Akiyoshi Sugawara

In Vitro Evaluation of the Sealing Ability of a Calcium Phosphate Cement When Used as a Root Canal Sealer-Filler

A calcium phosphate cement (CPC) was examined for its ability to seal the root canal when used as a sealer-filler. Extracted human teeth were divided into three groups. Root canals were filled with either CPC paste containing dicalcium phosphate anhydrous (group 1), CPC containing dicalcium phosphate dihydrate (group 2), or gutta-percha points sealed with Grossmans cement (group 3). After filling, all specimens were kept in 100% humidity for 1 day, immersed in a CaPO4 solution or distilled water at 37 degrees C for 1 wk, and then immersed in 1% Poly-R dye solution at 37 degrees C for 1 wk, after which they were rinsed and sectioned longitudinally for microscopic examination. Specimens in groups 1 and 2, especially those aged in the CaPO4 solution showed considerably less dye penetration than those in group 3. The good sealing ability of the CPC against dye penetration in vitro suggests that it may provide an adequate seal of the canal without a separate sealer.

Calcium phosphate-based cements: clinical needs and recent progress

Although autografts are considered to be the current gold standard, there is still clinical demand for synthetic bone graft substitutes. Calcium phosphate cements (CPCs) have many favourable properties that support their clinical use in the repair of bone defects. Although the translation of CPCs from the bench to the bedside has been quite successful, some issues remain. This review article provides an overview of the recent progress in the development of CPC-based materials and also emphasises the challenges facing clinical applications. The next generation of CPCs with unique properties is emerging for specific clinical applications.

In Vivo Characteristics of Premixed Calcium Phosphate Cements When Implanted in Subcutaneous Tissues and Periodontal Bone Defects.

Previous studies showed that water-free, premixed calcium phosphate cements (Pre-CPCs) exhibited longer hardening times and lower strengths than conventional CPCs, but were stable in the package. The materials hardened only after being delivered to a wet environment and formed hydroxyapatite as the only product. Pre-CPCs also demonstrated good washout resistance and excellent biocompatibility when implanted in subcutaneous tissues in rats. The present study evaluated characteristics of Pre-CPCs when implanted in subcutaneous tissues (Study I) and used for repairing surgically created two-wall periodontal defects (Study II). Pre-CPC pastes were prepared by combining CPC powders that consisted of CPC-1: Ca4(PO4)2O and CaHPO4, CPC-2: α-Ca3(PO4)2 and CaCO3 or CPC-3: DCPA and Ca(OH)2 with a glycerol at powder-to-liquid mass ratios of 3.5, 2.5, and 2.5, respectively. In each cement mixture, the Ca to P molar ratio was 1.67. The glycerol contained Na2HPO4 (30 mass %) and hydroxypropyl methylcellulose (0.55 %) to accelerate cement hardening and improve washout resistance, respectively. In Study I, the test materials were implanted subcutaneously in rats. Four weeks after the operation, the animals were sacrificed and histopathological observations were performed. The results showed that all of the implanted materials exhibited very slight or negligible inflammatory reactions in tissues contacted with the implants. In Study II, the mandibular premolar teeth of mature beagle dogs were extracted. One month later, two-wall periodontal bone defects were surgically created adjacent to the teeth of the mandibular bone. The defects were filled with the Pre-CPC pastes and the flaps replaced in the preoperative position. The dogs were sacrificed at 1, 3 and 6 months after surgery and sections of filled defects resected. Results showed that one month after surgery, the implanted Pre-CPC-1 paste was partially replaced by bone and was converted to bone at 6 months. The pockets filled with Pre-CPC-2 were completely covered by newly formed bone in 1 month. The Pre-CPC-2 was partially replaced by trabecular bone in 1 month and was completely replaced by bone in 6 months. Examination of 1 month and 3 month samples indicated that Pre-CPC-2 resorbed and was replaced by bone more rapidly than Pre-CPC 1. Both Pre-CPC pastes were highly osteoconductive. When implanted in periodontal defects, Pre-CPC-2 was replaced by bone more rapidly than Pre-CPC-1.

In Vitro and in Vivo Characteristics of Fluorapatite-Forming Calcium Phosphate Cements

This study reports for the first time in vitro and in vivo properties of fluorapatite (FA)-forming calcium phosphate cements (CPCs). The experimental cements contained from (0 to 3.1) mass % of F, corresponding to presence of FA at levels of approximately (0 to 87) mass %. The crystallinity of the apatitic cement product increased greatly with the FA content. When implanted subcutaneously in rats, the in vivo resorption rate decreased significantly with increasing FA content. The cement with the highest FA content was not resorbed in soft tissue, making it the first known biocompatible and bioinert CPC. These bioinert CPCs might be useful for applications where slow or no resorption of the implant is required to achieve the desired clinical outcome.