Sintered hydroxyfluorapatites. Part I: Sintering ability of precipitated solid solution powders

Hydrothermal Synthesis of Fluorapatite Coatings over Titanium Implants for Enhanced Osseointegration-An In Vivo Study in the Rabbit

This work aims at the development and characterization of fluorapatite coatings, innovatively prepared by the hydrothermal method, aiming for enhanced osseointegration of titanium implants. Fluoride-containing coatings were prepared and characterized by scanning and transmission electron microscopy, Fourier-transform infrared spectroscopy-attenuated total reflectance, and X-ray photoelectron spectroscopy. The biological response was characterized by microtomographic evaluation and histomorphometric analysis upon orthotopic implantation in a translational rabbit experimental model. Physic-chemical analysis revealed the inclusion of fluoride in the apatite lattice with fluorapatite formation, associated with the presence of citrate species. The in vivo biological assessment of coated implants revealed an enhanced bone formation process-with increased bone-to-implant contact and bone volume. The attained enhancement of the osteogenic process may be attributable to the conjoined modulatory activity of selected fluoride and citrate levels within the produced coatings. In this regard, the production of fluorapatite coatings with citrate, through the hydrothermal method, entails a promising approach for enhanced osseointegration in implant dentistry and orthopedic applications.

Solid-State NMR and Raman Spectroscopic Investigation of Fluoride-Substituted Apatites Obtained in Various Thermal Conditions

Fluoride-substituted apatites were synthesized by the standard sol-gel method and then calcined at three different temperatures: 800 °C, 1000 °C, and 1200 °C. Using a similar method, hydroxyapatite was synthesized and used as a reference material. The obtained powders were characterized by physicochemical methods: powder X-ray diffractometry, Raman spectroscopy, transmission electron microscopy, and solid-state nuclear magnetic resonance. All these methods allowed to identify additional α-TCP phase (tricalcium phosphate) in the HAP samples heated at 1000 °C and 1200 °C while fluoridated apatites turned out to be thermally stable. Moreover, Raman spectroscopy and NMR allowed to establish that the powders substituted with fluoride ions are not pure fluorapatite and contain OH- groups in the crystal structure. All the obtained materials had crystals with a shape similar to that of biological apatite.

Highly Porous Fluorapatite/β-1,3-Glucan Composite for Bone Tissue Regeneration: Characterization and In-Vitro Assessment of Biomedical Potential

A novel fluorapatite/glucan composite (“FAP/glucan”) was developed for the treatment of bone defects. Due to the presence of polysaccharide polymer (β-1,3-glucan), the composite is highly flexible and thus very convenient for surgery. Its physicochemical and microstructural properties were evaluated using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), mercury intrusion, mechanical testing and compared with the reference material, which was a hydroxyapatite/glucan composite (“HAP/glucan”) with hydroxyapatite granules (HAP) instead of FAP. It was found that FAP/glucan has a higher density and lower porosity than the reference material. The correlation between the Young’s modulus and the compressive strength between the materials is different in a dry and wet state. Bioactivity assessment showed a lower ability to form apatite and lower uptake of apatite-forming ions from the simulated body fluid by FAP/glucan material in comparison to the reference material. Moreover, FAP/glucan was determined to be of optimal fluoride release capacity for osteoblasts growth requirements. The results of cell culture experiments showed that fluoride-containing biomaterial was non-toxic, enhanced the synthesis of osteocalcin and stimulated the adhesion of osteogenic cells.

Hydroxyapatite and Fluorapatite in Conservative Dentistry and Oral Implantology-A Review

Calcium phosphate, due to its similarity to the inorganic fraction of mineralized tissues, has played a key role in many areas of medicine, in particular, regenerative medicine and orthopedics. It has also found application in conservative dentistry and dental surgery, in particular, as components of toothpaste and mouth rinse, coatings of dental implants, cements, and bone substitute materials for the restoration of cavities in maxillofacial surgery. In dental applications, the most important role is played by hydroxyapatite and fluorapatite, i.e., calcium phosphates characterized by the highest chemical stability and very low solubility. This paper presents the role of both apatites in dentistry and a review of recent achievements in the field of the application of these materials.

