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PubMed2001

Black copper phosphate cement: does it have a future?

The aim of this study was to compare the in vitro compressive strength and solubility of a black copper cement with one established restorative material (a conventional glass ionomer cement) and two temporary restorative materials (a zinc phosphate and a zinc polycarboxylate cement). The mean compressive strength of black copper cement varied with the powder: liquid ratio, with an intermediate ratio having a comparable strength to that of the zinc polycarboxylate cement (the best material in this respect). The solubility of the black copper cement at all mixing ratios was significantly greater than that of all other test materials.

Algorithms↗

PubMed1998

A comparative study of retentive strengths of zinc phosphate, polycarboxylate and glass ionomer cements with stainless steel crowns--an in vitro study.

This study was conducted on 30 extracted human primary molars to assess the retentive strengths of zinc phosphate, polycarboxylate and glass ionomer cements. The teeth were embedded in resin blocks and were randomly divided into 3 groups of 10 each. The occlusal surfaces of all teeth were reduced uniformly by 1.0 to 1.5 mm. All mesial, distal undercuts were removed and sharp angles rounded. This was followed by cementing pretrimmed and precontoured stainless steel crowns on each tooth with hand pressure and storing in artificial saliva at 37 degrees C for 24 hours. Retentive strength was tested using Instron Universal Testing Machine. The load was applied starting from a zero reading and gradually increased until the cemented stainless steel crowns showed signs of movement and then the readings were recorded. It was found that retentive strengths of zinc phosphate and glass ionomer cements were statistically better (P < 0.05) when compared to the polycarboxylate cement. Negligible difference (0. 59 kg/cm2) was however observed between zinc phosphate and glass ionomer cements.

Analysis of Variance↗

PubMedDate not supplied

The relationship between abutment taper and resistance of cemented crowns to dynamic loading.

This study investigated the relationship between abutment total occlusal convergence angle (taper) and the resistance of cemented crowns subjected to dynamic loading. Crown and abutment analogs were placed using zinc-oxide-eugenol, zinc-phosphate, glass-ionomer, or resin composite cement. Total occlusal convergence angles of 2.5, 5, 10, 15, 20, 30, and 40 degrees were used. Dynamic stresses were applied to the luted components until the bond failed or the components reached 10(6) load cycles. The data were analyzed using the staircase technique. The relationship between convergence and resistance was approximately linear for all the cements tested. Crowns luted with resin composite cement were more resistant to dynamic lateral loading than those placed using glass-ionomer or zinc-phosphate cements. Crowns luted with zinc-oxide-eugenol cement presented the least resistance to cyclic lateral stresses.

Cementation↗

PubMed1996

In vivo solubility of three types of luting cement.

The in vivo solubility of glass-ionomer, zinc polycarboxylate, and zinc phosphate luting cements was compared. The specimens were inserted in the lingual flanges of the mandibular dentures of 10 edentulous patients. After 8 months, the cement specimens were removed and the amount of solubility was measured with direct techniques. Scanning electron microscopy was used to evaluate surface topography after disintegration. The elements present in each cement were determined with energy-dispersive spectroscopy. The zinc phosphate and zinc polycarboxylate cements demonstrated approximately equal solubility. Glass-ionomer cement exhibited significantly less solubility than did either zinc phosphate or polycarboxylate cement.

Chemical Phenomena↗

PubMed1996

A self-setting TTCP-DCPD apatite cement for release of vancomycin.

Vancomycin (VCM), a methiciline-cefem resistant Staphylococcus aureus (MRSA)-specific antibiotic, was incorporated in a self-setting tetracalcium phosphate (TTCP)-dicalcium phosphate dihydrate (DCPD) apatite cement that hardened isothermally into a hydroxyapatite (HAP) phase with crystallinity similar to that of host bone. Effective release of VCM into PBS lasted for 2 weeks from cements containing 1% VCM and for longer than 9 weeks from cements containing 5% VCM. The rate of release of VCM differed between cements with different crystallinities as well as between the two dissolution media, PBS and simulated body fluid. Mean concentration of VCM in the bone marrow tissue released from cements containing 5% VCM was 20 times the minimum inhibitory concentration 3 weeks after implantation in bone. Direct contact with new bone was observed with the cements containing 1% VCM. Slow delivery of VCM from a self-setting TTCP-DCPD apatite cement with low crystallinity could be used to treat MRSA osteomyelitis.

