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PubMed1981

Factors affecting the adhesion of polycarboxylate cement to enamel and dentin.

The adhesive bond strength of polycarboxylate cement with enamel and dentin and the factors affecting the adhesion of the cement to both structure were studied. A thick cement film reduced the tensile and shear bond strengths of the cement. Although surface roughness reduced the tensile bond strength of the cement, it significantly increased the shear bond strength. The application of the cement under pressure increased its shear bond strength. Surface treatment with 4% sodium fluoride solution for 5 minutes, 4% stannous fluoride solution for 2 minutes, and a 10% suspension of calcium hydroxide for 5 minutes significantly increased the shear bond strength of the cement with dentin.

Acid Etching, Dental↗

PubMed1979

Biomechanics of the femoral component of total hip prostheses with particular reference to the stress in the bone-cement.

Two-dimensional finite element analyses were used to determine the normal and shear stress distributions at the prostheses-cement and cement-bone interfaces in the femoral component of a total hip replacement. Various combinations of stem, cement and bone stiffnesses were investigated. In particular the influences of stem taper, cement stiffness, prosthesis stiffness and the effect of a plateau, on the cement stresses were examined and compared. It was particulary noticeable that the normal direct stress across the cement in the proximal region of the stem, both literally and medially, as generally compressive. It was found that the more flexible the cement the more uniform were the stress distributions. Furthermore, these stresses increase as the stiffness of the stem decreases.

Biomechanical Phenomena↗

PubMed1980

Alumina as a filler for bone cement: a feasibility study.

A composite bone cement of Alcoa A-10 Alumina and very finely ground poly(methyl methacrylate) beads (PMMA) was fabricated. It was tested in an attempt to improve on the conventionally used pure PMMA bone cement. By knowing the densities of the powders and their volumes, the mass of each was calculated for the most efficient packing of PMMA and Al2O3 powders and a 65% PMMA: 35% Al2O3 ratio by weight composition was determined. This was tested, as well as the pure cement so comparisons could be made. Cylinders for the strength tests were also made of silane treated Al2O3. The compositions were tested for compressive and tensile strengths. The pure PMMA, composite and silane treated composite had compressive strengths of 79.64 +/- 13.0, 83.17 +/- 4.8, and 71.52 +/- 8.6 MPa and the tensile strengths were 6.69 +/- 0.6, 5.12 +/- 0.3, and 7.12 +/- 0.5 MPa respectively. Also the 65%-35% PMMA-Al2O3 composite required 64% less monomer for mixing than did the pure cement which is thought to be better for tissue healing. The maximum temperature attained from room temperature was 110 degrees-115 degrees C for both cements. The composite took 6.5 min longer to reach its peak temperature than did the pure cement. The bone cements were implanted for one week in a rabbit and both compositions seemed acceptable by the tissue.

Aluminum↗

PubMed1993

Microstructural pathway of fracture in poly(methyl methacrylate) bone cement.

Mechanical failure of poly(methyl methacrylate) (PMMA) bone cement is linked to failure of cemented total joint prostheses. An essential step to minimize, if not eliminate, cement fracture is to understand the material characteristics controlling fracture resistance. At least four phases of bone cement can be identified that may affect the damage zone formation: pre-polymerized beads, interbead matrix polymer, BaSO4, and porosity. Gel permeation chromatography (GPC) was used to determine the molecular weight (MW) distributions of the two polymer phases. Mechanical testing, scanning electron microscopy and light microscopy were used to analyse fracture mechanisms. Fatigue crack propagation of bone cement was distinctly different from rapid crack propagation. Microcracks defined the damage zone for fatigue fracture. The microcracks developed in the interbead matrix and not through the pre-polymerized beads. Light microscopy revealed evidence of craze formation on surfaces of fractured beads during rapid fracture, but not on fatigue surfaces. GPC analysis indicated an increase in MW from the bead phase alone to the fully cured bone cement, indicating a greater MW in the interbead matrix polymer. Increases of 36 and 176% were measured for two different bone cements, but the bulk of the polymer has an MW of less than 1 x 10(6). Three factors were suggested to explain why the microcracks seem to prefer to grow in the interbead matrix: the presence of BaSO4, shrinkage during the curing process, and the different polymerization processes of the bead and the interbead polymers.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗

PubMed1993

Radiological and histological study of aseptic loosening using a cemented tibial hemiarthroplasty in the rabbit knee.

