Biomaterials 26 (2005) 6423–6429
Leading Opinion
Technological issues for the development of more efficient calcium
phosphate bone cements: A critical assessment
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M. Bohner
a,
Ã
, U. Gbureck
b
, J.E. Barralet
c
a
Dr Robert Mathys Foundation, Bischmattstrasse 12, CH-2544 Bettlach, Switzerland
b
Department of Functional Materials in Medicine and Dentistry, University of Wurzburg, Wurzburg, D-97070, Germany
c
Faculty of Dentistry, McGill University, Montre
´
al, Quebec, Canada H3A 2B2
Received 24 January 2005; accepted 24 March 2005
Available online 17 June 2005
Abstract
The first calcium phosphate cements (CPCs) were discovered in the 1980s. Two decades later, the interest for these materials is still
rising. The goal of the present document is to review the most recent achievements in the field and to analyze future directions in
research and development.
r 2005 Elsevier Ltd. All rights reserved.
Keywords: Calcium phosphate cement; Vertebroplasty; Delivery; In vivo
1. Introduction
Calcium phosphate cements (CPCs) are obtained by
mixing one or several reactive calcium phosphate powders
with an aqueous solution to form a paste that hardens
within a restricted period of time (e.g. 15 min). In that
respect, CPCs are different from traditionally used bone
substitutes such as granules and blocks which are not in a
paste form and do not sustain a rapid phase transition.
CPCs were proposed 2 decades ago by LeGeros et al.
[1], and Brown and Chow [2]. The first commercial CPC
products were introduced a decade ago for the treatment
of maxillo-facial defects and deformities [3] as well as for
the treatment of fracture defects [4]. Now, companies
are introducing second-generation cements and are also
widening their portfolio to fulfil the various require-
ments of their customers (Table 1). For example,
brushite cements which have proved to be faster
resorbing than apatite cements in animal studies [5]
have entered the clinics. Other cements are designed for
one very specific application, i.e. cranioplasty or
vertebroplasty.
These achievements have been possible due to the
considerable effort and large number of studies devoted
to CPCs. In fact, a few thousand papers have been
published so far and the publication rate increases
almost every year (Fig 1). The goal of the present article
is not to review most of the literature as has been done
by several authors in the past [6–9], but to give a brief
overview of the present achievements and to pinpoint
newest developments and trends.
2. Brief overview
Many discoveries and developments made in the field
of CPCs stem from calcium silicate and sulphate-
based cements in the construction industry or from
ARTICLE IN PRESS
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doi:10.1016/j.biomaterials.2005.03.049
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Editor’s Note: Leading Opinions: This paper is one of a newly
instituted series of scientific articles that provide evidence-based
scientific opinions on topical and important issues in biomaterials
science. They have some features of an invited editorial but are based
on scientific facts, and some features of a review paper, without
attempting to be comprehensive. These papers have been commis-
sioned by the Editor-in-Chief and reviewed for factual, scientific
content by referees.
Ã
Corresponding author. Tel.: +41 32 6441413; fax: +41 32 6441176.
E-mail address: Marc.bohner@rms-foundation.ch (M. Bohner).