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PubMed2004

Influence of cross-linked PMMA beads on the mechanical behavior of self-curing acrylic cements.

Cross-linked PMMA beads were prepared with the use of two cross-linking agents with different chain lengths: triethylene glycol dimethacrylate (TEGDMA) and poly(ethylene glycol) dimethacrylate (PEGDMA). Beads containing 10 wt % TEGDMA and 2, 5, and 10 wt % PEGDMA were synthesized by suspension polymerization. Experimental cement formulations were prepared by replacing part of the PMMA powder phase by an equivalent weight of the cross-linked beads. The mechanical behavior of the modified cements was carried out by testing the cements in flexure and compression. All cements displayed a higher flexural modulus, which was accompanied with a slight decrease in the flexural strength. The two-parameter Weibull model, which was used to analyze the flexural strength data, gave a good representation of the fracture load distribution. In cements prepared with beads containing 2 and 5 wt % PEGDMA and 10 wt % TEGDMA, no improvement in the flexural strength was observed. Debonding of the particles from the matrix was considered responsible for the decreased flexural strength. On the contrary, cements prepared with different proportions of beads containing 10 wt % PEGDMA resulted in a markedly increased flexural strength compared with the unmodified cement. An improved reinforcing effect of the cross-linked beads and a significant degree of bonding with the matrix in these cements account for the superior flexural strength compared with the other composite cements tested.

Acrylates↗
PubMed2006

Tissue response to in situ polymerization of a new two-solution bone cement: evaluation in a sheep model.

A two-solution bone cement (2-SC) was evaluated in a non-load bearing sheep model that simulated insertion of a cemented total joint replacement. A commercial powder-liquid bone cement formulation (Palacos R) was used as the control. The systemic response to the two cements was determined by monitoring changes in arterial blood pressure (ABP) and serum concentrations of methyl methacrylate monomer at intervals after insertion of the cement. The short-term tissue response to the two cements was assessed by quantifying histomorphometric parameters of new bone formation at 2, 4, and 12 weeks postsurgery. Intraoperatively, injection and pressurization of bone cement were well tolerated, with no significant changes in ABP in either group and no detectable circulating monomer in any animal. Several interesting trends were identified in the histomorphometry data. In the trabecular specimens, new bone formation immediately adjacent to the cement mantle was apparently suppressed in the first 2 weeks postsurgery, increased dramatically at 4 weeks, and then returned to baseline values by 12 weeks. This pattern was seen with both Palacos and 2-SC. In the cortical specimens, new bone formation was reduced on the endosteal surface when compared with the periosteal surface, with this effect being more noticeable at 2 and 4 weeks than at 12 weeks. There were no significant histopathological findings in either the bone or the draining lymph nodes. These data indicate that the biological response to 2-SC is substantially equivalent to that of Palacos R. Additional testing in a functional, load-bearing animal model is now recommended to more fully characterize the long-term biological response to 2-SC and to determine the mechanical performance of this new cement in vivo.

Animals↗
PubMed1988

Antibiotic release from an experimental biodegradable bone cement.

An experimental biodegradable bone cement [poly(propylene fumarate)-methylmethacrylate] (PPF-MMA) has been compared in vivo with polymethylmethacrylate (PMMA) as a carrier agent for local release of antibiotics. This approach is potentially applicable to the treatment of chronic osteomyelitis where the clinical goal is to achieve sustained high concentrations of antibiotics locally in the infected bone. In our experiments, gentamicin- and vancomycin-impregnated cylindrical PMMA and PPF-MMA cement specimens were implanted subcutaneously in rats, and blood and wound fluid samples were obtained over a 2-week period. Antibiotic levels were determined using immunoassays, and microbiologic activity was confirmed with agar diffusion techniques. The biodegradable PPF-MMA cement achieved and maintained considerably higher wound antibiotic levels than did PMMA cement. Vancomycin levels for the PPF-MMA cement were greater than 20 times those for the PMMA cement at all sampling times from 24 h to 14 days. For both cements, the serum antibiotic concentrations remained safely below maximum levels recommended for parenteral therapy. Mechanical testing of the PPF-MMA cement showed that admixture of 3% by weight of antibiotic did not adversely affect material properties. We conclude that this experimental biodegradable bone cement (PPF-MMA) can be used as a carrier to achieve high sustained local levels and low serum levels of antibiotics. Because it is biodegradable and thus does not require a secondary procedure for removal, it has special potential for use in treatment of chronic osteomyelitis.

