Regenerating Craniofacial Dental Defects With Calcium Phosphate Cement Scaffolds: Current Status and Innovative Scope Review

The management and treatment of dental and craniofacial injuries have continued to evolve throughout the last several decades. Limitations with autograft, allograft, and synthetics created the need for more advanced approaches in tissue engineering. Calcium phosphate cements (CPC) are frequently used to repair bone defects. Since their discovery in the 1980s, extensive research has been conducted to improve their properties, and emerging evidence supports their increased application in bone tissue engineering. This review focuses on the up-to-date performance of calcium phosphate cement (CPC) scaffolds and upcoming promising dental and craniofacial bone regeneration strategies. First, we summarized the barriers encountered in CPC scaffold development. Second, we compiled the most up to date in vitro and in vivo literature. Then, we conducted a systematic search of scientific articles in MEDLINE and EMBASE to screen the related studies. Lastly, we revealed the current developments to effectively design CPC scaffolds and track the enhanced viability and therapeutic efficacy to overcome the current limitations and upcoming perspectives. Finally, we presented a timely and opportune review article focusing on the significant potential of CPC scaffolds for dental and craniofacial bone regeneration, which will be discussed thoroughly. CPC offers multiple capabilities that may be considered toward the oral defects, expecting a future outlook in nanotechnology design and performance.

Preparation, Structural Characterization, and Biomedical Applications of Gypsum-Based Nanocomposite Bone Cements

Hard tissues are natural nanocomposites comprising collagen nanofibers that are interlocked with hydroxyapatite (HAp) nanocrystallites. This mechanical interlocking at the nanoscale provides the unique properties of hard tissues (bone and teeth). Upon fracture, cements are usually used for treatment of simple fractures or as an adhesive for the treatment of complicated fractures that require the use of metallic implants. Most of the commercially available bone cements are polymer-based, and lack the required bioactivity for a successful cementation. Besides calcium phosphate cements, gypsum is one of the early recognized and used biomaterials as a basi for a self-setting cementation. It is based on the controlled hydration of plaster of Paris at room temperature and its subsequent conversion to a self-setting solid gypsum product. In our work, we have taken this process further towards the development of a set of nanocomposites that have enhanced bioactivity and mechanical properties. This chapter will outline the formation, characterization, and properties of gypsum-based nanocomposites for bone cement applications. These modified cements can be formulated at room temperature and have been shown to possess a high degree of bioactivity, and are considered potential candidates for bone fracture and defect treatment.

Effect of the Addition of Alginate and/or Tetracycline on Brushite Cement Properties

Calcium phosphate cements have the advantage that they can be prepared as a paste that sets in a few minutes and can be easily adapted to the shape of the bone defect, which facilitates its clinical application. In this research, six formulations of brushite (dicalcium phosphate dihydrated) cement were obtained and the effect of the addition of sodium alginate was analyzed, such as its capacity as a tetracycline release system. The samples that contain sodium alginate set in 4 or 5 min and showed a high percentage of injectability (93%). The cements exhibit compression resistance values between 1.6 and 2.6 MPa. The drug was released in a range between 12.6 and 13.2% after 7 days. The antimicrobial activity of all the cements containing antibiotics was proven. All samples reached values of cell viability above 70 percent. We also observed that the addition of the sodium alginate and tetracycline improved the cell viability.

Nanostructured Strontium-Doped Calcium Phosphate Cements: A Multifactorial Design

Calcium phosphate cements (CPCs) have been extensively studied in last decades as nanostructured biomaterials for the regeneration of bone defects, both for dental and orthopedic applications. However, the precise control of their handling properties (setting time, viscosity, and injectability) still represents a remarkable challenge because a complicated adjustment of multiple correlated processing parameters is requested, including powder particle size and the chemical composition of solid and liquid components. This study proposes, for the first time, a multifactorial investigation about the effects of powder and liquid variation on the final performance of Sr-doped apatitic CPCs, based on the Design of Experiment approach. In addition, the effects of two mixing techniques, hand spatula (low-energy) and planetary shear mixing (high-energy), on viscosity and extrusion force were compared. This work aims to shed light on the various steps involved in the processing of CPCs, thus enabling a more precise and tailored design of the device, based on the clinical need.

Therapy and regeneration-combined bone cements for minimally invasive treatment of neoplastic bone defects

Although calcium phosphate cements (CPC) have been clinically used to repair bone defects caused by bone tumor resection, traditional CPC cannot kill the remaining tumor cells after surgery and prevent...