Animals↗

PubMed1997

Investigation into the release of bioactive recombinant human growth hormone from normal and low-viscosity poly(methylmethacrylate) bone cements.

Previous studies showed that recombinant human growth hormone (hGH) released from hormone-loaded poly(methylmethacrylate) (PMMA) cement stimulated osteoid formation in a rabbit model. Local delivery of hGH from cemented hip arthroplasties may thereby provide a means of reducing the problem of aseptic loosening. We have investigated two different formulations of PMMA as delivery systems for bioactive hGH. The bioactivity of the hormone release in vitro was monitored with an eluted stain assay (ESTA). The hGH was also measured by an immunoassay, which provides an alternative assessment of structural integrity of the hormone released. In addition, we adapted the ESTA bioassay to assess the in vitro cytotoxicity of the cements. Using unloaded cements, the undiluted eluates from both types of PMMA proved cytotoxic. This cytotoxicity could be diluted out, and the procedure allowed us to measure the bioactivity of hGH in the eluates from hormone-loaded cements independent of their cytotoxicity. The major fraction of the bioactivity was released from both of the PMMA cements during the first 24 h, but the hormone remained detectable in eluates collected after 36 days of elution. Comparison of the bio- and immunoactivity of the hGH released showed that the ratio of these two activities (i.e., the B:I ratio) was constant over this time period. However in parallel studies in which hormone-loaded discs were stored under dry conditions prior to elution, we found that the B:I ratio then declined markedly. This suggests that fully hydrated conditions, such as when the discs are bathed in assay medium, are necessary to maintain the bioactivity of the hGH. Both cements released only approximately 1% of the hormone originally incorporated, but the hGH concentration which accumulated in the eluates were high in physiologic terms (approximately 1000 mU/L).

Animals↗

PubMed2000

Bioactive bone cement: effect of surface curing properties on bone-bonding strength.

The fact that bisphenol-a-glycidyl methacrylate (bis-GMA)-based cements contain an uncured surface is believed to play an important role when determining the surface curing properties of the cements. Therefore, in the present study, the bone-bonding strength of cement plates having an uncured surface on one side and a cured surface on the other side has been evaluated. These cement plates were composites of a bis-GMA-based resin with either an apatite- and wollastonite-containing glass-ceramic (AW-GC) powder or a hydroxyapatite (HA) powder, respectively designated AWC and HAC. The amount of each of these powders in a composite cement was 70 wt %. We formulate the hypothesis that the uncured surface of a cement plate is bioactive having bone-bonding properties. The goal of the present study was to indicate the bone-bonding strength of the uncured surfaces of AWC and HAC and compare the strength with the respective cured surfaces by a detaching in vivo test, as well as to histologically examine the bone-cement interface. Each plate has been implanted into the tibiae of male Japanese white rabbits, taking care to retain the surface properties, and the so-called "failure load has been measured using a detaching test followed 8 weeks after implantation. The failure load for AWC-plates at the uncured surface (2.05 +/- 1.11 kgf, n = 8) was significantly higher than AWC at its cured surface side (0.28 +/- 0.64 kgf, n = 8). The failure load for HAC-plates at the uncured surfaces (1.40 +/- 0.68 kgf, n = 8) was significantly higher than HAC at its cured surface (0.00 +/- 0.00 kgf, n = 8). Failure loads for AWC at its uncured and cured surfaces were both higher than for HAC, although not significantly. Direct bone formation has been observed histologically for both AWC and HAC on the uncured surfaces, and a Ca-P-rich layer was observed only at the uncured surface of AWC. These findings strongly suggest that uncured surfaces are useful for exposing a bioactive filler on a surface of composites, being very effective in inducing bone bonding.

Animals↗

PubMed2000

Tensile characteristics of ten commercial acrylic bone cements.

