A Novel Fast-Setting Strontium-Containing Hydroxyapatite Bone Cement With a Simple Binary Powder System

Physical and drug- releasing properties of a cement containing simvastatin (SimCeram)

BACKGROUND

This in vitro study compared the physical characteristics and drug release patterns of a bioactive cement containing with 0.1 μM Simvastatin (SimCeram) with mineral trioxide aggregate (MTA; Angelus, Brazil).

METHODS

SimCeram, a calcium silicate-based cement was prepared with the powder composition of 25 wt% silicon-doped hydroxyapatite, 25 wt% strontium-doped hydroxyapatite, and 50 wt% tricalcium silicate/dicalcium silicate. SimCeram liquid contained 0.1 μM dissolved in distilled water. After preparing SimCeram and MTA, the initial setting time of cements was determined with a Gillmore needle. Compressive strength was measured at 1 h, 1 day, and 1 week using a Universal Testing Machine. Cement solubility was assessed according to ISO 6876 after one day, two, and four weeks. Calcium ion release was measured with an ICP-AES device, and simvastatin release was also examined using a UV-spectrophotometer at 238 nm.

RESULTS

MTA setting time was significantly shorter (12.33 ± 0.57 min) compared to SimCeram (36.33 ± 1.15 min; P < 0.001). MTA exhibited significantly higher compressive strength than SimCeram after 1 h and 1 day (P < 0.05). However, after 1 week, the compressive strength of SimCeram (10.82 ± 1.93 MPa) surpassed that of MTA (6.79 ± 3.24 MPa; P = 0.009). SimCeram showed greater calcium ion release and solubility throughout all time points tested compared to MTA (P < 0.05). Simvastatin release demonstrated an initial burst after 1 h and reached a plateau after 24 h.

CONCLUSION

SimCeram showed higher compressive strength and calcium release compared to MTA. Given simvastatin's beneficial properties-such as anti-inflammatory effects, angiogenesis promotion, and the ability to induce differentiation of dental pulp stem cells-along with the significant calcium ion release from the calcium silicate-based component of the cement, SimCeram could be a promising material for vital pulp therapy.

The Effects of the Addition of Strontium on the Biological Response to Calcium Phosphate Biomaterials: A Systematic Review

Strontium is known for enhancing bone metabolism, osteoblast proliferation, and tissue regeneration. This systematic review aimed to investigate the biological effects of strontium-doped calcium phosphate biomaterials for bone therapy. A literature search up to May 2024 across Web of Science, PubMed, and Scopus retrieved 759 entries, with 42 articles meeting the selection criteria. The studies provided data on material types, strontium incorporation and release, and in vivo and in vitro evidence. Strontium-doped calcium phosphate biomaterials were produced via chemical synthesis and deposited on various substrates, with characterization techniques confirming successful strontium incorporation. Appropriate concentrations of strontium were non-cytotoxic, stimulating cell proliferation, adhesion, and osteogenic factor production through key signaling pathways like Wnt/β-catenin, BMP-2, Runx2, and ERK. In vivo studies identified novel bone formation, angiogenesis, and inhibition of bone resorption. These findings support the safety and efficacy of strontium-doped calcium phosphates, although the optimal strontium concentration for desired effects is still undetermined. Future research should focus on optimizing strontium release kinetics and elucidating molecular mechanisms to enhance clinical applications of these biomaterials in bone tissue engineering.

New Research Progress of Modified Bone Cement Applied to Vertebroplasty

Percutaneous vertebroplasty and percutaneous kyphoplasty are effective methods to treat acute osteoporotic vertebral compression fractures that can quickly provide patients with pain relief, prevent further height loss of the vertebral body, and help correct kyphosis. Many clinical studies have investigated the characteristics of bone cement. Bone cement is a biomaterial injected into the vertebral body that must have good biocompatibility and biosafety. The optimization of the characteristics of bone cement has become of great interest. Bone cement can be mainly divided into 3 types: polymethyl methacrylate, calcium phosphate cement, and calcium sulfate cement. Each type of cement has its own advantages and disadvantages. In the past 10 years, the performance of bone cement has been greatly improved via different methods. The aim of our review is to provide an overview of the current progress in the types of modified bone cement and summarize the key clinical findings.

Bacterial Inhibition and Osteogenic Potentials of Sr/Zn Co-Doped Nano-Hydroxyapatite-PLGA Composite Scaffold for Bone Tissue Engineering Applications

Bacterial infection associated with bone grafts is one of the major challenges that can lead to implant failure. Treatment of these infections is a costly endeavor; therefore, an ideal bone scaffold should merge both biocompatibility and antibacterial activity. Antibiotic-impregnated scaffolds may prevent bacterial colonization but exacerbate the global antibiotic resistance problem. Recent approaches combined scaffolds with metal ions that have antimicrobial properties. In our study, a unique strontium/zinc (Sr/Zn) co-doped nanohydroxyapatite (nHAp) and Poly (lactic-co-glycolic acid) -(PLGA) composite scaffold was fabricated using a chemical precipitation method with different ratios of Sr/Zn ions (1%, 2.5%, and 4%). The scaffolds' antibacterial activity against Staphylococcus aureus were evaluated by counting bacterial colony-forming unit (CFU) numbers after direct contact with the scaffolds. The results showed a dose-dependent reduction in CFU numbers as the Zn concentration increased, with 4% Zn showing the best antibacterial properties of all the Zn-containing scaffolds. PLGA incorporation in Sr/Zn-nHAp did not affect the Zn antibacterial activity and the 4% Sr/Zn-nHAp-PLGA scaffold showed a 99.7% bacterial growth inhibition. MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay showed that Sr/Zn co-doping supported osteoblast cell proliferation with no apparent cytotoxicity and the highest doping percentage in the 4% Sr/Zn-nHAp-PLGA was found to be ideal for cell growth. In conclusion, these findings demonstrate the potential for a 4% Sr/Zn-nHAp-PLGA scaffold with enhanced antibacterial activity and cytocompatibility as a suitable candidate for bone regeneration.

Strontium-doped apatitic bone cements with tunable antibacterial and antibiofilm ability

Injectable calcium phosphate cements (CPCs) represent promising candidates for the regeneration of complex-shape bone defects, thanks to self-hardening ability, bioactive composition and nanostructure offering high specific surface area for cell attachment and conduction. Such features make CPCs also interesting for functionalization with various biomolecules, towards the generation of multifunctional devices with enhanced therapeutic ability. In particular, strontium-doped CPCs have been studied in the last years due to the intrinsic antiosteoporotic character of strontium. In this work, a SrCPC previously reported as osteointegrative and capable to modulate the fate of bone cells was enriched with hydroxyapatite nanoparticles (HA-NPs) functionalized with tetracycline (TC) to provide antibacterial activity. We found that HA-NPs functionalized with TC (NP-TC) can act as modulator of the drug release profile when embedded in SrCPCs, thus providing a sustained and tunable TC release. In vitro microbiological tests on Escherichia coli and Staphylococcus aureus strains proved effective bacteriostatic and bactericidal properties, especially for the NP-TC loaded SrCPC formulations. Overall, our results indicate that the addition of NP-TC on CPC acted as effective modulator towards a tunable drug release control in the treatment of bone infections or cancers.