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A bilayered bioactive-gradient coating, consisting of a superficial layer of biphasic calcium phosphate (BCP) and a deep layer of hydroxyapatite (HA), promotes faster osseointegration and higher shear strength in non-loading conditions than do monolayer BCP or HA coatings. This study evaluated the biofunctionality of this coating in weight-bearing conditions at 6 and 12 months. The coating was plasma-sprayed on the metaphyseal portion of a sandblasted Ti6Al4V canine femoral prosthesis implanted using the surgical press-fit technique. An identical uncoated stem served as the control. Metaphyseal bone-to-implant apposition was increased for coated ( approximately 90% and 80% respectively at 6 and 12 months) as compared to uncoated implant ( approximately 7% at 6 and 12 months). Limited bone apposition was observed at the diaphyseal level. After 12 months, the uncoated implant interface consisted of well-organized, active fibrous tissue, whereas only inactive fibrous tissue interposition was observed at diaphyseal levels of the coated implant. At 6 months, the mineralization apposition rate (MAR) was similar, regardless of implant or bone structures. At 12 months, a significant decrease of MAR was observed around the uncoated implant. Transmission electron microscopy studies of the interface showed precipitation of biological apatite crystals in close association with mineralized collagenous bone matrix. Our results suggest a direct relationship between bioactivity and enhanced bone formation. The sandwich coating used is effective in promoting massive metaphyseal osseointegration, which ensures mechanical stability for early weight-bearing and should prevent long-term complications.

We have developed 15 years ago, with the collaboration of Lynch, Nery, and LeGeros in the USA, a bioactive concept based on biphasic calcium phosphate (BCP) ceramics. The concept is determined by an optimum balance of the more stable phase of HA and more soluble TCP. The material is soluble and gradually dissolves in the body, seeding new bone formation as it releases calcium and phosphate ions into the biological medium. The bioactive concept based on the dissolution/transformation processes of HA and TCP has been applied to both Bulk, Coating and Injectable Biomaterials. The events at the calcium phosphate (CaP) biomaterial/bone interface represent a dynamic process, including physico-chemical processes, crystal/proteins interactions, cells and tissue colonization, bone remodeling, finally contributing to the unique strength of such interfaces. An important literature and numerous techniques have been used for the evaluation of the fundamental physico chemical and biological performance of BCP concept. This type of artificial bone used from a long time in preclinical and in clinical trial, revealed the efficiency for bone filling, performance for bone reconstruction and efficacy for bone ingrowth at the expense of the micro macroporous BCP bioceramics.

Although initial results were promising for an injectable bone substitute (IBS) associating a hydroxypropyl methylcellulose (HPMC) polymer vector (Benecel, 2 w/w %) with biphasic calcium phosphate (BCP), a sensitization reaction occurred probably related to the degree of polymer purity. In this context, Benecel and another HPMC, E4M were investigated in the present study. The expected composition of the polymers was confirmed by gas-liquid chromatography. Studies in the guinea pig showed that Benecel has strong sensitization capacity and E4M none. Benecel manifests impurities (30 times more than E4M) in individual fibers or rounded clumps that are apparently responsible for extreme sensitization. Purification by ultracentrifugation associated with 0.2 microm filtration can decrease sensitization capacity considerably, though with a slight loss of polymer concentration. Fourier transform infrared (FTIR) analysis showed that the impurities were largely cellulose derivatives. However, extraction by organic solvent, followed by FTIR studies and micro-X analysis, detected an oily substance containing carbon and silicon associated with the cellulose derivatives. E4M, a polymer with no sensitization capacity, could replace Benecel and improve results with IBS.

This study compared microleakage at enamel/composite and dentine/composite interfaces following Er:YAG laser, Nd:YAP laser, or acid-etch preparation. Class V cavities produced on the lingual and buccal surfaces of 20 extracted carie- and restoration-free human teeth were randomly assigned to four groups of 10 cavities. Teeth were treated with 37% phosphoric acid and primer (group 1), irradiated with an Er:YAG laser (group 2) or an Nd:YAP laser (group 3), or served as controls (group 4). The specimens were restored with Scotchbond Multipurpose/Z100 (3M), stored in physiological solution at 37 degrees C for 7 days, thermocycled 500 times between 5 degrees C and 55 degrees C, placed in a 0.5% solution of basic fuchsin for 48 h, embedded in resin, and sectioned. Microleakage was assessed according to the depth of dye penetration along the restorative composite. The results showed that irradiation with Er:YAG and Nd:YAP lasers did not produce a good seal. Mean microleakage was greater than with acid-etch and statistically comparable to that of control cavities (Kruskal-Wallis test).

The purpose of this study was to investigate the effect of steam sterilization on some biologically relevant calcium phosphates: CaHPO4 . 2H2O (DCPD), calcium deficient apatite (CDA) and biphasic calcium phosphate (BCP). Suspensions of 0.2 g of each calcium phosphate compound with 5.0 ml of deionized water were prepared and steam sterilized in an autoclave (20 min at 121 degrees C). After sterilization the suspensions were filtered and the dried solids characterized with scanning electron microscopy, IR-spectroscopy and X-ray diffraction. The pH and calcium concentrations of the filtrates were determined with ion selective electrodes. Similar measurements were made with the same samples which were not sterilized. The sterilization procedure was found to result in the dehydration of DCPD and hydration of calcium oxide incorporated into the BCP. Solution pH was observed to change from 7.3 to 5.5 for the solutions in equilibrium with DCPD and from 8.5 to 10.6 for those in equilibrium with BCP. Minor changes both with the solid and liquid phases were found to occur during the steam sterilization of CDA. These results indicate that steam sterilization may have different effects on different calcium phosphate suspensions: it can result in dehydration of DCPD, fast hydration for CaO in BCP, but no significant effect on CDA., (Copyright 2000 Kluwer Academic Publishers)