The mechanical properties of acrylic bone cement, used in orthopedic surgery, are very influential in determining successful long-term stability of a prosthesis. A large number of commercial formulations are available, differing in chemical composition and physical properties of both powder and monomer constituents. In this study, the static and dynamic tensile characteristics of a number of the most commonly used bone cements (Palacos R, Simplex P, CMW 1 & 3, Sulfix-60, Zimmer Dough), along with some newer formulations (Endurance, Duracem 3, Osteobondtrade mark and Boneloc), have been investigated under the same testing regimes. Testing was performed in air at room temperature. Significant differences in both static and fatigue properties were found between the various bone cements. Tensile tests revealed that Palacos R, Sulfix-60, and Simplex P had the highest values of ultimate tensile strength, closely followed by CMW 3, while Zimmer Dough cement had the lowest strength. Fatigue testing was performed under stress control, using sinusoidal loading in tension-tension, with an upper stress level of 22MPa. The two outstanding cements when tested in these cyclic conditions were Simplex P and Palacos R, with the highest values of Weibull median cycles to failure. Boneloc bone cement demonstrated the lowest cycles to failure. While the testing regimes were not designed to replicate exact conditions experienced by the bone cement mantle in vivo, there was a correlation between these results and clinical outcome.

Bone Cements↗

PubMed2000

Prevention of infection with tobramycin-containing bone cement or systemic cefazolin in an animal model.

We investigated in an animal model the efficacy of tobramycin-containing bone cement and systemic cefazolin for infection prophylaxis. In 18 female rabbits, the femoral cavity was inoculated with Staphylococcus aureus before injection of bone cement. The first group of six rabbits received tobramycin-containing Simplex-P bone cement. Two other groups of six rabbits received plain Simplex-P bone cement. Preoperatively, in one of the two latter groups cefazolin was administered intravenously. The other group served as untreated controls. The rabbits were monitored for clinical signs of infection. At 7 days' follow-up, the femora were harvested and cultures from the bone adjacent to the cement plug were quantified. Cultures from the rabbits which received antibiotic prophylaxis (either cefazolin systemically or tobramycin-containing bone cement) were all negative. In contrast, all rabbits in the untreated control group had positive cultures. These rabbits also had other signs of infection such as an elevated erythrocyte sedimentation rate and loss of body weight. Culture results were confirmed by the absence of bacterial DNA in the polymerase chain reaction hybridization assay. In conclusion, we found that both tobramycin-containing bone cement and systemic cefazolin are effective in preventing implant bed infection in rabbits up to 7 days after contamination with S. aureus.

Animals↗

PubMed1992

The effect of a thin coating of polymethylmethacrylate on the torsional fatigue strength of the cement-metal interface.

Recent studies have established that a mechanism of initiation of failure of fixation of cemented femoral components is debonding of the cement-metal interface. Other studies have shown that the torsional forces induced by stair climbing and rising from a chair are very high. Thus, the interface between the femoral prosthesis and the bone cement in total hip arthroplasty (THA) is required to transmit high torsional loads from the metal to the cement in a cyclic shear mode many times per year. These torsional loads likely contribute to the debonding. This study evaluated the efficacy of a thin layer of polymethylmethacrylate (PMMA) precoating in increasing the torsional fatigue strength of the cement-metal interface. Fatigue studies were performed on 15 specimens. Each specimen was tested with and without PMMA precoating. The PMMA precoat significantly and substantially increased the torsional fatigue strength of the cement-metal interface. Thus, PMMA precoating is likely to be a clinical advantage in maintaining the long-term integrity of the cement-prosthesis interface.

Bone Cements↗

PubMed1980

Methyl methacrylate concentrations in tissues adjacent to bone cement.

The amount of methyl methacrylate monomer present in bone tissue immediately adjacent to implanted bone cement that has polymerized in vivo has been determined. Poly(methyl methacrylate) was implanted into the distal femoral condyle of the dog and allowed to polymerize. At various times following polymerization, samples were removed and sections adjacent to the cement were cut and subjected to homogenization followed by liquid gas chromatographic determination of the amount of methyl methacrylate monomer present. The highest concentration of methyl methacrylate monomer present in bone tissue was 0.140% in the 1000 micrometers of bone tissue adjacent to bone cement immediately after polymerization of the cement. The concentration was very similar (0.137%) 1 hr after cement polymerization, but dropped off rapidly following that with no free methyl methacrylate monomer present in bone tissue adjacent to cement after 4 hr following cement polymerization.

Animals↗

PubMed1981

Mechanical properties of poly(methyl methacrylate) bone cements.