Administration, Topical↗
PubMed1998

Total hip reconstruction in the anatomically distorted hip. Cemented versus hybrid total hip arthroplasty.

Recent reports in the literature strongly support the idea that cement is the optimum form of fixation of the femoral component in total hip replacement. For hybrid total hip arthroplasty, we used a cemented cup instead of an uncemented cup since this was inevitable in cases of poorly developed acetabulum. The uncemented cone femoral component is also beneficial in cases of extremely narrow and cylindrical configuration of the medullary cavity of untreated congenital dislocation of the hips (CDH) and tuberculosis or septic arthritis in childhood. We reviewed the clinical result of a consecutive series of patients with cemented total hip arthroplasty (THA) compared with recent studies on hybrid reconstruction using survivorship analysis. This subsequent study involved a hybrid uncemented Wagner cone femoral component and a cemented acetabular component with roof reinforcement by additional impacted cancellous allograft with hydroxyapatite (HA). We believe that early failure of the cemented components was due to an adverse effect of thin cement mantles around cemented femoral stems as well as the cemented cup in THA. In addition, 8 patients who received our modification of the Charnley CDH component had poor results even though we reduced the stem geometry and thickness. Furthermore, intraoperative fracture and splitting of the proximal femur was a major complication during implantation. Contrary to expectations, the results of these hybrid reconstructions were extremely encouraging (average follow-up period of 2-4.5 years). In addition to our experience of the cemented versus hybrid THA involving the uncemented Wagner femoral component, we have determined positive indications for the untreated and severely distorted anatomy of bilateral CDH for which surgical interventions for reconstruction were not recommended before.

Adult↗
PubMed2005

Cement from nanocrystalline hydroxyapatite: effect of calcium phosphate ratio.

Nanocrystalline hydroxyapatite (nHA) can be mixed with phosphoric acid to form a brushite cement; a degradable inorganic bone filling material. nHA was precipitated from reactants of calcium to phosphate (Ca/P) ratio 0.8 to 2.0 and mixed with phosphoric acid, which resulted in the formation of a brushite cement. Cement was also formed by mixing microcrystalline calcium phosphates, beta-tricalcium phosphate, hydroxyapatite and tetracalcium phosphate with phosphoric acid solution. Cement produced with nHA was stronger in compression than that formed with crystalline calcium phosphate phases. Setting time, strength and composition of cement produced with nHA was dependant on both the Ca/P ratio of nHA and the concentration of phosphoric acid in cement slurry. Increasing phosphoric acid concentration increased compressive strength whilst reducing the initial setting time of cement. Reducing the Ca/P ratio of nHA precipitation reactants retarded the setting and increased the extent of reaction of cements. This finding was unexpected and suggests that Ca/P ratio may strongly affect dissolution behaviour and this parameter is more important than stoichiometry in determining extent of reaction in this system. This study demonstrated that the wide variation in stoichiometry that may be attained in nanocrystalline apatite may be utilised to change cement performance and setting behaviour.

Bone Cements↗
PubMed2007

Biological response of new activated acrylic bone cements with antiseptic properties. Histomorphometric analysis.