Fourteen mature New Zealand white female rabbits had a unilateral cemented, stemmed, titanium, condylar-type tibial hemiarthroplasty, using an anteromedial arthrotomy of the right knee. The articular cartilage and minimal bone were resected. There were two prosthetic groups of seven animals each: a well-fixed, non-loose group and a loose group. In the non-loose group, the implant was inserted into the cement bed and axially compressed until the PMMA had cured. In the loose group, the same volume of cement was allowed to cure on the implant ex vivo; the prosthesis was then implanted to ensure that it was loose fitting. Radiographs were performed at zero and 3 months and graded for new lucent lines. Histological analysis was performed using undecalcified coronal sections, surface stained with toluidine blue with the prosthesis in situ, and the cement mantle preserved. Back-scattered electron microscopy was also performed. The mean cumulative grading of new lucent lines was 0.3 +/- 0.1 for the non-loose group and 2.2 +/- 0.4 for the loose group (P < 0.005). Non-loose prostheses were surrounded by a thin fibrous membrane or bone. Loose prostheses were surrounded by a thicker, fibrous tissue layer, containing histiocytes and giant cells which were more prevalent around cement particles, especially near the prosthetic tip. These findings parallel the histology found at cemented prosthetic interfaces in humans. The results of this study suggest that the fibrohistiocytic membrane commonly found around loose cemented implants may be the result of, rather than the cause of, the loosening process.

Animals↗

PubMed1995

Non-decay type fast-setting calcium phosphate cement: composite with sodium alginate.

Non-decay type fast-setting calcium phosphate cement (nd-FSCPC) was prepared by introducing sodium alginate (0-2.0 wt%) into the liquid phase of FSCPC. nd-FSCPC was stable even when the cement paste was immersed in distilled water immediately after mixing, whereas conventional FSCPC (c-FSCPC) decayed completely within 1 min upon immersion. The setting time of the cement, approximately 5 min, was not dependent on the presence of sodium alginate. In contrast, the introduction of sodium alginate into conventional CPC, i.e. CPC without neutral phosphate in the liquid phase, resulted in no setting when the amount of sodium alginate introduced was more than 1 wt%. Powder X-ray diffraction analysis revealed no significant difference for the conversion of cement to apatite for any concentrations of sodium alginate studied (0-2.0 wt%). The mechanical strength of the cement increased rapidly with the addition of sodium alginate up to 0.8 wt% when the cement paste was immersed and kept in distilled water at 37 degrees C, whereas further addition of sodium alginate decreased the mechanical strength. The results obtained in this investigation, taken together with sodium alginate's known excellent biocompatibility and absorption behaviour, indicate that the use of sodium alginate composite FSCPC as nd-FSCPC should be of value in orthodontics and oral and maxillofacial surgery where the cement is exposed to blood.

Alginates↗

PubMed1990

The influence of curing time and environment on the fracture properties of bone cement.

Fracture of bone cement at the bone-cement interface is considered to be of significance in the aseptic loosening of orthopaedic implants. The characterisation of the fracture properties of bone cement is influenced by the time and environment in which it is cured. Cement samples stored in air and water at 21 and 37 degrees C for 7 and 21 days were tested using the 'Chevron' test to determine the work of fracture. It was found that the storage temperature and environment had important influences on the fracture resistance of bone cement. In a physiological environment cement appears to take longer to attain a fracture resistance equivalent to that of cement stored at room temperature.

Bone Cements↗

PubMed2006

Effects of different sizes of occlusal metal on curing depth of light-cured orthodontic band cement.

INTRODUCTION: Sufficient penetration and quantity of light are necessary to cure band cement. It is doubtful whether this occurs when bands are cemented to teeth restored with large pieces of occlusal metal. The purpose of this in-vitro investigation was to examine the curing depth and degree of conversion from monomer to polymer of light-cured adhesives when used to cement bands to ceramic blocks covered with metal restorations. METHODS: Two resin adhesives--Transbond Plus (3M Unitek, Monrovia, Calf) and Ultra Band-Lok (Reliance Orthodontic Products, Itasca, Ill)--and 3 curing methods were used. The upper surfaces of ceramic blocks (13 x 10 x 15 mm), used instead of human molars, were restored by using metal pieces of different sizes (4 x 8 x 2, 6 x 8 x 2, and 8 x 8 x 2 mm). The curing depth of the cement along the lateral surface of the block was measured at the middle of its width with slide calipers. Fourier transform infrared spectrometry was used to evaluate the degree of conversion of the adhesives. RESULTS: There was unpolymerized resin in the deep area of the cement on curing with central irradiation from the occlusal surface. However, the amount of unpolymerized resin was significantly (P < .05) decreased with the boundary and circle irradiation methods. CONCLUSIONS: The curing depth of band cement was significantly affected by the size of the occlusal metal restoration and the irradiation method. Therefore, a suitable irradiation method is essential for complete curing of resin for cementing bands to teeth with large metal restorations.