Samples of low viscosity poly(methyl methacrylate) (PMMA), graphite reinforced PMMA, and graphite reinforced low viscosity PMMA were evaluated for their compression strength and fracture toughness. These results were compared with two currently used plain PMMA bone cements. There were no statistically significant differences in compression strength between the five cements. Graphite reinforcement of plain cement produced a 32% increase in fracture toughness over plain cement. Graphite reinforcement of low viscosity cement also produced a significant increase in toughness (31%) over low viscosity cement with fiber reinforcement. However, low viscosity cement demonstrated significantly less fracture toughness than plain PMMA.

Analysis of Variance↗

PubMedDate not supplied

The influence of temperature and specimen size on the flexural properties of PMMA bone cement.

A three-stage investigation was undertaken to examine the influence of specimen size and polymerization environment on the flexural properties of PMMA. In the first stage, specimens were cut from large pieces of commercially cast acrylic (lucite) and self-curing dental acrylic. The material properties of the cast acrylic as calculated from the results of flexural testing were not influenced by specimen size in the range of 1 X 10 X 30 to 3 X 10 X 60 mm, whereas 1-mm thick dental cement specimens had 12% (p less than 0.001) higher stress and 24% (p less than 0.001) higher strain to failure than 3-mm specimens cut from the same sample. In the second stage, self-curing dental cement and Simplex P bone cement were molded in different thicknesses. These experiments demonstrated that molding thin 1.6-mm specimens resulted in increases of 14% (p less than 0.001) in stress and 30% (p less than 0.001) in strain to failure as compared with 3.2-mm specimens, which were greater differences than those due to the specimen thickness effects alone. In the third stage, temperatures of cement were monitored during polymerization, and cements were molded at different temperatures. These results demonstrated that thicker cement samples reached higher temperatures and that cement samples polymerized at lower temperatures (21 versus 37 degrees C) had 12% (p less than 0.001) greater stress and 105% (p less than 0.001) greater strain to failure.

Bone Cements↗

PubMedDate not supplied

The load carrying and fatigue properties of the stem-cement interface with smooth and porous coated femoral components.

Porous coated surfaces for fixation of total hip replacement are a current trend in clinical orthopedics. Such devices are designed to be fixed by ingrowth of bony tissue, although in the absence of FDA approval for biologic fixation, fixation with PMMA cement is recommended by the implant manufacturers. In order to characterize the mechanical properties of the micro-interlocked stem-cement interface, we tested both porous coated and smooth femoral components in cement mantles of consistent overall geometry. Under conditions of increasing load the smooth stems demonstrated stepwise irreversible subsidence into the mantle. Axial and circumferential strains measured in the cement containment vessels with the smooth stems showed that stepwise increases in tensile hoop strain occurred concomitantly with the stepwise incidents of stem subsidence. When subjected to the same loading conditions, the porous coated stems did not undergo stepwise incidents of subsidence, and hoop strain generation was reduced. In addition, a twofold increase in the failure load of the stem-cement interface was measured with the porous coated stems. Fatigue loading for 10(7) loading cycles did not result in gross failure of either the micro-interlocked or smooth interfaces. However, the data showed that during fatigue loading, stepwise subsidence of the smooth stems again occurred. The final subsidence magnitude of the smooth stem-cement interface at 10(7) loading cycles was six times greater than the value associated with the porous coated stem. Thus the porous coating of femoral stems was shown to dramatically improve the load carrying capability and fatigue characteristics of the stem-cement interface.

Biomechanical Phenomena↗

PubMed1986

Influence of mixing technique on some properties of PMMA bone cement.