The biological response to an acrylic bone cement cured with 4,4'-bis-dimethylamino benzydrol (BZN) as activator of reduced cytotoxicity and antiseptic properties, has been carried out and compared with that obtained for CMW 3 cement. Histomorphometrical data (undecalcified trichromic Goldner staining) were obtained by measuring the most significant variables at the bone-cement interface. Quantitative results of tissue response revealed that newly formed bone and connective tissue were maximum at 4 weeks whereas bone marrow increased with time of implantation for both cements. Statistical analysis (p < 0.05) showed no significant differences in newly formed bone and bone marrow with time and between both groups, however, connective tissue significantly decreased between 4 weeks and 12 weeks for BZN cement, and between 12 weeks and 24 weeks for CMW3. By comparing both cements at each time, lower significant percentage of connective tissue at the bone-cement interface of the BZN cement, was obtained at 12 and 24 weeks, however, a very low amount of connective tissue was found for both cements. All the results indicate that the new activated system could be applied clinically in a relatively short time, after the corresponding preclinical study.

Animals↗
PubMed1985

Bond strength of cements to nickel-chromium and silver-palladium alloys.

The bonding of zinc phosphate, polycarboxylate, and reinforced ZOE cements to nickel-chromium and silver-palladium alloys was measured by cementing flat surfaces of the metals together. Polycarboxylate cement produced higher bond strengths than the other two cements to both metals. Polycarboxylate cement bonded better to nickel-chromium alloys than to a silver-palladium alloy. Zinc phosphate and reinforced ZOE cements had similar bond strengths except for Biobond, to which zinc phosphate cement provided higher bond strength. Polycarboxylate cement failed cohesively to both types of metals, and zinc phosphate and reinforced ZOE cements failed adhesively.

Chromium Alloys↗
PubMed1994

Finite element analysis estimates of cement microfracture under complete veneer crowns.

Long-term clinical failures of complete veneer crowns are commonly attributed to microleakage of the cement. Excessive stress or fatigue cycling may create cement microfractures and promote microleakage. Two-dimensional (2D) finite element analysis (FEA) was selected to determine stress levels and distributions on dental cements resulting from 10 MPa occlusal loads on single-unit complete artificial veneer crowns during various clinical conditions. Sixteen 2D-FEA computer models were generated for a mandibular first premolar to study the effects of (1) marginal configuration (shoulder for all-ceramic crown versus chamfer for type III gold alloy crown), (2) four types of cement (zinc phosphate, polycarboxylate, glass ionomer and composite resin), and (3) two thicknesses of cement (25 and 100 microns) for single-cycle loads and fatigue loading. There was almost no difference between a chamfer and shoulder marginal configuration except at the edge of the margin where the chamfer finish lines reached 2 to 8 times greater stresses. There were minimal effects for thickness of cement and marginal configurations. Stresses were slightly less for thicker cement. Fatigue analysis was based on estimated stress versus number of cycle curves for cements and resulted in stresses below the estimated endurance limit. If the average occlusal loading levels were 10 MPa, there did not appear to be a risk of microfracture in dental cement because of mechanical loading.

Ceramics↗
PubMed1994

Physical and chemical properties of resin-reinforced calcium phosphate cements.

OBJECTIVES: The purpose of this study was to improve the handling and physical properties of a self-setting, water-based calcium phosphate cement by combining it with polymerizable resins and to study the setting reactions involved. METHODS: Dual-cured composite cements were prepared from a calcium phosphate cement powder and dental monomers that contain carboxylated hydrophilic resins or resin/water mixtures. The setting reaction of the calcium phosphate cement in the presence of the resins was evaluated by pH measurements, infrared spectroscopy, diametral tensile strength, x-ray diffraction analysis, and scanning electron microscopy. RESULTS: Carboxylated resins were chosen because they can form ionic bonds to the mineral filler, which was confirmed by appearance of an infrared absorbance peak at 1552 cm-1 within 24 h after mixing due to the formation of a carboxylate salt. Hydroxyapatite did not develop in composites prepared from resin and calcium phosphate cement. However, composites from calcium phosphate cement, resin and water showed approximately 40% hydroxyapatite. The resulting composite cements have moderately high DTS of 14-15 MPa and high pH. SIGNIFICANCE: Hydrophilic acidic resins allows mixing with water and/or allow rapid diffusion of water into the resinous cement so that the dissolution and reprecipitation processes required for the conversion of the calcium phosphate components to hydroxyapatite can occur. The characteristics of the resulting composite cements suggest that the materials may be useful in pulp capping and/or cavity lining.

