Optimisation of the composition of an acrylic bone cement: application to relative amounts of the initiator and the activator/co-initiator in Surgical Simplex®P

Adverse events have been reported with acrylic bone cements. However, current test standards for acrylic materials fail to characterize the potentially harmful monomers released during the curing stage. In clinical applications, materials are implanted into the human body during this phase. Silicone may be a safer alternative to acrylic cements. Silicone is used in medical applications for its biocompatibility and stability characteristics. Previously, no study has been completed which compares silicone to acrylic cements. In this study, both materials were injected into the cell medium during the curing process which more accurately reflects clinical use of material. Initially, cell cultures followed ASTM standard F813-07 which fails to capture the effects of monomer released during curing. Subsequently, a modified cell culture method was employed which evaluated cytotoxicity while the materials cured. The objective of this study was to capture toxicity data during curing phase. Thus, the test method employed measured and excluded the impact of the exothermic reaction temperature of polymethyl methacrylate (PMMA) on cell growth. The concentration of PMMA monomer was measured at 1 and 24 h after injecting PMMA into culture plates in a manner consistent with established cell growth methodologies. Our results indicate current in vitro cytotoxicity assays recommended by ASTM standards are unable to reveal the real cytotoxic effect caused by methyl methacrylate monomers during polymerization. Our modified experiment can more accurately illustrate the true nature of the toxicity of materials and improve assay results. In these tests, silicone based elastomeric polymers showed excellent cytocompatibility. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2693-2699, 2018.

Section: Discussionmentioning

confidence: 99%

Comparison of in vitro biocompatibility of silicone and polymethyl methacrylate during the curing phase of polymerization

Song

Seta

Eichler³

et al. 2018

“…For such a cement, t set , T max , and UCS were found to be $10% higher, $4% lower, and $15% higher than for the commercially available brand for which R is 30.00 wt %/vol % (75 wt % of the co-polymer that contained the BPO/2.5 vol % DMPT). 45 In other words, the new formulation displays attractive properties. A shortcoming of this study, 45 however, is that the actual amounts of the BPO in the cement powders were not determined.…”

Section: Relative Amounts Of Initiator and Acceleratormentioning

confidence: 99%

“…Nonetheless, the issue of the influence of the amount of the initiator relative to that of the accelerator ( R ) on polymerization kinetics and other properties of both the curing and the cured cement remains unexplored for any of the alternative cements. In fact, this issue has been the subject of only one systematic study in the case of commercially available cements 45. Based on the values of t set , T max , and UCS, the optimum value of R for Surgical Simplex®P, was found to be 57.14 wt %/vol % (80 wt % of the PMMA‐styrene copolymer that contained the BPO/1.4 vol % DMPT).…”

Section: Issuesmentioning

confidence: 99%

“…For one commercially available brand (Surgical Simplex 1 P), a reduction of DMPT content (from 2.5 vol % to between 0.8 and 1.4 vol %) resulted in a cement whose setting time (t set ) was $54% higher, maximum exotherm temperature (T max ) was $7% lower, ultimate compressive strength (UCS) was $4% lower, and the computed polymerization rate at 378C, (k 0 ) was $97% lower. [45][46][47] The high value of t set for the reduced-DMPT-content cement may pose a problem during its preparation and handling for use in a cemented THJR. (The cement's t set is at about the maximum limit recommended, per ISO 5833, which is 14 min.)…”

Section: Reduced-dmpt-content Cementsmentioning

confidence: 99%

“…In fact, this issue has been the subject of only one systematic study in the case of commercially available cements. 45 Based on the values of t set , T max , and UCS, the optimum value of R for Surgical Simplex 1 P, was found to be 57.14 wt %/vol % (80 wt % of the PMMA-styrene copolymer that contained the BPO/1.4 vol % DMPT). For such a cement, t set , T max , and UCS were found to be $10% higher, $4% lower, and $15% higher than for the commercially available brand for which R is 30.00 wt %/vol % (75 wt % of the co-polymer that contained the BPO/2.5 vol % DMPT).…”

Section: Relative Amounts Of Initiator and Acceleratormentioning

confidence: 99%

See 2 more Smart Citations

Alternative acrylic bone cement formulations for cemented arthroplasties: Present status, key issues, and future prospects

Lewis

2007

104

All the commercially available plain acrylic bone cement brands that are used in cemented arthroplasties are based on poly (methyl methacrylate) and, with a few exceptions, have the same constituents. It is well known that these brands are beset with many drawbacks, such as high maximum exotherm temperature, lack of bioactivity, and volumetric shrinkage upon curing. Furthermore, concerns have been raised about a number of the constituents, such as toxicity of the activator (N,N,dimethyl-p-toluidine) and possible involvement of the radiopacifier (BaSO(4) or ZrO(2) particles) in third-body wear. Thus, over the years, many research efforts have been expended to address these drawbacks, culminating in a large number of alternative formulations, which may be grouped into 16 categories. Although there are a number of reviews of the large literature that now exists on these formulations, each covers only some of the categories and none contains a detailed discussion of the germane issues. The objective of the present work, therefore, was to present a comprehensive and critical review of the whole field. In addition to succinct descriptions of the cements in each category, there are explicative summaries of literature reports, a detailed discussion of several key issues surrounding the potential for use of these cements in cemented arthroplasties, and a presentation of numerous ideas for future studies.

Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

Lewis

2006

Enormous research efforts are being expended on two minimally invasive procedures: percutaneous vertebroplasty (VP) and kyphoplasty (KP). The present report, which is a detailed critical review of VP and KP that emphasizes their biomechanics aspects, is divided into six parts. In the first two parts, succinct descriptions are given of osteoporosis-induced vertebral body (VB) compression fractures as the underlying pathology to be treated with VP and KP, the theory of VP and KP, and the techniques used in performing these procedures. Concerns about VP and KP, such as the high radiation exposure burden that may be imposed on both patient and medical personnel and extravasation of the injectable bone cement, are discussed in the third part. Detailed discussions of fourteen issues/questions, such as the extent to which VP or KP affects various biomechanical measures of the augmented VB and those adjacent to it and the appropriate volume of the cement to use, are presented in the fourth part. Ideas for future research, such as development of a new generation of injectable bone cements and identification of an appropriate animal model, are covered in the fifth part. The final section contains a summary of the most salient points/observations made in the report.