Review article
A review of synthesis methods, properties and use of monetite cements as filler for bone defects

https://doi.org/10.1016/j.ceramint.2021.01.240Get rights and content

Abstract

The major objective of the current review is to highlight the prime importance of bone cements particularly monetite cement as filler to treat various bone defects which may result due to osteoporosis, some accidents, some trauma disease or any other orthopedic surgical disorders. Previous studies showed that polymethyl methacrylate (PMMA), calcium phosphate cements (CPCs), dicalcium phosphate (DCP) cement and acrylic polymer cements have been employed to improve the bone defects, but these materials have a certain issue of in-situ setting. To overcome these problems, concentration was swiftly diverted towards monetite cement which revealed better results. Therefore, in this review, more focus has been given to the monetite cement. In this work, a brief but very productive discussion has also been inducted about the various synthetic routes to synthesize monetite cement and its properties which will help the readers to get key information about the growing significance of monetite cement as a bone filler and its future use and importance. The main theme of this review is to highlight the tremendous achievements achieved in the monetite cementing materials and their further scope in the near future as to upgrade their properties and use in the biomedical field.

Introduction

Bone is the hard-living tissue of the body and major part of the body which gives shape, stability, and strength to the living body. Any disorder or fracture in the bone may result in a partial or sometimes complete collapse of the living body movement. However, when some part of the bone is injured, the bone itself may go under a self-healing process. On the other hand, due to some accidents or any unhealthy condition, some part of the bone is lost, its reconstruction becomes essential. These bone defects can be reconstructed either using biodegradable biomaterials or non-biodegradable biomaterials and sometimes both can be employed simultaneously in the living body [[1], [2], [3]], as shown in Fig. 1.

Biodegradable polymeric materials such as poly(l-lactic acid), poly(caprolactone), poly(lactic-co-glycolic acid), poly(3-hydroxybutyric acid), poly (adipic acid), poly (sebacic acid), gelatine and chitosan have the advantage to disappear from the body within a short span of time and biologically safer because they have hydrolysable chemicals like amides or esters [4,5]. Although biodegradable polymeric materials or composites have certain properties, their inability to use them for load-bearing applications make them unpopular due to their weakness [6]. Therefore, their usage in bone defects treatment is not recommended [7]. In contrast to biodegradable polymers, non-biodegradable polymers have shown significant mechanical strength and therefore their usage in the osteo-related problems is more preferred [8,9]. Besides, these polymeric materials, there are many other well-known biomaterials such as hydroxyapatite (HA), tricalcium phosphate (TCP), dicalcium phosphate (DCP) all in phase pure form or in substituted with various ions to enhance their biological and mechanical properties have been in use by the orthopedic surgeons to cure the orthopedic defects [[10], [11], [12]]. Many researchers have been working on the development of these biomaterials to solve the day to day emerging trauma-based issues occurring either due to accidents or diseases. Although even currently researchers are trying to synthesize various bioactive and biocompatible materials such as HA and TCP but preferably now, they have diverted their attention to the development of novel materials with better mechanical strength, wear strength and better resistance towards various bacterial post-operational infections.

This review begins with a brief introduction about the biomaterials especially hard tissue cementing materials, calcium phosphate-based constituents, acrylic glues, monetite and their properties. This review also involves a brief detail about the behaviour and properties of these cementing constituents. The middle section of this review has been ascribed to the applications and properties of acrylic bone cement, Calcium phosphate cements (CPCs) and brushite cement. Finally, the last section of this review reveals a comprehensive discussion about the monetite cement; different synthetic techniques presently are in use to prepare monetite cement, effect of these techniques on the properties of this cement and about the clinical applications of this cement. This section also contains the conclusion of this discussion and some suggestions for future work.

Section snippets

Bone cements

According to orthopedic surgeons, about 30% of the population will become ill due to the process of osteoporosis or osteoporotic hip fractures and nearly 20% of the patients are unable to survive just after one year of surgery. All this statistical data demonstrates that there is a tremendous need for alternative therapies to treat the damaged or diseased bones. The major portion of the mammalian hard tissue consisted of 70% of calcium phosphate (CP) which means that this material will be the

Conclusion and recommendations for future works

This review demonstrated the importance of CPCs, Acrylic cements, brushite and monetite. Besides this, a brief detail of the medical applications of these CPC based cements has been entailed. Although many pieces of information about various types of biomaterials have been narrated but monetite cement has particularly been discussed. The benefits and current challenges that are the big obstacles in the usage of this cement in orthopedic surgery also have been described in this review.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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