Pregelatinized starch as a cohesion promoter improves mechanical property and surgical performance of calcium phosphate bone cement: the effect of starch type

ABSTRACT Calcium phosphate cement (CPC) has potentials in orthopaedics and orthodontics but it has significant limitations such as low mechanical strength, low injectability and instability in body. Starches from five botanical sources were used as cohesion additives to prepare calcium phosphate bone cement (CPB) and the starch source showed significant impact on physicochemical properties of the CPBs. CPB modified by pregelatinised waxy maize starch (CPB-W) had the highest mechanical strength, longest setting time, and most compact structure compared with other CPBs. As the amylose content increased, the viscosity of starch modified cement paste increased, and the cured cement had lower density and mechanical strength. It appears that starch with a low amylose content significantly improves the surgical performance and mechanical strength of CPC. CPB-W also exhibited good cytocompatibility to MC3T3-E1 cells. Starch modified CPBs are considered as promising injectable bone cements for minimally invasive surgery applications like vertebroplasty and kyphoplasty.