Effect of fluorine substitution on sintering behaviour, mechanical and bioactivity of hydroxyapatite

Fluorine substituted hydroxyapatite (FAp) with different degree of fluorine (F) substitution, has been synthesized using hydrothermal synthesis method. In the present work, as synthesized powders were consolidated by sintering at 1200 °C in air for 1 h. The sintered specimens were characterized using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) for phase analysis. Further, fluorine intake in the sintered specimens was evaluated using ion chromatography (IC). XRD peaks clearly showed biphasic nature of the sintered specimen. However, the sintered samples containing more than ∼60% fluorine substitution showed no β-tricalcium phosphate (β-TCP) phase formation. The IC results revealed that the degree of fluoridation decreased significantly in the sintered specimen compare to the respective as synthesized powders. The effect of actual fluorine content in the sintered specimens was further evaluated in terms of sinterability, surface energy, mechanical properties and in vitro cytocompatibility study. The surface energy of the sintered specimen decreased from 51.8 mN/m to 42.5 mN/m, in which degree of fluoridation varies from 0% to 110%. The in vitro cytocompatibility of the sintered specimen were carried out against mouse osteoblast cell line (MC3T3-E1). In vitro study showed that all the samples were nontoxic but cell proliferation for the samples containing more than 40% fluorine substitution became significantly low.

Induction suspension plasma sprayed biological-like hydroxyapatite coatings

Substituted hydroxyapatite coatings with different ions (Mg, Na, K, Cl, F) have been developed by the induction suspension plasma spray process. Suspensions were prepared with sol–gel. The main objective of this study was to demonstrate that induction suspension plasma spray technology possesses high material composition flexibility that allows as-sprayed coatings to closely mimic natural bone composition. Long-term in vitro behaviour of as-sprayed substituted coatings was evaluated with simulated body fluid. Data on the suspensions showed the formation of a pure hydroxyapatite phase. Transmission electron microscopy characterized various preparation stages of the suspensions. As-sprayed samples were distinguished by X-ray diffraction and scanning electron microscopy. Substituted elements were quantified by neutron activation. A well-crystallized hydroxyapatite phase was produced with concentration in various substitutions very close to natural bone composition. Ca/P and (Ca + Mg + Na + K)/P ratios provided evidence of the introduction of different cations into apatite structures. The immersion of samples into simulated body fluid led to the nucleation and growth of a flake-like octacalcium phosphate crystal layer at the surface of as-sprayed coatings after one week. Proof of octacalcium phosphate transformation and its partial dissolution and direct re-precipitation into apatite was disclosed by local energy dispersive spectroscopy and microstructure observation. Formation of a Ca/P ratio gradient from the precipitated layer surface to the as-sprayed coatings interface was observed after four weeks once the octacalcium phosphate crystals reached a critical size, resulting in the formation of a rich apatite layer at the interface after six weeks. A set of mechanisms has been proposed to explain these findings.

Dielectric properties of fluorine substituted hydroxyapatite: the effect of the substitution on configuration of hydroxide ion chains

Dielectric properties of fluoridated hydroxyapatite (F-HAp; Ca₅(PO₄)₃(OH)_1−xF_x) were measured. The results show that the F-substitution induces the specific configuration that contains hydrogen bonds in F-HAp.

Biomimetic ceramics for periodontal regeneration in infrabony defects: A systematic review

Biomimetic materials are widely used in the treatment of osseous defects as an alternative to autogenous bone graft. The aim of this article was to review the literature and compare the quality of published articles on biomimetic ceramic material used for periodontal regeneration in the treatment of infrabony defects and to discuss the future direction of research. The bibliographic databases PubMed, Ebsco, and Google Scholar were searched from January 2000 to March 2014 for randomized control trials in which biomimetic ceramic graft material was compared with open flap debridement or in combination with any other regenerative material. To avoid the variability of the search terms, the thesaurus Mesh was used. The primary outcome variable assessed was clinical attachment level (CAL). The screening of eligible studies, assessment of the methodological quality of the trials, and data extraction were performed by two observers independently. Twenty-six articles were identified and included in this systematic review. The primary outcome was CAL. Out of the 26 studies, 24 showed more than 2 mm of CAL gain. The difference in CAL change between test and control groups varied from 1.2 mm to 5.88 mm with respect to different biomaterials/biomimetic materials, which was clinically and statistically significant. Meta-analysis was not done due to heterogeneity in results between studies. Overall, biomaterials were found to be more effective than open flap debridement in improving the attachment levels in intraosseous defects. Future research should aim at increasing the osteoinductive capacity of these biomimetic graft materials.

