Calcium phosphate cement: review of mechanical and biological properties

Calcium phosphate cement is a bioactive and biodegradable grafting material in the form of powder and liquid, which when mixed, sets as primarily hydroxyapatite, sometimes mixed with unreacted particles and other phases. This material has been extensively investigated due to its excellent biological properties, potential resorbability, molding capabilities, and easy manipulation. Because the material can potentially be replaced with bone after a period of time, it could retain the short-term biological advantages of hydroxyapatite without the long-term disadvantages. Although little is known about this material in the dental community, in vivo and in vitro studies show calcium phosphate cement as a promising material for grafting applications. In the following article, the authors review the biological and mechanical properties of calcium phosphate cement, as well as its potential use in clinical applications.

A Medline search was performed (timeline: 1980 to 2003) using the following keywords: calcium phosphate cement, hydroxyapatite cement, HA cement, and hydroxyapatite. The search was limited to the English language. The patent literature as well as a limited number of master's theses and books were reviewed after using the electronic database search service from a dental school library.

Calcium phosphate cement appears to have excellent biological properties. At only 2 weeks, spicules of living bone with normal bone marrow and osteocytes can be seen. Excellent moldability is a desired clinical characteristic; however, further research is necessary in order to improve the mechanical properties of the cement. The resorption/replacement by bone capability of the cement remains controversial. Further research is needed to clarify this issue. Due to poor mechanical properties, clinical applications are currently limited to craniofacial applications. Further research is necessary to take advantage of the excellent biological properties of this cement under clinical applications.

Further research is necessary to understand and improve the behavior of this type of cement under clinical situations.