Design of ceramic-based cements and putties for bone graft substitution

Abstract

In the last 15 years, a large number of commercial ceramicbased cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.

Endochondral Ossification for Enhancing Bone Regeneration: Converging Native Extracellular Matrix Biomaterials and Developmental Engineering In Vivo

“…Subsequently, efforts in the bone ECM biomimetic area have yielded dozens of commercially available products. 15,16 Two reviews by Gruskin et al 15 and Bohner 16 compare an extensive number of these products that can be divided into two broad categories: (1) organic scaffolds (e.g., allografts and xenografts) and (2) inorganic scaffolds (e.g., calcium phosphate cements); however, the majority of orthopedic procedures continue to utilize ABG. 6,[12][13][14] This is likely due to the fact that bone ECM biomimetic strategies fail to sufficiently mimic the complex three-dimensional (3D) physical, chemical, and cellular composition of healthy autologous bone.…”

“…As a result, many bone regeneration strategies have focused on mimicking portions of the complex composition and bioactive signals present in ABG, such as demineralized bone matrix (DBM), which resembles the late reparative stage extracellular matrix (ECM) in bone fracture repair (i.e., ''hard'' or ''bony'' callus). [1][2][3][4][5][6][7][8] These efforts have yielded dozens of clinical products, including synthetic scaffolds, allografts, and xenografts 15,16 ; however, the majority of orthopedic procedures continue to utilize ABG. 6,[12][13][14] To date, acellular biomaterial-based products have dominated the alternative bone implant market at the commercial level.…”

“…6,[12][13][14] To date, acellular biomaterial-based products have dominated the alternative bone implant market at the commercial level. 11,15,16 A major characteristic of these products is the ability to mimic the biological ECM environment that is specific for bone regeneration. These materials possess both conductive scaffold moieties and inductive signaling molecules that have been difficult to match with synthetic designs.…”

Composite Scaffolds for Orthopaedic Regenerative Medicine

“…Many of these devices have been used clinically with some degree of success and are still widely used as bony void fillers. However, their clinical applications have been limited because of their brittleness and difficulty of shaping for implantation (Wang et al, 2003), low porosity and long term mechanical integrity issues (Bohner, 2010). Difficulties also exist in controlling the degradation rate of ceramics so as to ensure optimal resorption (Tancred et al, 1998).…”

Development of a Resorbable Calcium Phosphate Cement with Load Bearing Capacity

“…Calcium phosphate cements (CPCs), which are highly biocompatible, represent a good starting point, but are limited by their low strength and ductility. At present the interest in CPCs is high, and there are many products available on the market [1]. However, the main use of CPCs is as nonload bearing bone void fillers where the experienced stresses are limited (e.g., craniofacial applications [2,3]) or where they can be used together with external fixation (e.g., orthopedic applications [4]).…”