Topical Laser Application Enhances Enamel Fluoride Uptake and Tribological Properties

Topical fluoride treatment prevents dental caries. However, the resulting calcium-fluoride-like deposits are soft and have poor wear resistance; therefore, frequent treatment is required. Lasers quickly heat surfaces and can be made portable and suitable for oral remedies. We examined the morphology, nanohardness, elastic modulus, nanowear, and fluoride uptake of fluoride-treated enamel followed by CO2 laser irradiation for 5 and 10 sec, respectively. We found that laser treatments significantly increased the mechanical properties of the calcium-fluoride-like deposits. The wear resistance of the calcium-fluoride-like deposits improved about 34% after laser irradiation for 5 sec and about 40% following irradiation for 10 sec. We also found that laser treatments increased fluoride uptake by at least 23%. Overall, laser treatment significantly improved fluoride incorporation into dental tissue and the wear resistance of the protective calcium-fluoride layer.

Sintering of calcium phosphate bioceramics

Calcium phosphate ceramics have become of prime importance for biological applications in the field of bone tissue engineering. This paper reviews the sintering behaviour of these bioceramics. Conventional pressureless sintering of hydroxyapatite, Ca10(PO4)6(OH)2, a reference compound, has been extensively studied. Its physico-chemistry is detailed. It can be seen as a competition between two thermally activated phenomena that proceed by solid-state diffusion of matter: densification and grain growth. Usually, the objective is to promote the first and prevent the second. Literature data are analysed from sintering maps (i.e. grain growth vs. densification). Sintering trajectories of hydroxyapatite produced by conventional pressureless sintering and non-conventional techniques, including two-step sintering, liquid phase sintering, hot pressing, hot isostatic pressing, ultrahigh pressure, microwave and spark plasma sintering, are presented. Whatever the sintering technique may be, grain growth occurs mainly during the last step of sintering, when the relative bulk density reaches 95% of the maximum value. Though often considered very advantageous, most assisted sintering techniques do not appear very superior to conventional pressureless sintering. Sintering of tricalcium phosphate or biphasic calcium phosphates is also discussed. The chemical composition of calcium phosphate influences the behaviour. Similarly, ionic substitutions in hydroxyapatite or in tricalcium phosphate create lattice defects that modify the sintering rate. Depending on their nature, they can either accelerate or slow down the sintering rate. The thermal stability of compounds at the sintering temperature must also be taken into account. Controlled atmospheres may be required to prevent thermal decomposition, and flash sintering techniques, which allow consolidation at low temperature, can be helpful.

The incorporation of europium into apatite: anew explanation

Time resolved laser fluorescence spectroscopy (TRLFS) and X-ray absorption fine structure (XAFS) are used as complimentary techniques to show that the hetero-valent incorporation of europium into apatite at temperatures relevant to environmental and biological processes occurs at grain boundaries and not the crystallographic calcium sites as previously presumed. For this study, we focus on mechanisms at the solid solution interface and therefore define this temperature regime as the range in which liquid water exists (0–100 ºC). Site-selective TRLFS show that the local Eu3+ symmetry does not match the presumed crystallographic site of incorporation. This is confirmed by XAFS results that show a deviation from the local environment in apatite. The transition of this amorphous europium to acrystallographic calcium site upon heating is then explained by grain growth and followed through a transition species by TRLFS.

Osteoclast resorption of thermal spray hydoxyapatite coatings is influenced by surface topography

