Doped calcium-aluminium-phosphate cements for biomedical applications

The efficacy of femoral augmentation for hip fracture prevention using ceramic-based cements: A preliminary experimentally-driven finite element investigation

Femoral fractures due to sideways falls continue to be a major cause of concern for the elderly. Existing approaches for the prevention of these injuries have limited efficacy. Prophylactic femoral augmentation systems, particularly those involving the injection of ceramic-based bone cements, are gaining more attention as a potential alternative preventative approach. We evaluated the mechanical effectiveness of three variations of a bone cement injection pattern (basic ellipsoid, hollow ellipsoid, small ellipsoid) utilizing finite element simulations of sideways fall impacts. The basic augmentation pattern was tested with both high- and low-strength ceramic-based cements. The cement patterns were added to the finite element models (FEMs) of five cadaveric femurs, which were then subject to simulated sideways falls at seven impact velocities ranging from 1.0 m/s to 4.0 m/s. Peak impact forces and peak acetabular forces were examined, and failure was evaluated using a strain-based criterion. We found that the basic HA ellipsoid provided the highest increases in both the force at the acetabulum of the impacted femur ("acetabular force", 55.0% ± 22.0%) and at the force plate ("impact force", 37.4% ± 15.8%). Changing the cement to a weaker material, brushite, resulted in reduced strengthening of the femur (45.2% ± 19.4% acetabular and 30.4% ± 13.0% impact). Using a hollow version of the ellipsoid appeared to have no effect on the fracture outcome and only a minor effect on the other metrics (54.1% ± 22.3% acetabular force increase and 35.3% ± 16.0% impact force increase). However, when the outer two layers of the ellipsoid were removed (small ellipsoid), the force increases that were achieved were only 9.8% ± 5.5% acetabular force and 8.2% ± 4.1% impact force. These results demonstrate the importance of supporting the femoral neck cortex to prevent femoral fractures in a sideways fall, and provide plausible options for prophylactic femoral augmentation. As this is a preliminary study, the surgical technique, the possible effects of trabecular bone damage during the augmentation process, and the effect on the blood supply to the femoral head must be assessed further.

Functional role of inorganic trace elements in dentin apatite tissue-Part 1: Mg, Sr, Zn, and Fe

Many essential elements exist in nature with significant influence on dentin and bone apatite tissue. Hydroxyapatite (HAp) is the major inorganic crystalline structure of dentin that provides a site for various physiological functions such as surface layer ion exchange. Decades of apatite research have shown that enamel is a high-substituted crystalline apatite, but recent findings suggest that dentin apatite may play a more important role in regulating ion exchange as well as mineral crystallinity. This article is the first part of a review series on the functional role of inorganic trace elements including magnesium, strontium, zinc, and iron in dentin hydroxyapatite. The morphology, physiology, crystallinity, and solubility of these elements as they get substituted into the HAp lattice are extensively discussed. An electronic search was performed on the role of these elements in dentin apatite from January 2007 to September 2021. The relationship between different elements and their role in the mineral upkeep of dentin apatite was evaluated. Several studies recognized the role of these elements in dentinal apatite composition and its subsequent effects on morphology, crystallinity, and solubility. These elements are of great importance in physiological processes and an essential part of living organisms. Magnesium and strontium stimulate osteoblast activity, while zinc can improve overall bone quality with its antibacterial properties. Iron nanoparticles are also vital in promoting bone tissue growth as they donate or accept electrons in redox reactions. Thus, understanding how these elements impact dentin apatite structure is of great clinical significance.