Injectable Calcium Phosphate Cement: Effects of Powder-to-liquid Ratio and Needle Size

Overview

Journal J Biomed Mater Res B Appl Biomater

Specialty Biomedical Engineering

Date 2007 Jul 20

PMID 17635038

Citations 28

Authors

Elena F Burguera

Hockin H K Xu

Limin Sun

Affiliations

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Abstract

Calcium phosphate cement (CPC) sets in situ and forms apatite with excellent osteoconductivity and bone-replacement capability. The objectives of this study were to formulate an injectable tetracalcium phosphate-dicalcium phosphate cement (CPC(D)), and investigate the powder/liquid ratio and needle-size effects. The injection force (mean +/- SD; n = 4) to extrude the paste increased from (8 +/- 2) N using a 10-gauge needle to (144 +/- 17) N using a 21-gauge needle (p < 0.05). With the 10-gauge needle, the mass percentage of extruded paste was (95 +/- 4)% at a powder/liquid ratio of 3; it decreased to (70 +/- 12)% at powder/liquid = 3.5 (p < 0.05). A relationship was established between injection force, F, and needle lumen cross-sectional area, A: F = 5.0 + 38.7/A(0.8). Flexural strength, S, (mean +/- SD; n = 5) increased from (5.3 +/- 0.8) MPa at powder/liquid= 2 to (11.0 +/- 0.8) MPa at powder/liquid = 3.5 (p < 0.05). Pore volume fraction, P, ranged from 62.4% to 47.9%. A relationship was established: S = 47.7 x (1 - P)(2.3). The strength of the injectable CPC(D) matched/exceeded the reported strengths of sintered porous hydroxyapatite implants that required machining. The novel injectable CPC(D) with a relatively high strength may be useful in filling defects with limited accessibility such as periodontal repair and tooth root-canal fillings, and in minimally-invasive techniques such as percutaneous vertebroplasty to fill the lesions and to strengthen the osteoporotic bone.

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References

Brown G, Mealey B, Nummikoski P, Bifano S, Waldrop T . Hydroxyapatite cement implant for regeneration of periodontal osseous defects in humans. J Periodontol. 1998; 69(2):146-57. DOI: 10.1902/jop.1998.69.2.146. View

Ginebra M, Rilliard A, Fernandez E, Elvira C, San Roman J, Planell J . Mechanical and rheological improvement of a calcium phosphate cement by the addition of a polymeric drug. J Biomed Mater Res. 2001; 57(1):113-8. DOI: 10.1002/1097-4636(200110)57:1<113::aid-jbm1149>3.0.co;2-5. View

Xu H, Takagi S, Quinn J, Chow L . Fast-setting calcium phosphate scaffolds with tailored macropore formation rates for bone regeneration. J Biomed Mater Res A. 2004; 68(4):725-34. DOI: 10.1002/jbm.a.20093. View

Ishikawa K, Miyamoto Y, Takechi M, Toh T, Kon M, Nagayama M . Non-decay type fast-setting calcium phosphate cement: hydroxyapatite putty containing an increased amount of sodium alginate. J Biomed Mater Res. 1997; 36(3):393-9. DOI: 10.1002/(sici)1097-4636(19970905)36:3<393::aid-jbm14>3.0.co;2-f. View

Burguera E, Xu H, Takagi S, Chow L . High early strength calcium phosphate bone cement: effects of dicalcium phosphate dihydrate and absorbable fibers. J Biomed Mater Res A. 2005; 75(4):966-75. DOI: 10.1002/jbm.a.30497. View

Gbureck U, Barralet J, Spatz K, Grover L, Thull R . Ionic modification of calcium phosphate cement viscosity. Part I: hypodermic injection and strength improvement of apatite cement. Biomaterials. 2004; 25(11):2187-95. DOI: 10.1016/j.biomaterials.2003.08.066. View

