Examination of hydroxyapatite filled 4-META/MMA-TBB adhesive bone cement in vitro and in vivo environment.

Bone response to hydroxyapatite (HA) fillers in the cured-4-methacryloyloxye-thyl trimellitate anhydride (4-META)/methyl methacrylate (MMA)-tri-n-butyl borane (TBB) adhesive bone cement was examined mechanically and histologically. A two-component system, consisting of powder and liquid, was formulated. The liquid portion was 5% 4-META dissolved in MMA and TBB; the powder was composed of 50 wt% poly (MMA) (PMMA) and 50 wt% dense HA fillers. The results indicated that the tensile strength decreased with the increase of HA filler size. The bone-bonding behavior of the improved cement was examined by optical microscopy and scanning electron microscopy. Seventy-two implants in six dogs for up to 24 weeks showed 4-META cement filled with HA was stable in the cement-bone interface. Histologic examinations showed that the exposed HA particles at the surface of the cured cement were generally associated with intimate attachment to bone without fibrous tissue, as well as interdigitation of cement to bone. The results suggest the importance of HA fillers in inducing bone apposition that improves cement binding to bone for long-term stability, thereby complementing rapid initial bone fixation of the cement.