Calcium Phosphates↗
PubMed1996

Non-decay type fast-setting calcium phosphate cement: setting behaviour in calf serum and its tissue response.

Non-decay type fast-setting calcium phosphate cement (nd-FSCPC) was evaluated in terms of its setting behaviour in calf serum and its tissue response to investigate the feasibility of its clinical use in surgical applications. Non-decay type cements were prepared by adding various amounts of sodium alginate to the liquid phase of base cements, fast-setting calcium phosphate cement (FSCPC) and conventional calcium phosphate cement (c-CPC). Cement pastes were immersed in serum at 37 degrees C immediately after mixing, and decay behaviour, setting time and mechanical strength were measured to evaluate the possibility of their use in surgical applications. Also, nd-FSCPC was implanted into rat subcutaneous tissue for the initial evaluation of biocompatibility of this potential bioactive cement. nd-FSCPC set in approximately 6-7 min in serum, even when the cement paste was immersed in the serum immediately after mixing, whereas c-CPC and FSCPC decayed completely upon immersion. nd-FSCPC transforms to hydroxyapatite (HA) within 24 h and shows a diametral tensile strength of approximately 4-5 MPa. As a result of transformation to HA, nd-FSCPC showed excellent tissue response when implanted subcutaneously in rats. We conclude that nd-FSCPC has good potential value for use in orthopaedics, plastic and reconstructive surgery, and oral and maxillofacial surgery, where the cement is exposed to blood.

Animals↗
PubMedDate not supplied

In vivo behavior of three different injectable hydraulic calcium phosphate cements.

Two dicalcium phosphate dihydrate (DCPD) hydraulic cements and one apatite hydraulic cement were implanted in epiphyseal and metaphyseal, cylindrical bone defects of sheep. The in vivo study was performed to assess the biocompatibility of the DCPD cements, using the apatite cement as control. After time periods of 2, 4 and 6 months the cement samples were clinically and histologically evaluated. Histomorphometrically the amount of new bone formation, fibrous tissue and the area of remaining cement were measured over time. In all specimens, no signs of inflammation were detectable either macroscopically or microscopically. All cements were replaced by different amounts of new bone. The two DCPD-cements showed the highest new bone formation and least cement remnants at 6 months, whereas the apatite was almost unchanged over all time periods.

Animals↗
PubMed2005

The effect of the antimicrobial peptide, Dhvar-5, on gentamicin release from a polymethyl methacrylate bone cement.

The objective of this study was to investigate the release mechanism and kinetics of the antimicrobial peptide, Dhvar-5, both alone and in combination with gentamicin, from a standard commercial polymethyl methacrylate (PMMA) bone cement. Different amounts of Dhvar-5 were mixed with the bone cement powders of Osteopal and the gentamicin-containing Osteopal G bone cement and their release kinetics from the polymerized cement were investigated. Additionally, the internal structure of the bone cements were analysed by scanning electron microscopy (SEM) of the fracture surfaces. Secondly, porosity was investigated with the mercury intrusion method and related to the observed release profiles. In order to obtain an insight into the mechanical characteristics of the bone cement mixtures, the compressive strength of Osteopal and Osteopal G with Dhvar-5 was also investigated. The total Dhvar-5 release reached 96% in the 100 mg Dhvar-5/g Osteopal cement, whereas total gentamicin release from Osteopal G reached only 18%. Total gentamicin release increased significantly to 67% with the addition of 50mg Dhvar-5/g, but the Dhvar-5 release was not influenced. SEM showed an increase of dissolved gentamicin crystals with the addition of Dhvar-5. The mercury intrusion results suggested an increase of small pores (< 0.1 microm) with the addition of Dhvar-5. Compressive strength of Osteopal was reduced by the addition of Dhvar-5 and gentamicin, but still remained above the limit prescribed by the ISO standard for clinical bone cements. We therefore conclude that the antimicrobial peptide, Dhvar-5, was released in high amounts from PMMA bone cement. When used together with gentamicin sulphate, Dhvar-5 made the gentamicin crystals accessible for the release medium presumably through increased micro-porosity (< 0.1 microm) resulting in a fourfold increase of gentamicin release.