Laurencin C, Ambrosio A, Borden M, Cooper Jr J . Tissue engineering: orthopedic applications. Annu Rev Biomed Eng. 2001; 1:19-46. DOI: 10.1146/annurev.bioeng.1.1.19. View

Garcia A, Ducheyne P, Boettiger D . Effect of surface reaction stage on fibronectin-mediated adhesion of osteoblast-like cells to bioactive glass. J Biomed Mater Res. 1998; 40(1):48-56. DOI: 10.1002/(sici)1097-4636(199804)40:1<48::aid-jbm6>3.0.co;2-r. View

Sarda S, Fernandez E, Nilsson M, Balcells M, Planell J . Kinetic study of citric acid influence on calcium phosphate bone cements as water-reducing agent. J Biomed Mater Res. 2002; 61(4):653-9. DOI: 10.1002/jbm.10264. View

10.

Ginebra M, Fernandez E, De Maeyer E, Verbeeck R, Boltong M, Ginebra J . Setting reaction and hardening of an apatitic calcium phosphate cement. J Dent Res. 1997; 76(4):905-12. DOI: 10.1177/00220345970760041201. View

11.

Gan L, Pilliar R . Calcium phosphate sol-gel-derived thin films on porous-surfaced implants for enhanced osteoconductivity. Part I: Synthesis and characterization. Biomaterials. 2004; 25(22):5303-12. DOI: 10.1016/j.biomaterials.2003.12.038. View

12.

Friedman C, Costantino P, Takagi S, Chow L . BoneSource hydroxyapatite cement: a novel biomaterial for craniofacial skeletal tissue engineering and reconstruction. J Biomed Mater Res. 1998; 43(4):428-32. DOI: 10.1002/(sici)1097-4636(199824)43:4<428::aid-jbm10>3.0.co;2-0. View

13.

Durucan C, Brown P . Low temperature formation of calcium-deficient hydroxyapatite-PLA/PLGA composites. J Biomed Mater Res. 2000; 51(4):717-25. DOI: 10.1002/1097-4636(20000915)51:4<717::aid-jbm21>3.0.co;2-q. View

14.

Hing K, Best S, Bonfield W . Characterization of porous hydroxyapatite. J Mater Sci Mater Med. 2004; 10(3):135-45. DOI: 10.1023/a:1008929305897. View

15.

Xu H, Sun L, Weir M, Antonucci J, Takagi S, Chow L . Nano DCPA-whisker composites with high strength and Ca and PO(4) release. J Dent Res. 2006; 85(8):722-7. PMC: 2423228. DOI: 10.1177/154405910608500807. View

16.

Ueyama Y, Ishikawa K, Mano T, Koyama T, Nagatsuka H, Matsumura T . Initial tissue response to anti-washout apatite cement in the rat palatal region: comparison with conventional apatite cement. J Biomed Mater Res. 2001; 55(4):652-60. DOI: 10.1002/1097-4636(20010615)55:4<652::aid-jbm1060>3.0.co;2-k. View

17.

Xu H, Quinn J . Calcium phosphate cement containing resorbable fibers for short-term reinforcement and macroporosity. Biomaterials. 2002; 23(1):193-202. DOI: 10.1016/s0142-9612(01)00095-3. View

18.

Bohner M, Baroud G . Injectability of calcium phosphate pastes. Biomaterials. 2004; 26(13):1553-63. DOI: 10.1016/j.biomaterials.2004.05.010. View

19.

Hench L . Biomaterials: a forecast for the future. Biomaterials. 1998; 19(16):1419-23. DOI: 10.1016/s0142-9612(98)00133-1. View

20.

Bai B, Jazrawi L, Kummer F, Spivak J . The use of an injectable, biodegradable calcium phosphate bone substitute for the prophylactic augmentation of osteoporotic vertebrae and the management of vertebral compression fractures. Spine (Phila Pa 1976). 1999; 24(15):1521-6. DOI: 10.1097/00007632-199908010-00004. View