Absorption↗

PubMed2004

Improved acetabular pressurization gives better cement penetration: in vivo measurements during total hip arthroplasty.

During total hip arthroplasty, the intraoperative cementation pressure was measured inside one of the acetabular anchorage holes. Patients were randomized to pressurization of cement with either a conventional pressurizer or a sequential method including individual pressurization of each anchorage hole. The pressure was correlated to the cement penetration measured on digital radiographs. The early peak pressures were higher for the sequential method, resulting in a significantly better penetration of 2.8 mm compared with 0.7 mm with the conventional pressurizer. We found a strong correlation between early peak cementation pressures and cement penetration into the cancellous bone of the anchoring holes, indicating a cause-effect relationship at this early stage. The highest peak pressures were achieved during the later cup insertion, but these pressures did not correlate with the cement penetration. We conclude that conventional methods for cement pressurization in the acetabulum may not be optimal.

Acetabulum↗

PubMed2005

Analysis of 16 retrieved proximally cemented femoral stems.

Sixteen proximally cemented, collared, and distally splined, Bridge Hip femoral stems with a matte proximal surface and smooth distal surface were retrieved because of loosening. Electron microscopy, with correlated elemental analysis, identified titanium particulate embedded in the internal surface of the cement mantle. Data supported the observations that loosening of the femoral stems was related to proximal debonding at the cement-implant interface, loosening at the proximal cement-bone interface, and inherent rotational instability. Cement-implant interface debonding resulted in the proximally matte femoral stem surface abrading with the opposing cement mantle, resulting in particulate and osteolysis in some cases. Careful consideration of implant design and clinically relevant biomechanical testing protocols should be considered before the clinical introduction of future proximally cemented femoral stems.

Adult↗

PubMed2005

Bone inductive properties of rhBMP-2 loaded porous calcium phosphate cement implants inserted at an ectopic site in rabbits.

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is known for its osteoinductive potential in bone tissue engineering. Calcium phosphate (Ca-P) cements are injectable, osteoconductive ceramic materials in which a macroporous structure can be induced during the setting reaction. In this study, the osteoinductive capability of rhBMP-2 loaded porous Ca-P cement was evaluated. Porous Ca-P cement discs were made and loaded with rhBMP-2 in vitro and implanted subcutaneously in the back of New Zealand white rabbits. The implantation period was either 2 or 10 weeks. Histological analysis of retrieved specimens revealed evident bone formation in the rhBMP-2 loaded Ca-P cement discs (pore fill: 18+/-6%) after 10 weeks of implantation. Bone formation occurred only in rhBMP-2 loaded porous Ca-P cement discs. Degradation of the Ca-P cement could not be confirmed after 10 weeks of implantation. The scaffold maintained its shape and stability during this time period. We conclude that porous Ca-P cement is a suitable carrier material for ectopic bone engineering.

Animals↗

PubMed2005

Comparative study on the properties of acrylic bone cements prepared with either aliphatic or aromatic functionalized methacrylates.

Bone cements prepared with methacrylic acid (MAA) and diethyl amino ethyl methacrylate (DEAEM) were compared with formulations employing 4-methacryloyloxybenzoic acid (MBA) and 4-diethyaminobenzyl methacrylate (DEABM) as comonomer. The influence of these new aromatic monomers on various physicochemical, setting and mechanical properties was assessed. Surface characterization demonstrated that bone cements prepared with any of the functionalized monomers exhibited increasing hydrophilicity with monomer concentration and that the aromatic monomers provided more hydrophilic cements than their aliphatic counterparts for low concentrations of the functional monomer. It was also found that bone cements prepared with high amounts of the acidic aliphatic monomer provided the highest exotherm of reaction and their setting times were shorter than MBA based cements. On the other hand, DEABM containing bone cements exhibited shorter setting times than DEAEM formulations and slightly higher peak temperatures. In general, it was found that the glass transition temperature increased with the presence of acidic comonomer and decreased when alkaline comonomers were present, especially aliphatic ones. When aromatic methacrylates were used at 0.05 molar fraction, the highest tensile and compressive strength were achieved i.e. 46 and 118 MPa for MBA and 51 and 108 MPa for DEABM formulations. A further increase in the aromatic monomer concentration led to cements of low mechanical properties due to solubility problems as revealed by SEM.