Antimicrobial Cationic Peptides↗
PubMed2005

Antimicrobial potency of alkali ion substituted calcium phosphate cements.

Potassium and sodium containing nanoapatite cements were produced by the reaction of mechanically activated CaNaPO(4) (CSP), CaKPO(4) (CPP) and Ca(2)KNa(PO(4))(2) (CPCP) with a 2.5% Na(2)HPO(4) solution. The cements exhibited clinically acceptable setting times of approximately 5 min and compressive strengths of 5-10 MPa. The antimicrobial properties of the cements were tested with the agar diffusion test using Streptococcus salvarius, Staphylococcus epidermis and Candida albicans. All types of alkali ion containing cements showed a significantly higher antimicrobial potency with inhibition zones of approx. 4-11 mm than a commercial calcium hydroxide cement which resulted in small inhibition zones around the cement samples of a maximum of 1.5 mm. The antimicrobial properties of all the cements were not found to diminish even after longer incubation times. This behaviour was attributed to the formation of soluble alkaline metal phosphates during setting which increased the pH value in the agar gel around the alkali containing calcium phosphate cement to 8.5-10.7 compared to 6.5-8.0 for the Ca(OH)(2) product. The high antimicrobial potency of alkali-calcium phosphate cements may find an application in dentistry as pulp capping agents, root fillers or cavity liners.

Alkalies↗
PubMed2005

Preparation, physical-chemical characterisation and cytocompatibility of calcium carbonate cements.

The feasibility of calcium carbonate cements involving the recrystallisation of metastable calcium carbonate varieties has been demonstrated. Calcium carbonate cement compositions presented in this paper can be prepared straightforwardly by simply mixing water (liquid phase) with two calcium carbonate phases (solid phase) which can be easily obtained by precipitation. An original cement composition was obtained by mixing amorphous calcium carbonate and vaterite with an aqueous medium. The cement set and hardened within 2h at 37 degrees C in an atmosphere saturated with water and the final composition of the cement consisted mostly of aragonite. The hardened cement was microporous and showed poor mechanical properties. Cytotoxicity tests revealed excellent cytocompatibility of calcium carbonate cement compositions. Calcium carbonates with a higher solubility than the apatite formed for most of the marketed calcium phosphate cements might be of interest to increase biomedical cement resorption rates and to favour its replacement by bone tissue.

Biocompatible Materials↗
PubMed2006

The effect of water uptake on the behaviour of hydrophilic cements in confined environments.

Physiological fluids will be in contact with the implant components from the first moments after a surgery. Therefore, the study of the effect of water on the properties of the bone cements that are part of the arthroplasty procedure is of critical importance to predict the long-term performance of the whole system. In our research group, we have developed a novel concept, the hydrophilic, partially degradable and bioactive cements which uptake considerably more water than standard bone cements. In this paper, we aimed to study the effect of water uptake (WU) by these cements on their behaviour. The tests were carried out in confined cavities, which represent more accurately the in vivo situation the cement will face (constrained by the bone and prosthesis surfaces). We observed that the equilibrium WU decreased up to 60% (as compared to non-confined situations), depending of the formulation. This decrease resulted in a latent tendency of the cements to swell, and the hindering of such swelling generated a swelling pressure against the constraining walls. The pressure, and consequent press-fitting effect, could be controlled by a number of mechanisms, and resulted in higher stability of the hydrophilic cements, expressed as an increase in the push-out force, required to extract the specimens from such constrained cavities. This effect was only observed in hydrophilic cements, not in commercial, hydrophobic ones used as controls. We conclude that such cements will provide an additional and very useful source of immediate adhesion in the short-term after surgery: water induced press fitting.