Coating characteristics such as composition, crystallite features and topography collectively impact the cell response. The influence from splats has not yet been assessed for hydroxyapatite (HAp) thermal spray coatings. The objective of this work is to (a) survey the topography on commercial implants, (b) ascertain topography formation from single splats, and (c) determine the osteoclast resorption pattern on a topographically refined coating compared to dentine. Coatings on dental implants, an orthopedic screw, a femoral stem and a knee implant were studied for reference. The effects of substrate pre-heat, roughness, spray distance and particle size on the coating roughness and topography were studied. Human-derived osteoclasts were placed on a coating with refined topography and compared to dentine, a polished coating and polished sintered HAp. A pre-heat of at least 200°C on titanium was required to form rounded splats. The greatest influence on coating roughness and topography arose from particle size. A 2-fold increase in the mean particle size from 30 to 72 μm produced a significant difference (P<0.001) in roughness from 4.8 and 9.7 μm. A model is shown to illustrate topography formation, nanostructure evolution on single splats, and the topography as seen in commercial implants. Osteoclasts showed a clear preference for activity on coatings with refined topography. A one-way ANOVA test revealed a significantly greater pit depth (P=0.022) for dentine (14 μm) compared to the as-sprayed and polished coating (5 μm). Coatings with topography display a similar number of resorption pits with dentine, but a 10-fold greater number than polished coatings, emphasizing the importance of flattened droplet topography on implant surfaces.

A New Natural Biomaterial: Sheep Dentine Derived Hydroxyapatite

Hydroxyapatite (HA) is a particularly attractive material for bone and tooth implants since it does not only closely resemble human tooth and bone mineral but it has also biologically proven to be compatible with these tissues. The applications of pure HA are restricted to non load bearing implants due to the poor mechanical properties of HA. Biomaterials of synthetic HA are highly reliable but the synthesis of HA is often complicate and expensive. Bioceramics of naturally derived biological apatites are more economic. Aim of the present work is to introduce sheep teeth dentine HA material as an alternative source of bioactive biomaterials for grafting purposes. The work was started with such a way that extracted sheep teeth were cleaned. The teeth were calcinated at 850°C in air. It was seen that enamel matter was easily separated from dentine after calcination. The collected dentine parts were crushed and ball milled. The powder was pressed between hardened steel dies to produce samples suitable for compression and microhardness tests. The obtained powder compacts were sintered at different temperatures, specifically 1000, 1100, 1200, and 1300°C in air. Results of microhardness and compression strength (along with the statistical analysis of these results) as well as those of SEM and XRD analyses are presented. In the literature, there is very little information about the mechanical properties of dentine and enamel matter derived from sheep, bovine and human. The highest compression strength value in the present study was measured around 146 MPa (from human dentine derived HA the highest value was almost 60 MPa after sintering at 1300°C). The best microhardness in the present study was found as nearly 125 HV. The results of this study showed that the HA material produced from sheep tooth dentine can be qualified as a promising source of HA needed to produce bioactive ceramics.

The effect of novel fluorapatite surfaces on osteoblast-like cell adhesion, growth, and mineralization

There is increasing demand for biomedical implants to correct skeletal defects caused by trauma, disease, or genetic disorder. In this study, the MG-63 cells were grown on metals coated with ordered and disordered fluorapatite (FA) crystal surfaces to study the biocompatibility, initial cellular response, and the underlying mechanisms during this process. The long-term growth and mineralization of the cells were also investigated. After 3 days, the cell numbers on etched metal surface are significantly higher than those on the ordered and disordered FA surfaces, but the initial adherence of a greater number of cells did not lead to earlier mineral formation at the cell-implant interface. Of the 84 cell adhesion and matrix-focused pathway genes, an up- or down-regulation of a total of 15 genes such as integrin molecules, integrin alpha M and integrin alpha 7 and 8 was noted, suggesting a modulating effect on these adhesion molecules by the ordered FA surface compared with the disordered. Osteocalcin expression and the mineral nodule formation are most evident on the FA surfaces after osteogenic induction (OI) for 7 weeks. The binding of the ordered FA surfaces to the metal, with and without OI, was significantly higher than that of the disordered FA surfaces with OI. Most significantly, even without the OI supplement, the MG-63 cells grown on FA crystal surfaces start to differentiate and mineralize, suggesting that the FA crystal could be a simple and bioactive implant coating material.

Fossils as candidate material for orthopedic applications

Ceramic powders from fossil deposits were thoroughly characterized from the material point of view and sintered to produce massive components. The raw material, a mixture of apatite minerals, feldspars, and quartz, seems ideally suitable to obtain a biologically compatible glass ceramic. Preliminary in vitro tests of proliferation and adhesion of MG63 human osteoblast-like cell line on a selected sample are encouraging. Results are correlated with sintering conditions and phase composition: the fossil can be sintered to almost full density at temperatures as low as 900 °C and seems to quickly promote cell activation with respect to hydroxylapatite.