Benzoates↗

PubMed2005

Biocompatibility and resorption of a brushite calcium phosphate cement.

A hydraulic calcium phosphate cement with beta-tricalcium phosphate (TCP) granules embedded in a matrix of dicalcium phosphate dihydrate (DCPD) was implanted in experimentally created defects in sheep. One type of defect consisted of a drill hole in the medial femoral condyle. The other, partial metaphyseal defect was located in the proximal aspect of the tibia plateau and was stabilized using a 3.5 mm T-plate. The bone samples of 2 animals each per group were harvested after 2, 4, 6 and 8 weeks. Samples were evaluated for cement resorption and signs of immediate reaction, such as inflammation, caused by the cement setting in situ. Differences regarding these aspects were assessed for both types of defects using macroscopical, radiological, histological and histomorphometrical evaluations. In both defects the brushite matrix was resorbed faster than the beta-TCP granules. The resorption front was followed directly by a front of new bone formation, in which residual beta-TCP granules were embedded. Cement resorption occurred through (i) extracellular liquid dissolution with cement disintegration and particle formation, and (ii) phagocytosis of the cement particles through macrophages. Signs of inflammation or immunologic response leading to delayed new bone formation were not noticed at any time. Cement degradation and new bone formation occurred slightly faster in the femur defects.

Absorbable Implants↗

PubMed2005

Early and long-term wear of 'fast-set' conventional glass-ionomer cements.

OBJECTIVE: Fast setting high viscous glass-ionomer cements have been introduced to reach the set state sooner and to improve early mechanical properties. The aim of this study was to investigate whether 'fast-set' cements have improved the early three-body wear. METHOD: The three-body wear of four glass-ionomer cements was measured after 1, 4, 7, 30, 90, and 365 days. The chemical composition of the cements was determined with EDAX. The particle size of the powders was determined with a Mastersizer 2000. RESULTS: The three-body wear of Fuji IX Fast was only slightly less than that of 'regular-set' Fuji IX, but Ketac Molar Quick showed a higher wear compared to the regular-set Ketac Molar. The wear rate of all four glass-ionomer cements decreased over a period of 1 year and could be described by second order reaction kinetics and depended on polyalkenoic acid content, chemical composition, and the size of the glass particles. SIGNIFICANCE: Based on the results of this laboratory study on long-term wear, the glass-ionomer cements investigated may compete with composites, but the early wear characteristics should be further improved. Furthermore, a better understanding of the wear and reaction behavior of glass-ionomer cements is obtained.

Electron Probe Microanalysis↗

PubMed2006

Synthesis and preparation of novel 4-arm star-shape poly(carboxylic acid)s for improved light-cured glass-ionomer cements.

OBJECTIVE: The objective of this study was to synthesize and characterize novel 4-arm star-shape poly(acrylic acid)s (poly(AA)s) via atom-transfer radical polymerization (ATRP) technique, tether in situ light-curable methacrylate functionalities onto the poly(AA) backbone, use these star-shape poly(AA)s to formulate the light-cured glass-ionomer cements (LCGICs), and evaluate the mechanical strengths of the formed cements. MATERIALS AND METHODS: The 4-arm poly(AA)s were synthesized using ATRP and tethered with either 2-isocyanatoethyl methacrylate (IEM) or glycidyl methacrylate (GM). The polymers were formulated with 2-hydroxyethyl methacrylte (HEMA) or methacryloyl beta-alanine (MBA), water, initiators, and Fuji II LC filler. Compressive strength (CS) was used as a tool to evaluate the formed cements. The specimens were conditioned in distilled water at 37 degrees C for 24h prior to testing. RESULTS: The 4-arm poly(AA) showed a lower viscosity as compared to its linear counterpart. Both IEM-tethered and GM-tethered 4-arm poly(AA) constructed LCGICs showed significantly high mechanical strengths. Both types of co-monomer and grafting agent dramatically affected the mechanical strengths. The MBA-containing poly(AA) cements exhibited much higher CS than the HEMA-containing cements. The IEM-tethered poly(AA) cements showed much higher CS and DTS than the GM-tethered cements. CONCLUSIONS: This study developed a novel light-curable 4-arm star-shape poly(AA) system. The system was 13% in CS, 178% in DTS and 123% in FS, compared to Fuji II LC.

Acrylic Resins↗

PubMed2005

Biomechanical assessment of stability in the metastatic spine following percutaneous vertebroplasty: effects of cement distribution patterns and volume.