Biocompatible Materials↗
PubMed2005

A novel amphiphilic acrylic copolymer based on Triton X-100 for a poly(alkenoate) glass-ionomer cement.

OBJECTIVES: The aim of this study was to synthesize a novel ampiphilic polyalkenoic acid copolymer based on acrylic acid and a methacrylic macromonomer of Triton X-100 and determine the efficacy of the novel copolymeric polyalkenoic acid in the formation of glass-ionomer cements. METHODS: Two water soluble copolymers of acrylic acid (AA) and a new amphiphilic macromonomer derived from Triton X-100 (MT) were prepared via radical copolymerisation at 60 degrees C, using azobisisobutyronitrile (AIBN) as the initiator and used to formulate conventional glass-ionomer cements with reactive glass fillers. The acid-base reaction was carried out by reacting aqueous solutions of the new copolymer (40 and 50%) with a commercial aluminofluorosilicate glass as used in conventional glass-ionomer cements. The efficacy of the new copolymer in the formation of glass-ionomer cements was investigated and preliminary results on setting parameters, FTIR analysis, mechanical properties and SEM analysis are reported in this paper. RESULTS: The copolymers were synthesized and characterized and further used to successfully prepare glass-ionomer cements. The experimental cements exhibited longer setting and working times in comparison to conventional glass-ionomer cements and the inclusion of tartaric acid enhanced the mechanical properties, which were comparable to the commercial glass-ionomer cement, Fuji IX. SIGNIFICANCE: Glass-ionomer cements prepared using ampiphilic comonomers is expected to influence their behavior in both polar and non-polar environments. As bulky side chains have been incorporated within the polymeric chain it is expected to affect the reaction kinetics of the acid-base reaction.

Acrylates↗
PubMed2006

Comparison of the physical and mechanical properties of MTA and portland cement.

This study evaluated and compared the pH, radiopacity, setting time, solubility, dimensional change, and compressive strength of ProRoot MTA (PMTA), ProRoot MTA (tooth colored formula) (WMTA), white Portland cement (WP), and ordinary Portland cement (OP). The results showed that PMTA and Portland cement have very similar physical properties. However, the radiopacity of Portland cement is much lower than that of PMTA. The compressive strength of PMTA was greater than Portland cement at 28 days. The major constituent of PMTA is Portland cement. Given the low cost of Portland cement and similar properties when compared to PMTA, it is reasonable to consider Portland cement as a possible substitute for PMTA in endodontic applications. However, industrially manufactured Portland cement is not approved currently for use in the United States and therefore no clinical recommendation can be made for its use in the human body. Further in vitro and in vivo tests, especially with regards its biocompatibility, should be conducted to ascertain if it meets the FDA requirements for use as a medical device.

Aluminum Compounds↗
PubMed1983

Bond strength of orthodontic direct-bonding cement-plastic bracket systems in vitro.

Tensile bond strength and failure location were used to evaluate in vitro the effectiveness of commercial bracket primers for bonding diacrylate cements to plastic brackets. Also, the bond strengths of three two-paste, diacrylate cements were compared with those of three one-step diacrylate cements and an acrylic cement for bonding to three commercial plastic brackets. Bond strength of three diacrylate cements to three plastic brackets ranged from 0.03 to 0.34 kg/mm2 without bracket primer and from 0.51 to 0.85 kg/mm2 with bracket primer. Most failures (83%) occurred within the bracket when the primers were used. For the seven cements tested, bond strengths were highly dependent on the bracket. Bracket T had the highest values of bond strength, followed by bracket L and then R. For brackets L and T, values of bond strength for the one-step cements were equal to or slightly greater than values for the two-paste cements and the acrylic cement.

Acrylic Resins↗