Novel long-term immobilization method for radioactive iodine-129 using a zeolite/apatite composite sintered body

The amount of radioactive iodine generated from nuclear power plants is expected to increase with the proliferation of nuclear energy production, and long-term immobilization methods for such radioactive elements need to be developed to make nuclear energy sustainable. The standard immobilization method of radioactive elements, vitrification, is not very effective for radioactive iodine-129 because of the low solubility of iodine in silicate melts, its very high volatility at standard vitrification process temperatures, and its instability in the alkaline environment of deep geological layers below 300 m. We have developed a novel three-phase ceramic composite produced by a sintering process. Iodine adsorbed onto Ca-type zeolite A was covered with a hydroxyapatite nanolayer through the exchange reaction of ammonium with calcium. Clusters of iodine of 30 nm within the zeolite structure were found to be thermally stable up to 1253 K because of the partial blockage of the alpha-cage apertures by ammonium ions and the partial change from a crystalline phase to an amorphous phase at 473 K. No gasification of iodine molecules was found to occur during the sintering process. The outer phase was highly crystalline hydroxyfluorapatite in which the hydroxyapatite nanolayer plays an important role for successful sintering. The elution of iodine in low-dioxygen water, similar to that found within the Earth's crust, was investigated and was found to occur only in the surface layer of the sintered body.

Potential applications of fluorhydroxyapatite as biomaterials in medicine

The present work was undertaken to investigate the bioactivity and cytotoxicity of fluorhydroxyapatite ceramics. The bioactivity was evaluated by in vitro testing in simulated body fluid (SBF), in which ion concentrations are almost identical with inorganic ion concentrations of human blood plasma. Pellets of FA, HA and FHA were immersed in SBF for 48 hours, 1 week and 4 weeks at 36.5°C. Changes of the surface microstructure of the samples were observed by scanning electron microscopy (SEM). 48 hours and one week immersion in SBF did not result in any substantial progress in bioactivity. After 4 weeks in SBF a new biologically active layer was created on the surface of the biomaterials. In addition, the embryonal mouse fibroblast cell line NIH-3T3 was used for a comparative study of basal cytotoxicity of FHA, HA and FA discs. The sensitivity of these cells for tested biomaterials was evaluated on the basis of two cytotoxic end points: cell proliferation and cell morphology. The basal cytotoxicity of FHA, FA and HA discs was measured by a direct contact method. After 24, 48 and 72 hours, the cell growth was evaluated by direct counting of non-affected cells and cells treated by biomaterials. After 72 hours of biomaterials treatment, about 25% inhibition of cell number and unchanged morphology was found.

Structural analysis of a series of strontium-substituted apatites

A series of Sr-substituted hydroxyapatites, (Sr(x)Ca(1-)(x))(5)(PO(4))(3)OH, where x=0.00, 0.25, 0.50, 0.75 and 1.00, were made by a standard wet chemical route and investigated using X-ray diffraction (XRD), Rietveld refinement and Raman spectroscopy. We report apatites manufactured by two synthesis routes under 90 degrees C, and only the fully Sr-substituted sample had a small amount of an impurity phase, which is believed to be strontium pyrophosphate. Lattice parameters (a and c), unit cell volume and density were shown to increase linearly with strontium addition and were consistent with the addition of a slightly larger and heavier ion (Sr) in place of Ca. XRD Lorentzian peak widths increased to a maximum at x=0.50, then decreased with increasing Sr content. This indicated an increase in crystallite size when moving away from the x=0.50 composition (d approximately 9.4nm). There was a slight preference for strontium to enter the Ca(II) site in the mixed apatites (6 to 12% depending on composition). The position of the Raman band attributed to v(1)PO(4)(3-) at around 963cm(-1) in hydroxyapatite decreased linearly to 949cm(-1) at full Sr-substitution. The full width at half maximum of this peak also correlated well and increased linearly with increasing crystallite size calculated from XRD.

