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Lukina Y, Safronova T, Smolentsev D, Toshev O. Calcium Phosphate Cements as Carriers of Functional Substances for the Treatment of Bone Tissue. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4017. [PMID: 37297151 PMCID: PMC10254876 DOI: 10.3390/ma16114017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Interest in calcium phosphate cements as materials for the restoration and treatment of bone tissue defects is still high. Despite commercialization and use in the clinic, the calcium phosphate cements have great potential for development. Existing approaches to the production of calcium phosphate cements as drugs are analyzed. A description of the pathogenesis of the main diseases of bone tissue (trauma, osteomyelitis, osteoporosis and tumor) and effective common treatment strategies are presented in the review. An analysis of the modern understanding of the complex action of the cement matrix and the additives and drugs distributed in it in relation to the successful treatment of bone defects is given. The mechanisms of biological action of functional substances determine the effectiveness of use in certain clinical cases. An important direction of using calcium phosphate cements as a carrier of functional substances is the volumetric incorporation of anti-inflammatory, antitumor, antiresorptive and osteogenic functional substances. The main functionalization requirement for carrier materials is prolonged elution. Various release factors related to the matrix, functional substances and elution conditions are considered in the work. It is shown that cements are a complex system. Changing one of the many initial parameters in a wide range changes the final characteristics of the matrix and, accordingly, the kinetics. The main approaches to the effective functionalization of calcium phosphate cements are considered in the review.
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Affiliation(s)
- Yulia Lukina
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
- Faculty of Digital Technologies and Chemical Engineering, Mendeleev University of Chemical Technology of Russia, Miusskaya pl. 9, 125047 Moscow, Russia
| | - Tatiana Safronova
- Department of Chemistry, Lomonosov Moscow State University, Building 3, Leninskie Gory 1, 119991 Moscow, Russia;
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
| | - Dmitriiy Smolentsev
- National Medical Research Center for Traumatology and Orthopedics Named after N.N. Priorov, Ministry of Health of the Russian Federation, Priorova 10, 127299 Moscow, Russia;
| | - Otabek Toshev
- Department of Materials Science, Lomonosov Moscow State University, Building 73, Leninskie Gory 1, 119991 Moscow, Russia;
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Md Dali SS, Wong SK, Chin KY, Ahmad F. The Osteogenic Properties of Calcium Phosphate Cement Doped with Synthetic Materials: A Structured Narrative Review of Preclinical Evidence. Int J Mol Sci 2023; 24:ijms24087161. [PMID: 37108321 PMCID: PMC10138398 DOI: 10.3390/ijms24087161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Bone grafting is commonly used as a treatment to repair bone defects. However, its use is challenged by the presence of medical conditions that weaken the bone, like osteoporosis. Calcium phosphate cement (CPC) is used to restore bone defects, and it is commonly available as a bioabsorbable cement paste. However, its use in clinical settings is limited by inadequate mechanical strength, inferior anti-washout characteristics, and poor osteogenic activity. There have been attempts to overcome these shortcomings by adding various natural or synthetic materials as enhancers to CPC. This review summarises the current evidence on the physical, mechanical, and biological properties of CPC after doping with synthetic materials. The incorporation of CPC with polymers, biomimetic materials, chemical elements/compounds, and combination with two or more synthetic materials showed improvement in biocompatibility, bioactivity, anti-washout properties, and mechanical strength. However, the mechanical property of CPC doped with trimethyl chitosan or strontium was decreased. In conclusion, doping of synthetic materials enhances the osteogenic features of pure CPC. The positive findings from in vitro and in vivo studies await further validation on the efficacy of these reinforced CPC composites in clinical settings.
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Affiliation(s)
- Siti Sarah Md Dali
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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Tian X, Raina DB, Vater C, Kilian D, Ahlfeld T, Platzek I, Nimtschke U, Tägil M, Lidgren L, Thomas A, Platz U, Schaser KD, Disch AC, Zwingenberger S. Evaluation of an Injectable Biphasic Calcium Sulfate/Hydroxyapatite Cement for the Augmentation of Fenestrated Pedicle Screws in Osteoporotic Vertebrae: A Biomechanical Cadaver Study. J Funct Biomater 2022; 13:jfb13040269. [PMID: 36547529 PMCID: PMC9786089 DOI: 10.3390/jfb13040269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Cement augmentation of pedicle screws is one of the most promising approaches to enhance the anchoring of screws in the osteoporotic spine. To date, there is no ideal cement for pedicle screw augmentation. The purpose of this study was to investigate whether an injectable, bioactive, and degradable calcium sulfate/hydroxyapatite (CaS/HA) cement could increase the maximum pull-out force of pedicle screws in osteoporotic vertebrae. Herein, 17 osteoporotic thoracic and lumbar vertebrae were obtained from a single fresh-frozen human cadaver and instrumented with fenestrated pedicle screws. The right screw in each vertebra was augmented with CaS/HA cement and the un-augmented left side served as a paired control. The cement distribution, interdigitation ability, and cement leakage were evaluated using radiographs. Furthermore, pull-out testing was used to evaluate the immediate mechanical effect of CaS/HA augmentation on the pedicle screws. The CaS/HA cement presented good distribution and interdigitation ability without leakage into the spinal canal. Augmentation significantly enhanced the maximum pull-out force of the pedicle screw in which the augmented side was 39.0% higher than the pedicle-screw-alone side. Therefore, the novel biodegradable biphasic CaS/HA cement could be a promising material for pedicle screw augmentation in the osteoporotic spine.
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Affiliation(s)
- Xinggui Tian
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Deepak B. Raina
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 22184 Lund, Sweden
| | - Corina Vater
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - David Kilian
- Center for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Tilman Ahlfeld
- Center for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Ivan Platzek
- Department of Radiology, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Ute Nimtschke
- Institute of Anatomy, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Magnus Tägil
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 22184 Lund, Sweden
| | - Lars Lidgren
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 22184 Lund, Sweden
| | - Alexander Thomas
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Uwe Platz
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Klaus-Dieter Schaser
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Alexander C. Disch
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
| | - Stefan Zwingenberger
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, Germany
- Correspondence:
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Jain C, Surabhi P, Marathe K. Critical Review on the Developments in Polymer Composite Materials for Biomedical Implants. JOURNAL OF BIOMATERIALS SCIENCE, POLYMER EDITION 2022; 34:893-917. [PMID: 36369719 DOI: 10.1080/09205063.2022.2145870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There has been a lack of research for developing functional polymer composites for biomedical implants. Even though metals are widely used as implant materials, there is a need for developing polymer composites as implant materials because of the stress shielding effect that causes a lack of compatibility of metals with the human body. This review aims to bring out the latest developments in polymer composite materials for body implants and to emphasize the significance of polymer composites as a viable alternative to conventional materials used in the biomedical industry for ease of life. This review article explores the developments in functional polymer composites for biomedical applications and provides distinct divisions for their applications based on the part of the body where they are implanted. Each application has been covered in some detail. The various applications covered are bone transplants and bone regeneration, cardiovascular implants (stents), dental implants and restorative materials, neurological and spinal implants, and tendon and ligament replacement.
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Affiliation(s)
| | | | - Kumudinee Marathe
- Department of Chemical Engg, Institute of Chemical Technology, Matunga, Mumbai, Maharashtra, India 400019
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