PMMA bone cements (Refobacin-Palacos R, Sulfix 6, AKZ, and CMW bone cement, types I and II), from six different clinics, were investigated in three stages. In the first stage, studies of density, hardness, flexural strength, and compressive strength were made, as well as molecular weight measurements and microscopic investigations. These studies reflected the current state of techniques of application used in operating theaters. They revealed wide variations in the properties of the materials studied. Secondly, a comprehensive study of the process-technology in the laboratory was performed. The following variables were investigated or discussed: mixing vessel, order of the individual components, mixing time, rate of mixing, pressure application on the mixed bone cement, kneading, cement thickness, pouring into the syringe, contact force during polymerization, and preparation quantity. The third stage involved the development and clinical testing of an improved mixing technique. Using this improved mixing technique, all three selected clinics achieved far better results with reduced variability. A comparison between a centrifuging technique after mixing and our improved, but conventional, mixing technique, displays advantages for the latter. The question regarding a correlation between cement specimens of high porosity and early implant loosening could not be answered on the basis of the 43 PMMA bone cement explants investigated (implanted 6 months to 15 years). In some cases, the studies revealed that the bone cement manufacturers should be required to revise and quantify existing instructions for use. The users, on the other hand, should give more consideration to the mixing technique and its consequences.

Bone Cements↗

PubMed1992

The fracture toughness of titanium-fiber-reinforced bone cement.

Fracture of the poly(methyl methacrylate) bone cement mantle can lead to the loosening and ultimate failure of cemented total joint prostheses. The addition of fibers to the bone cement increases fracture resistance and may reduce, if not eliminate, in vivo fracturing. This study discusses the effect of incorporating titanium (Ti) fibers on fracture toughness. Essential characteristics of the composite bone cement included a homogeneous and uniform fiber distribution, and a minimal increase in apparent viscosity of the polymerizing cement. Ti fiber contents of 1%, 2%, and 5% by volume increased the fracture toughness over non-reinforced bone cement by up to 56%. Bone cements of two different viscosities were used as matrix material, but when reinforced with the same fiber type and content, they showed no difference in fracture toughness. Four different fiber aspect ratios (68, 125, 227, 417) were tested. At 5% fiber content, there was no statistically significant dependence of fracture toughness on fiber aspect ratio. Scanning electron microscopy revealed important toughening mechanisms such as fiber/matrix debonding, local fracture path alteration, and ductile fiber deformation and fracture. Fiber fracture was evidence that the critical fiber length was exceeded. The surfaces of the Ti fibers were rough and irregular, indicating that a high degree of mechanical interlock between matrix and fiber was likely. The energy absorption contribution of plastic deformation and ductile fracture is absent in brittle fibers, like carbon, but is a distinction of the Ti fibers used in this study.

Biocompatible Materials↗

PubMed1995

Drug release from a novel self-setting bioactive glass bone cement containing cephalexin and its physicochemical properties.

A novel device containing cephalexin as a model drug using a self-setting bioactive cement based on CaO-SiO2-P2O5 glass was investigated. The device consisted of 95 wt/wt% glass powders and 5 wt/wt% cephalexin powder hardened within 5 min after mixing with a phosphate buffer. After setting, in vitro drug release from homogeneous or heterogeneous drug-loaded cement pellets in a simulated body fluid (SBF) at pH 7.25 and 37 degrees C continued for over 4 weeks. The hardened cement gradually formed low-crystallinity hydroxyapatite with high bioactivity in hard bone tissue and reduced in volume by about 5% during dissolution testing in SBF. Consequently, 30% of the loaded drug was squeezed from the cement system at the initial stage of the drug release, and the remainder released more slowly. Because the heterogeneous system consisting of the cement and drug-loaded pellet avoided the drug-squeezing effect, it showed a longer drug release term than the homogeneous drug-loaded cement. The heterogeneous system using the hardened cement after soaking in SBF at 37 degrees C for 10 days showed very slow drug release at the initial stage because it completely avoided the drug-squeezing effect, and the release was a zero-order pattern.

Cephalexin↗

PubMed1995

Creep characteristics of hand- and vacuum-mixed acrylic bone cement at elevated stress levels.

Compressive creep testing of cylindrical specimens machined from two commercial self-polymerizing acrylic bone cements demonstrated measurable creep strains with higher creep strains for the hand-mixed cement specimens compared to vacuum-mixed cement ones. The average creep strains of hand-mixed cement, after 6 h of constant load, ranged from 0.11% at 10.5 MPa to 14.0% at 50 MPa of applied stress. Vacuum mixing reduced the average creep strain to 6.7% after 6 h of applied stress at 50 MPa. There were no significant differences in the creep response between the two types of acrylic cements. The difference in creep resistance of the two cements was reduced after vacuum mixing (P = .013), which also significantly reduced the cement's internal porosity.

Bone Cements↗