A novel and injectable strontium-containing hydroxyapatite bone cement for bone substitution: A systematic evaluation

Reconstruction of bone defects is still a challenge. In this study, we developed and systematically evaluated a novel injectable strontium-containing hydroxyapatite (Sr-HA) bone cement in which Sr-HA powder included 5% Sr and was mixed with a setting liquid that included 5% potassium citrate. This Sr-HA cement was mainly composed of HA and ?-tricalcium phosphate (TCP) and exhibited favorable injectability (100%), setting times (the initial setting time was 240 s and the final setting time was 420 s), compressive strength (73.4 MPa), maximal load and maximum bending stress, and excellent radiopacity. In addition, the Sr-HA cement also had excellent biocompatibility that exhibited low cytotoxicity for cell proliferation and no obvious disturbing effect on the osteogenic differentiation of periodontal ligament stem cells (DLSCs) and dental pulp stem cells (DPSCs). However, the Sr-HA cement could slightly promote the osteogenic differentiation of MC3T3 cells, which also implied that it would promote osseointegration between the cement and surrounding bone but would not obviously disturb the biological behavior of DLSCs and DPSCs. An in vivo study further confirmed that Sr-HA cement exhibited favorable osseointegration with the maxilla and tibia. All these findings implied that the novel Sr-HA cement was a suitable bone substitution for bone defects.