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Biocompatibility and resorption of a radiopaque premixed calcium phosphate cement
Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences. (Materials in Medicine)
Dept of Clinical Chemistry and Transfusion Medicine, och Dept of Biomaterials, Sahlgrenska Academy at University of Gothenburg, Göteborg. (Clinical Chemistry and Transfusion Medicine)
Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences. (Materials in Medicine)
Dept of Orthopedics, Sahlgrenska University Hospital, Gothenburg University, Göteborg.
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2012 (English)In: Journal of Biomedical Materials Research. Part A, ISSN 1549-3296, Vol. 100A, no 5, 1269-1278 p.Article in journal (Refereed) Published
Abstract [en]

Calcium phosphate cements (CPC) are used as bone void filler in various orthopedic indications; however, there are some major drawbacks regarding mixing, transfer, and injection of traditional CPC. By using glycerol as mixing liquid, a premixed calcium phosphate cement (pCPC), some of these difficulties can be overcome. In the treatment of vertebral fractures the handling characteristics need to be excellent including a high radio-opacity for optimal control during injection. The aim of this study is to evaluate a radiopaque pCPC regarding its resorption behavior and biocompatibility in vivo. pCPC and a water-based CPC were injected into a circle divide 4-mm drilled femur defect in rabbits. The rabbits were sacrificed after 2 and 12 weeks. Cross sections of the defects were evaluated using histology, electron microscopy, and immunohistochemical analysis. Signs of inflammation were evaluated both locally and systemically. The results showed a higher bone formation in the pCPC compared to the water-based CPC after 2 weeks by expression of RUNX-2. After 12 weeks most of the cement had been resorbed in both groups. Both materials were considered to have a high biocompatibility since no marked immunological response was induced and extensive bone ingrowth was observed. The conclusion from the study was that pCPC with ZrO2 radiopacifier is a promising alternative regarding bone replacement material and may be suggested for treatment of, for example, vertebral fractures based on its high biocompatibility, fast bone ingrowth, and good handling properties.

Place, publisher, year, edition, pages
2012. Vol. 100A, no 5, 1269-1278 p.
Keyword [en]
monetite, brushite, in vivo, bone void filler, immunological response
National Category
Ceramics Biomaterials Science
Research subject
Engineering Science with specialization in Materials Science
URN: urn:nbn:se:uu:diva-168647DOI: 10.1002/jbm.a.34065ISI: 000302017800020OAI: oai:DiVA.org:uu-168647DiVA: diva2:501729
Available from: 2012-02-14 Created: 2012-02-14 Last updated: 2013-04-08Bibliographically approved
In thesis
1. Premixed Acidic Calcium Phosphate Cements
Open this publication in new window or tab >>Premixed Acidic Calcium Phosphate Cements
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Calcium phosphate cements are used in medicine to fill bone defects or give support to screws and plates in fracture fixation. The cements are formed via mixing a powder with water and the mixture harden through a dissolution-precipitation reaction. Today the cement mixing is performed in the operating room and consists of several complicated steps that need to be performed under sterile conditions. This renders the mixing a risk factor, potentially leading to harm for the patient e.g. unsatisfactory healing or infection. To reduce this risk, premixed cements have been developed using glycerol as mixing liquid. The premixed cement sets when it is exposed to body liquids. Therefore, premixed cement can be delivered to the operating room in prefilled syringes ready for use, thus eliminating the mixing step.

The aim of this thesis is to describe differences between premixed and water-mixed cements and their advantages and drawbacks. The differences will be discussed based on results obtained from bench testing of specific cement properties as function of cement formulations as well as in vitro and in vivo studies.

Several cement formulations were evaluated e.g. the influence of powder to liquid ratio (P/L), powder particle size and addition of water on key properties. The results showed that premixed cements have excellent handling properties and have mechanical properties similar to water-based cements. Both P/L and particle size can be used to control these properties. It was shown that small amounts of water improve certain cement properties while dry raw materials were important for long shelf life. To better understand the setting of premixed cements new methods for evaluating working time and setting of premixed cements were developed. In vivo studies showed that the formulations developed in this thesis are biocompatible, resorbable and show good tissue response in bone.

This thesis concludes, that the premixed cements are a promising biomaterial with excellent handling properties and good biological response. The most important challenge for the premixed cements, in order to become commercially successful, is to obtain clinically relevant setting time and shelf life simultaneously. An increasing use of premixed cements in the clinics should shorten operation times and reduce infection rates to the benefit of both patients and medical staff.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 61 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 904
monetite, brushite, bone void filler, injecatilbity, in vivo, in vitro
National Category
Biomaterials Science Ceramics
urn:nbn:se:uu:diva-168650 (URN)978-91-554-8285-5 (ISBN)
Public defence
2012-03-29, Å2001, Ångstrsömslaboratoriet, Lägerhyddsvägen 1, Uppsala, 10:15 (English)
Available from: 2012-03-08 Created: 2012-02-14 Last updated: 2013-04-08Bibliographically approved

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