Preparation and cytocompatibility of a novel bismuth aluminate/calcium phosphate cement with high radiopacity

Abstract

In a minimally invasive surgery, using a bone cement being radiologically detectable is vital to the success of the procedure and avoiding cement leakage in the early stage. The radiopacity of calcium phosphate cement (CPC) is inadequate, thus limiting its clinic application in this area. In this work, bismuth aluminate (BiA) was employed as a radiopaque agent for CPC. The influences of BiA on physicochemical, radiopaque and in vitro biocompatible properties of CPC were investigated. With the increasing content of BiA, the setting time and the compressive strength of CPC were augmented, while the injectability of the cement pastes was reduced. The radiopacity of CPC was significantly improved by adding more than 6 wt.% BiA. CPC specimens with less than 12 wt.% BiA showed good cellular affinity. Moreover, the CPC containing 6 and 9 wt.% BiA promoted the cell growth and ALP activity of mouse bone marrow mesenchymal stem cells when compared with the control. On the basis of its improved radiopacity and cytocompatibility, the radiopaque CPC with 6 ~ 9 wt.% BiA is expected to be a potential substitute for bone defect restoration via minimally invasive surgery. CPC with bismuth aluminate reveals better radiopacity and cell affinity along with proper physicochemical properties.

Development of Natural-Based Bone Cement for a Controlled Doxorubicin-Drug Release

“…The relatively low level of radiopacity associated with CPCs are another reason for their limitation in widespread clinical use (Wu et al, 2018). To overcome this, bismuths, a family of radiopacifiers (Antonijevic et al, 2014), are often used to increase the level of CPC radiopacity (Wu et al, 2018). The ability to track cement placement, and identify any leakage, are both vital to minimize the effects of any complications.…”

Rapid Fabrication of MgNH4PO4·H2O/SrHPO4 Porous Composite Scaffolds with Improved Radiopacity via 3D Printing Process

“…Commonly, bone repair scaffolds are required to possess high radiopacity for noninvasively tracking and imaging the filling effect in clinical operations, in vivo degradation, and new bone growth by X-ray-based techniques, such as fluoroscopy, computer tomography, and radiography [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. However, the intrinsic radiopacity of bone repair scaffolds is usually insufficient, and it is difficult to distinguish them from natural bone tissues.…”

“…However, the intrinsic radiopacity of bone repair scaffolds is usually insufficient, and it is difficult to distinguish them from natural bone tissues. For enhancing their radiopacity, X-ray contrast agents such as Ba-based [ 22 , 23 ], Zr-based [ 24 , 25 , 26 ], Bi-based [ 27 , 28 , 29 ], and Sr-based [ 30 , 31 , 32 ] compounds are added into them to construct the composite scaffolds. Although BaSO 4 and ZrO 2 are widely used in poly (methyl methacrylate) (PMMA) bone cements as the radiopacifier, there are potential physical, mechanical, and biological risks if the particles are released from the scaffolds as they are unabsorbable in the physiological environment [ 22 , 24 , 27 ].…”

“…For enhancing their radiopacity, X-ray contrast agents such as Ba-based [ 22 , 23 ], Zr-based [ 24 , 25 , 26 ], Bi-based [ 27 , 28 , 29 ], and Sr-based [ 30 , 31 , 32 ] compounds are added into them to construct the composite scaffolds. Although BaSO 4 and ZrO 2 are widely used in poly (methyl methacrylate) (PMMA) bone cements as the radiopacifier, there are potential physical, mechanical, and biological risks if the particles are released from the scaffolds as they are unabsorbable in the physiological environment [ 22 , 24 , 27 ]. Bismuth-based radiopaque agents such as Bi 2 O 3 , (BiO) 2 CO 3 , and Bi 2 (Al 2 O 4 ) 3 are insoluble too, and there are similar potential risks if they are released from the scaffolds [ 27 , 28 , 33 , 34 ].…”

“…Although BaSO 4 and ZrO 2 are widely used in poly (methyl methacrylate) (PMMA) bone cements as the radiopacifier, there are potential physical, mechanical, and biological risks if the particles are released from the scaffolds as they are unabsorbable in the physiological environment [ 22 , 24 , 27 ]. Bismuth-based radiopaque agents such as Bi 2 O 3 , (BiO) 2 CO 3 , and Bi 2 (Al 2 O 4 ) 3 are insoluble too, and there are similar potential risks if they are released from the scaffolds [ 27 , 28 , 33 , 34 ]. Wu and co-workers [ 34 ] found that Bi 2 O 3 , the radiopacifier in calcium silicate bone cements, is harmful to cell proliferation, alkaline phosphatase (ALP) activity, and mineralization of human osteosarcoma MG63 cells.…”