Dissolution and mineralization of sintered and thermally sprayed hydroxy-fluoroapatites

Hydroxyapatites are commonly used as bone cement, coatings on implants for dental and orthopaedic applications, but also as middle ear implants. These applications all require a different tissue healing response that can be attained by different manufacturing processes or by chemically modifying the composition. During implantation apatites undergo a process of dissolution and mineralization. The degree of dissolution is dependent upon the manufacturing process & is higher for thermally sprayed implant materials. This allows them to integrate to the natural bone. This study tests the dissolution and mineralization of fluoride containing hydroxyapatites through immersion in simulated body fluid. It shows that mineralization occurs more readily in hydroxyapatites than fluorapatites because of their higher dissolution rate. Mineralization was detected most readily by image analysis using scanning electron microscopy than by weight changes using a microbalance. Microscopy allowed small heterogeneous precipitates to be observed during the initial stages of mineralization.

Constitutive modeling of the densification and the grain growth of hydroxyapatite ceramics

In the present work, constitutive models for densification and grain growth were employed to investigate the sintering behavior of pure hydroxyapatite ceramics. For densification study, lattice diffusion, grain-boundary diffusion, and interface reaction mechanisms, and for grain-growth study, surface diffusion mechanism, were considered respectively. Hydroxyapatite ceramics were pressurelessly sintered. The sintering results were discussed and compared with the modeling results. Based on the constitutive models employed and the experimental results obtained, grain-boundary diffusion was identified as the dominant mechanism for the densification of the investigated hydroxyapatite. The grain-growth model provided a good prediction to the grain growth of the investigated hydroxyapatite. The activation energies for densification and grain growth of hydroxyapatite ceramics were evaluated as 1150+/-40 and 1020+/-40 KJ mol(-1), respectively.

Sintered hydroxyfluorapatites. Part II: Mechanical properties of solid solutions determined by microindentation

Fluoride substitution within hydroxyapatite is an important occurrence for biological apatites and is a promising approach for the chemical modification of synthetic hydroxyapatite. Limited information on the influence of fluoride substitution for hydroxyl groups on the mechanical properties has provided the rationale for this study. Hydroxyfluorapatites with 0%, 20%, 40%, 60%, 80% and 100% replacement of hydroxyl groups with fluoride ions were assessed for hardness, elastic modulus, fracture toughness and brittleness using microindentation of sintered pellets. The production of samples with a similar grain size and density allowed the influence of fluoride on mechanical properties to be determined. It was found that the hardness remains unaffected until 80% replacement of hydroxyl groups with fluoride, after which the hardness rapidly increases. The elastic modulus increases linearly with fluoride content. Fracture toughness is improved with fluoride incorporation into the lattice and reaches a peak of 1.8 for a 95% dense sintered pellet with a 60% fluoride replacement, followed by a rapid decrease at higher fluoride concentrations. The brittleness index is lowered to a minimum at 60%, after which a rapid increase occurs. High fluoride levels are unfavourable from a mechanical perspective, are not recommended for biomaterials, and can lead to a higher incidence of fracture where sodium fluoride, for treatment of osteoporosis, may produce a highly fluoridated hydroxyapatite.

Sintered hydroxyfluorapatites. Part III: Sintering and resultant mechanical properties of sintered blends of hydroxyapatite and fluorapatite

The presence of chemically dissimilar apatites occurs widely in biological systems as a result of exposure to chemically enriched media, but also to optimize the mechanical properties. The use of mechanical blends of apatites can be used to manufacture high temperature processed fluoride containing hydroxyapatites with improved properties. Mechanical blends of fluorapatite and hydroxyapatite were produced with 0%, 20%, 40%, 60%, 80% and 100% fluorapatite. Pellets were sintered at 1150 degrees C, 1200 degrees C and 1250 degrees C and the density determined by the Archimedes method. Mechanical properties including hardness, elastic modulus and fracture toughness were measured using indentation. It was found that mechanical blends of 150 nm sized hydroxyapatite and 300 nm sized fluorapatite lead to solid solutions after sintering. The mechanical blends do not sinter as effectively as homogeneous hydroxyfluorapatite solid solutions and exhibit a minimum density at 80 wt.% fluorapatite. The hardness, elastic modulus and brittleness decreases with a higher flourapatite content, attributed primarily to a decrease in density. The higher fracture toughness for mechanical blends indicates that these materials are more crack resistant and provide a means for improving mechanical properties.