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Osteotransductive bone cements

F C Driessens1, J A Planell, M G Boltong

  • 1Department of Materials Science and Metallurgy, Universitat Politècnica de Catalunya, Barcelona, Spain.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
|December 16, 1998
PubMed
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Calcium phosphate bone cements (CPBCs) are osteotransductive materials that transform into new bone after implantation. Their chemistry and applications in bone repair, augmentation, and reconstruction are detailed, with some types suitable for load-bearing uses.

Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Regenerative Medicine

Background:

  • Calcium phosphate bone cements (CPBCs) are known for their osteotransductive properties, meaning they convert to bone tissue post-implantation.
  • Their moldable nature ensures immediate osteointegration, facilitating bone defect repair, augmentation, and reconstruction.
  • CPBCs exhibit varied in vivo osteotransduction rates depending on their crystalline or amorphous composition, including hydroxyapatite (HA), carbonated apatite (CA), and dicalcium phosphate dihydrate (DCPD).

Purpose of the Study:

  • To review the chemistry and osteotransduction mechanisms of various calcium phosphate bone cements.
  • To highlight the clinical applications of CPBCs in bone healing and reconstruction.
  • To discuss the potential for incorporating therapeutic agents and the load-bearing capabilities of specific CPBC formulations.

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Main Methods:

  • Review of established CPBC chemistry, including amorphous calcium phosphate (ACP) and crystalline formulations.
  • Analysis of in vivo osteotransduction rates for different CPBC compositions (gypsum-DCPD, DCPD, CDHA, CA, HA).
  • Evaluation of mechanical properties, specifically compressive strength, for load-bearing applications.

Main Results:

  • CPBCs demonstrate varying osteotransduction rates: gypsum-DCPD > DCPD > CDHA ≈ CA > HA.
  • Osteotransduction of CDHA-type cements can be enhanced by adding dicalcium phosphate anhydrous (DCP) and/or CaCO3.
  • Certain CPBCs (CDHA, CA, HA types) possess compressive strength exceeding human trabecular bone (10 MPa), enabling load-bearing applications.

Conclusions:

  • CPBCs are versatile biomaterials for bone regeneration, offering immediate osteointegration and osteotransduction.
  • Formulation optimization, including additives like DCP and CaCO3, can improve osteotransduction rates.
  • CPBCs hold significant potential for drug delivery and load-bearing orthopedic applications.