Percutaneous vertebroplasty is a minimally invasive, radiologically guided procedure whereby bone cement is injected into structurally weakened vertebrae to provide added biomechanical stability. In addition to treating osteoporotic vertebral fractures, this technique is also used to relieve pain by stabilizing metastatically compromised vertebrae that are at risk of pathologic burst fracture. Optimal cement distribution patterns to improve biomechanical stability to metastatically involved vertebral bodies remain unknown. This study aimed to determine the effect of cement location and volume of cement injected during percutaneous vertebroplasty on improving vertebral stability in a metastatically-compromised spinal motion segment using a parametric poroelastic finite element model. A three-dimensional parametric finite element model of a thoracic spinal motion segment was developed and analyzed using commercially available software. A total of 16 metastatic pre and post vertebroplasty scenarios were investigated using a serrated spherical representation of tumor tissue and various geometric representations of polymethylmethacrylate (PMMA). The effect of vertebroplasty on vertebral bulge, a measure of posterior vertebral body wall motion as an indicator of burst fracture initiation, was assessed. In all cases, vertebroplasty reduced vertebral bulge, but the risk of the initiation of burst fracture was minimized with cement located posterior to the tumor, near the posterior vertebral body wall. Vertebral bulge decreased by up to 62% with 20% cement injection. These findings demonstrate that location and distribution of cement within the vertebral body has a noticeable effect on the restoration of biomechanical stability following percutaneous vertebroplasty.

Bone Cements↗

PubMed2006

Cement flow during impaction allografting: a finite element analysis.

Cement intrusion into cancellous or impacted bone is not well understood. We adopted an engineering mechanics approach to predict the effect of surgical variables on the cement intrusion into impacted cancellous bone, used for the revision of failed total hip replacement with the impaction allografting technique. Specifically, a three-dimensional finite element model was used to determine the effects of cement viscosity, the magnitude and duration of pressurization, and the distribution of the porosity along the femur on cement intrusion. The overall averaged mean intrusion depth difference between the finite element model prediction and the cadaveric measurements was 1.1mm. The depth of penetration increased with higher pressurization pressure, duration of pressurization, and earlier stem insertion (lower viscosity), but maintained a similar profile. The distribution of the porosity along the femur determined the intrusion profile. Cement viscosity, the applied pressure or the duration of the pressurization can be adjusted to limit the cement volume injected into the medullary canal and therefore prevent the cement from reaching the endosteal surface.

Bone Cements↗

PubMed2004

The influence of alumina abrasion and cement lute on the strength of a porcelain laminate veneering material.

OBJECTIVES: The purpose of the current study was to examine whether alumina abrasion regime influenced the necessary surface roughness conducive to mechanical interlocking prior to composite resin bonding. The impact of alumina abrasion and cement lute on the bi-axial flexure strength and associated Weibull Moduli (m) on the cemented surfaces of disc specimens of porcelain laminate veneer (PLV) materials was therefore investigated. METHODS: Sets of 20 Vitadur-alpha dentine porcelain discs (15 mm diameter, 1.7 mm thickness) were condensed and prepared by abrading with 25, 50 or 110 microm alumina. Further specimen groups were stored wet or coated with a resin cement. Mean fracture strengths, standard deviations and associated m were determined using a ball-on-ring assembly. The surface roughness was assessed using profilometry and scanning electron microscopy. RESULTS: The one-way ANOVA revealed a significant reduction (P<0.05) between the means of the dry control and alumina abraded specimens. A significant increase in m was identified for 50 and 110 microm alumina abraded cemented specimens (6.1+/-1.4 and 6.0+/-1.3, respectively) compared with the 25 microm alumina abraded cemented and non-alumina abraded cemented controls (3.9+/-0.9 and 3.5+/-0.8, respectively). Increasing the alumina particle size utilised for the abrasion resulted in a decrease in the surface roughness (R(a) value) which is the arithmetic mean of the absolute departures of the roughness profile from the mean line. SIGNIFICANCE: Alumina abrasion acted to replace surface defects with a narrower distribution of defects. Composite resin polymerisation shrinkage may prevent surface flaws from being extended by healing the key surface defects and would appear to suggest that the use of a resin-based luting material may reduce the potential for crack propagation. Given the arrangement of ions across crack tips it is more likely that the resin composite cement enhanced strength by acting to heal key defects rather than imposing a compressive stress on the porcelain surface as suggested previously.

Aluminum Oxide↗