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Journal of Materials Science
Published in: Journal of Materials Science 9/2008

01-05-2008

Calcium orthophosphate cements for biomedical application

Author: Sergey V. Dorozhkin

Published in: Journal of Materials Science | Issue 9/2008

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Abstract

In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are a bioactive and biodegradable grafting material in the form of a powder and a liquid. Both phases after mixing form a viscous paste that after being implanted sets and hardens within the body as either a non-stoichiometric calcium deficient hydroxyapatite (CDHA) or brushite, sometimes blended with unreacted particles and other phases. As both CDHA and brushite are remarkably biocompartible and bioresorbable (therefore, in vivo they can be replaced with a newly forming bone), calcium orthophosphate cements represent a good correction technique of non-weight-bearing bone fractures or defects and appear to be very promising materials for bone grafting applications. Besides, these cements possess an excellent osteoconductivity, molding capabilities, and easy manipulation. Nearly perfect adaptation to the tissue surfaces in bone defects and a gradual bioresorption followed by new bone formation are additional distinctive advantages of calcium orthophosphate cements. Besides, reinforced formulations are available; those are described as calcium orthophosphate composites. The discovery of self-setting cements has opened up a new era in the medical application of calcium orthophosphates; several commercial formulations have already been introduced as a result. Many more compositions are in experimental stages. In this review, an insight into calcium orthophosphate cements, as excellent biomaterials suitable for both dental and bone grafting application, has been provided.
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Footnotes
1
There is an opinion [17] that the self-setting calcium orthophosphate cements for orthopedic and dental restorative applications have first been described in the early 1970s by Driskell et al. in US Patent No. 3913229 [18].
 
2
It is interesting to note that calcium sulfate (gypsum or plaster of Paris) has been implanted into fracture gaps and voids of bones for more than 100 years [32‐34].
 
3
There are some differences between TTCP+DCPD and TTCP+DCPA cements. Due to a higher solubility of DCPD (Table 1), a TTCP+DCPD cement sets faster than a TTCP+DCPA cement. Besides, injectability of a TTCP+DCPD cement is better [66, 67].
 
4
In the vast majority cases, a precipitated poorly crystalline HA and CDHA are undistinguishable and might be considered as synonyms [11].
 
5
To honor Prof. George Jarvis Brush (1831–1912), an American mineralogist, Yale University, New Haven, Connecticut, USA [11].
 
6
In early 1990s, depending on the type of calcium orthophosphate formed after setting, five groups of the cement formulations were thought to exist: DCPD, CDHA, HA, ACP, and OCP [70, 87], while currently only two cement groups remain.
 
7
The rheological properties of injectable calcium orthophosphate cement slurry are well described elsewhere [90, 91].
 
8
Earlier, it was believed that DCPA and TTCP reacted upon mixing with water to form the stoichiometric HA [13‐16]. However, further investigations have shown that only the first nuclei consist of a nearly stoichiometric HA, whereas further growth of these nuclei occurs in the form of CDHA [99]. Besides, there is a study demonstrating that the initially formed HA further interacts with remaining DCPD to form CDHA [100].
 
9
It is the time from which a cement no longer disintegrates when immersed in Ringer’s solution [87].
 
10
Water is omitted for simplicity. Therefore, dissolution of DCPA is written instead.
 
11
Further details on the major properties of Norian SRS® are available elsewhere [143, 278].
 
12
Ion-substituted ACPs contained other ions (carbonates, Mg, Zn, F) were used in that study [310].
 
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Metadata
Title
Calcium orthophosphate cements for biomedical application
Author
Sergey V. Dorozhkin
Publication date
01-05-2008
Publisher
Springer US
Published in
Journal of Materials Science / Issue 9/2008
Print ISSN: 0022-2461
Electronic ISSN: 1573-4803
DOI
https://doi.org/10.1007/s10853-008-2527-z

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