Effect of phosphate functional groups on the calcification capacity of acrylic hydrogels

The incorporation of negatively charged groups into the structure of synthetic polymers is frequently advocated as a method for enhancing their calcification capacity required in orthopedic and dental applications. However, the results reported by various research groups are rather contentious, since inhibitory effects have also been observed in some studies. In the present study, phosphate groups were introduced in poly(2-hydroxyethyl methacrylate) (PHEMA) by copolymerization with 10% mol of either mono(2-acryloyloxyethyl) phosphate (MAEP) or mono(2-methacryloyloxyethyl) phosphate (MMEP). Incubation of these hydrogels for determined durations (1-9 weeks) in a simulated body fluid (SBF) solution induced deposition of calcium phosphate (CaP) deposits of whitlockite type. After 9 weeks, the amount of calcium deposited on the phosphate-containing polymers was four times lower than that found on PHEMA, as determined by X-ray photoelectron spectroscopy (XPS). Samples of copolymer HEMA-MAEP were implanted subcutaneously in rats and evaluated after 9 weeks. No CaP deposits could be detected on the copolymer by XPS or energy dispersive X-ray spectroscopy, while PHEMA samples were massively calcified. It was concluded that the presence of phosphate groups decreased the calcification capacity of the hydrogels, and that in the conditions of this study, the phosphate groups had an inhibitory effect on the deposition of CaP phases on HEMA-based hydrogels.

Calcification of poly(2-hydroxyethyl methacrylate) hydrogel sponges implanted in the rabbit cornea: a 3-month study

Poly(2-hydroxyethyl methacrylate) (PHEMA) hydrogels have been used in the past as ocular implants. In a recent development, PHEMA sponges have shown suitable properties as materials for the peripheral component of an artificial cornea (keratoprosthesis). However, the propensity of PHEMA to calcify could threaten the long-term stability of the implanted devices. In an attempt to improve the understanding of the calcification mechanism, the dynamics, extent, and nature of calcified deposits within PHEMA sponges implanted in the cornea were investigated in this study, and the possible correlation between necrosis of cells and calcification was critically examined. Samples of a PHEMA sponge were implanted in rabbit corneas and explanted at predetermined time points (2, 4, and 12 weeks). The samples were examined by microscopy (light, transmission, scanning) and energy dispersive analysis of X-rays. Histological assessment and semiquantitative analysis of the amount of calcium deposited was performed using image analysis. An in vitro experiment was also performed by incubating sponge samples for 2 weeks in a solution of calcium and phosphate ions at a ratio similar to that in hydroxyapatite, in the absence of cells. Calcification was not seen in the 2- and 4-week explants, however, small deposits were detected in two of the 12-week explants, both within and on the sponge's constituent polymer particles. The deposit volumes represented 0.094% and 0.21%, respectively, of the total sponge volumes. Calcium deposits were present in large amounts both within the constituent polymer particles and on the surface of the sponges incubated in the abiotic calcifying solution. Cooperative mechanisms are suggested for the calcification of PHEMA sponges in vivo. The initial event may occur at a molecular level, when plasma proteins are adsorbed onto the polymer surface and bound through chelation to the calcium ions present in the medium. After their natural degradation, these structures may act as nucleation sites for calcium phosphate crystallization. Concurrently, the calcium ions can diffuse into the hydrogel particles and then the spontaneous precipitation of calcium phosphate may be caused by supersaturation due to the lower content of water in polymer, an effect which is likely predominant in vitro. The second event is the recruitment of phagocytic cells to clear calcium debris. Degeneration of these cells may then form nucleation sites for secondary calcification.

Tissue responses to Hydron, assessed by intraosseous implantation

Teflon tubes containing freshly mixed, polymerized Hydron root canal filling material, fully set AH26 or Teflon were implanted into the mandible of guinea pigs and assessed histologically at 2 days, 1, 2, 4, 12 and 26 weeks. None of the materials tested elicited signs of overt or significant tissue damage, and polymerized Hydron was assessed to be as biocompatible as fully set AH26 and Teflon. Bone formed in very close apposition to the polymerized Hydron, whereas a soft tissue capsule separated the regenerated bone from implants of AH26 and Teflon.

Tissue responses to Hydron, assessed by intramuscular implantation

Freshly mixed polymerized Hydron root canal filling material, fully set AH26 and Teflon were implanted in the quadriceps muscle of guinea pigs and assessed histologically at 2 days, 1, 2, 3, 12 and 26 weeks after implantation. All materials were characterized by peri-implant fibrous connective tissue capsule formation. Von Kossa-positive calcific material was observed at the implant-tissue interface of Hydron implants. The amount of apparently calcified material increased with time. Inflammation was not a prominent tissue response for any of the test materials, nor was a foreign body giant cell response.

Poly-HEMA sponge: a biocompatible calcification implant

Poly-hydroxyethyl methacrylate (Poly-HEMA) was investigated for biocompatibility and calcification potential. S.C. and I.M. implants and transplants to subperiosteal sites were examined. The material was judged to be tolerated by the host tissue since no inflammatory or degenerative changes were observed. This study established that calcification does occur. This calcification does not simulate bone formation; osteoblasts were not observed. The x-ray diffraction pattern resembles that of calcium hydroxyapatite.

Porous hydrophilic polymer: good and bad news in the orthopedic application of cruciate ligament substitution

In the configuration used, the Hydron sponge did not enhance the ingrowth of bone into the Dacron for prosthesis anchorage. In fact, the presence of the Hydron seemed to retard such ingrowth, even though there was bony incorporation of portions of the Hydron polymer. Fixation was more rigid when Dacron was implanted bare. Hydron sponge does not appear to remain intact within a joint. It would not seem suitable for intra-articular protection of a prosthesis or local delivery of antibiotics here. We did not search further for the polymer in the regional lymph nodes. Hydron sponge is capable of eleciting an unusual phenomenon of woven bone formation. This is "good news" for its potential, but realization of such potential will certainly require additional study. Double and triple interval fluorochrome labelling would be especially helpful in further studying the localization and rate of this bone formation.