This study demonstrates the utility of hydroxyapatite (HA) microspheres as an additive to enhance the radiopaque properties, biocompatibility, and osteoconductivity of poly(methyl methacrylate) (PMMA)-based bone cements. HA microspheres were synthesized using spray drying. They had well-defined spherical shapes, thus allowing for the production of PMMA/HA composites with a very high HA content (20 vol % and 40 vol %). The uniform distribution of these HA microspheres in the PMMA matrix resulted in a remarkable increase in compressive modulus (p < 0.05), while preserving a reasonably high compressive strength. The PMMA/HA bone cements showed much higher radiopacity than PMMA containing BaSO₄ as the additive. This was attributed to the high HA content up to 40 vol %. In addition, the biocompatibility and osteoconductivity of PMMA/HA bone cements were significantly enhanced compared to those of PMMA bone cements containing BaSO₄, which were assessed using in vitro tests and in vivo animal experiments.

Magnesium (Mg) has the advantage of being resorbed in vivo, but its resorption rate is difficult to control. With uncontrolled resorption, Magnesium as a bone fixation material has minimal clinical value. During resorption not only is the strength rapidly weakened, but rapid formation of metabolite also occurs. In order to overcome these disadvantages, hydroxyapatite (HA) surface coating of pure magnesium plate was attempted in this study. Magnesium plates were inserted above the frontal bone of Sprague-Dawley rats in both the control group (Bare-Mg group) and the experimental group (HA-Mg group). The presence of inflammation, infection, hydrogen gas formation, wound dehiscence, and/or plate exposure was observed, blood tests were performed, and the resorption rate and tensile strength of the retrieved metal plates were measured. The HA-Mg group showed no gas formation or plate exposure until week 12. However, the Bare-Mg group showed consistent gas formation and plate exposure beginning in week 2. WBC (White Blood Cell), BUN (Blood Urea Nitrogen), Creatinine, and serum magnesium concentration levels were within normal range in both groups. AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) values, however, were above normal range in some animals of both groups. The HA-Mg group showed statistically significant advantage in resistance to degradation compared to the Bare-Mg group in weeks 2, 4, 6, 8, and 12. Degradation of HA-Mg plates proceeded after week 12. Coating magnesium plates with hydroxyapatite may be a viable method to maintain their strength long enough to allow bony healing and to control the resorption rate during the initial period.

The purpose of this study was to evaluate the mechanical strength and biodegradation of a ZK60 plate coated with poly(l-lactic)-acid polymer (PLLA) in a LeFort I osteotomy canine model for maxillofacial applications. The PLLA-coated ZK60 plate and screw were evaluated using a LeFort I osteotomy canine model based on five beagles. The presence of wound dehiscence, plate exposure, gas formation, inflammation, pus formation, occlusion, food intake, and fistula formation were evaluated. After 12 weeks, these dogs were sacrificed, and an X-ray micro-computed tomography (µCT) was conducted. Plate exposure, gas formation, and external fistula were not observed, and the occlusion remained stable. Wound dehiscence did not heal for 12 weeks. CT images did not show plates in all the five dogs. A few screw bodies fixed in the bone remained, and screw heads were completely absorbed after 12 weeks. These findings may be attributed to the inability to optimize the absorption rate with PLLA coating. Rapid biodegradation of the PLLA-coated ZK60 occurred due to the formation of microcracks during the bending process. Further improvement to the plate system with PLLA-coated ZK60 is required using other surface coating methods or alternative Mg alloys.