Study of a hydraulic calcium phosphate cement for dental applications

Calcium phosphate-based cements (CPCs) have attracted much interest because of their good osteoconductivity for bone reconstruction. We obtained CPCs by mixing calcium bis-dihydrogenophosphate monohydrate (MCPM) and calcium oxide with water or sodium phosphate buffers (NaP) as liquid phase. Cement samples with different calcium-to-phosphate ratios (Ca/P), liquid-to-powder ratios (L/P) and liquid phases were analyzed by X-rays diffraction (XRD), pH-metry, extensometry and calorimetry. Antibacterial activity on two bacterial strains (Streptococcus mutans, Lactobacillus acidophilus) and a polycontaminated bacterial inoculum was also studied using the agar diffusion method. The best mechanical properties (approximately 25 MPa) corresponded to Ca/P ratios between 1.67 and 2.5, a 1 M sodium phosphate buffer pH 7, as liquid phase and a L/P ratio of 0.6ml g(-1). The final setting time increased with the Ca/P ratio. The setting expansion, around 1-2%, depended on the Ca/P and L/P ratios. The inner temperature of the cements rose to 45 degrees during setting then decreased rapidly. The injectability was 100% up to 3.5 min and then decreased. It increased with increasing the L/P ratio but to the detriment of the compressive strength and setting time. XRD analysis indicated that the setting reaction led to a mixture of calcium hydroxide and calcium-deficient hydroxyapatite even for a Ca/P ratio of 1.67. Consequently, the pH of the surrounding fluids rose to 11.5-12 during their dissolution. Bacterial growth inhibition was only clearly observed for Ca/P>or=2. This bioactive calcium phosphate cement can potentially be employed for pulp capping and cavity lining as classical calcium hydroxide-based cements, but it is not usable, in the present formulation, for root canal filling because of its short setting time.