterial protection. The present work is aimed at the development of cement with antibacterial effectivity achieved with the implementation of nanoparticles of different metals. The powders of Ag, Cu with particles size in a range of 10–30 nm (Cu10) and 70–100 nm (Cu70), AgCu, and Ni were added to PMMA cement. Their influence on compression strength, wettability, and antibacterial properties of cement was assessed. The surface topography of samples was examined with biological and scanning electron microscopy. The mechanical properties were determined by compression tests. A contact angle was observed with a goniometer. The biological tests included an assessment of cytotoxicity (XTT test on human cells Saos-2 line) and bacteria viability exposure (6 months). The cements with Ag and Cu nanopowders were free of bacteria. For AgCu and Ni nanoparticles, the bacterial solution became denser over time and, after 6 months, the bacteria clustered into conglomerates, creating a biofilm. All metal powders in their native form in direct contact reduce the number of eukaryotic cells. Cell viability is the least limited by Ag and Cu particles of smaller size. All samples demonstrated hydrophobic nature in the wettability test. The mechanical strength was not significantly affected by the additions of metal powders. The nanometal particles incorporated in PMMA-based bone cement can introduce long-term resistance against bacteria, not resulting in any serious deterioration of compression strength.

Conductive photothermal non-swelling nanocomposite hydrogel patch accelerating bone defect repair

Bone defect repair is one of the most common issue in clinic. Developmental multifunctional scaffolds have become a promising strategy to effectively promote bone defect repair. Here, a series of...

Recent advancement in 3-D printing: nanocomposites with added functionality

Three-Dimentional (3-D) printing is currently a popular printing technique that is used in many sectors. Potentially, this technology is expected to replace conventional manufacturing in the coming years. It is accelerating in gaining attention due to its design freedom where objects can be produced without imagination boundaries. The review presents a perspective on the application of 3-D printing application based on various fields. However, the ordinary 3-D printed products with a single type of raw often lack robustness leading to broken parts. Improving the mechanical property of a 3-D printed part is crucial for its applications in many fields. One of the promising solutions is to incorporate nanoparticles or fillers into the raw material. The review aims to provide information about the types of additive manufacturing. There are few types of raw materials can be used as foundation template in the printing, enhanced properties of the printed polymer nanocomposites with different types of nanoparticles as additives in the printing. The article reviews the advantages and disadvantages of different materials that are used as raw materials or base materials in 3-D printing. This can be a guideline for the readers to compare and analyse the raw materials prior to a decision on the type of material to be selected. The review prepares an overview for the researchers to choose the types of nanoparticles to be added in the printing of the products depending on the targeted application. With the added functionality of the 3-D polymer nanocomposites, it will help in widespread of the application of 3-D printing technology in various sector.

Optimization of Mechanical and Setting Properties in Acrylic Bone Cements Added with Graphene Oxide

The extended use of acrylic bone cements (ABC) in orthopedics presents some disadvantages related to the generation of high temperatures during methyl methacrylate polymerization, thermal tissue necrosis, and low mechanical properties. Both weaknesses cause an increase in costs for the health system and a decrease in the patient’s quality of life due to the prosthesis’s loosening. Materials such as graphene oxide (GO) have a reinforcing effect on ABC’s mechanical and setting properties. This article shows for the first time the interactions present between the factors sonication time and GO percentage in the liquid phase, together with the percentage of benzoyl peroxide (BPO) in the solid phase, on the mechanical and setting properties established for cements in the ISO 5833-02 standard. Optimization of the factors using a completely randomized experimental design with a factorial structure resulted in selecting nine combinations that presented an increase in compression, flexion, and the setting time and decreased the maximum temperature reached during the polymerization. All of these characteristics are desirable for improving the clinical performance of cement. Those containing 0.3 wt.% of GO were highlighted from the selected formulations because all the possible combinations of the studied factors generate desirable properties for the ABC.