OBJECTIVES To compare the effects of particle abrasion medium and pressure on shear bond strength and biaxial flexural strength of three generations of zirconia (Lava Frame, Lava Plus, and Lava Esthetic) with the goal of optimizing the bond to zirconia. METHODS 280 discs (14 mm diameter; 1 mm thickness) of each zirconia were milled and sintered. Specimens of each material were randomly distributed into 14 groups (n=20); half were tested for shear bond strength and half were tested for biaxial flexural strength. The specimens were particle abraded on one surface by 2 different media (50 μm alumina particles or 50 μm glass beads) for 10 seconds at three different pressures (15, 30, and 45 psi or 0.1, 0.2, 0.3 MPa). Untreated specimens served as positive control. A tube (1.50 mm diameter) filled with dual cured resin cement (Panavia SA) was placed onto the surface and light cured. Specimens were stored in water (37°C for 24 hours) and shear bond strength was measured in a universal testing machine (Instron). Biaxial flexural strength of each specimen was measured according to ISO 6872. Shear bond strength and biaxial flexural strength were compared individually with a 2-way analysis of variance (ANOVA) for factors surface treatment and zirconia composition. RESULTS Significant differences were seen between surface treatments (p<0.01), zirconia composition (p<0.01) and their interaction (p<0.01) for both bond strength and flexural strength. With alumina particle abrasion, higher pressure produced higher bonds for Lava Frame and Lava Plus zirconia while the bond of Lava Esthetic declined with increased pressure. Higher pressure (>0.2 MPa or 30 psi) with alumina decreased biaxial flexural strength with Lava Esthetic zirconia. CONCLUSIONS Particle abrasion with alumina produced a significantly better combination of bond strength while maintaining biaxial strength of three zirconia materials than particle abrasion with glass beads. The bond strength also depended upon the pressure of particle abrasion and the generation of zirconia used.

An autopolymerizing fracture-toughened acrylic lute was developed utilizing a toughened prepolymer and a gel-polymerization method. Samples for mechanical and chemical characterization were molded from this material and from untoughened controls. Mechanical testing showed that the mode I fracture toughness (K(IC)) of the toughened lute was increased by 163% over that of the untoughened acrylic controls while the compressive strength and modulus were decreased by 36% and 34%, respectively. The flexural properties of the experimental material were not adversely affected. Analysis of molecular weight and residual monomer data for the experimental and control materials demonstrated that the increase in toughness was due to the presence of the toughened prepolymer. The use of the gel polymerization process gave excellent homogeneity with very low porosity for the experimental polymer, but it resulted in a significant increase in the residual monomer concentration due to the absence of a dispersed phase of prepolymer remnants. This raises questions concerning tissue response to the experimental system.

The potential for bioactive ceramic surgical implants has resulted in a number of studies conducted to provide physical, mechanical, chemical, electrical, and biological property characteristics. Previous investigations are now providing the basis for ASTM F-4 standards associated with the basic material properties as they relate to implant device applications. Extensions of data on particulates and device-oriented research have resulted in coatings on higher strength substrates. The theoretical advantages of calcium phosphate ceramic coatings are multiple and include: elements normal to the biological host; moduli of elasticity similar to bone; structural bonding to bone capable of transferring tensile forces; minimal conductors of heat, electrons, and substrate elements (a physical, chemical, and electrical barrier); a color similar to bone; and an established profile for host biocompatibility. Possible limitations of coatings for musculoskeletal load-bearing application can be directly related to mechanical and biological interaction; e.g., (1) inherent fracture and fatigue strengths of the ceramic-metal interface; and (2) a susceptibility to time-dependent biodegradation by the host that is mediated by cellular- and enzymatic-based interactions during normal bone modeling and remodeling. The current emphasis on standards development should provide a basis for comparing existing and new bioactive particulates and coatings with one another, and, subsequently, correlations with clinical investigations.

The purpose of the study was to evaluate the use of cryopreserved allograft bone and tricalcium phosphate in promoting spinal fusion. Nine 20-30 lb swine underwent posterior spinal fusion at T5-T6, T13-T14, and L2-L3. Autogenous bone, cryopreserved allograft bone, or equal parts of allograft bone and tricalcium phosphate were added to the decorticated posterior elements. A total of 27 sites were prepared for fusion. The spines were retrieved at 6 months and evaluated for integrity and stability of the fusion sites by clinical examination, three-point bending tests, multiplanar radiographs, and undecalcified tetracycline-labeled and decalcified histologic sections. The nine sites that received autogenous bone were solidly fused. There were one clinical and two radiographic nonunions in the nine sites that received cryopreserved allograft bone. Sites that received a mixture of allograft bone and tricalcium phosphate demonstrated slight motion at two locations and radiographic evidence of fusion at all levels. The extent and degree of fusion was not site-specific. Three-point bending analysis did not demonstrate a significant trend as to site or materials specificity. No adverse histologic response was noted. Histologic sections and tetracycline labels confirmed abundant new bone formation at all sites at 6 months. Although autogenous bone remains the gold standard for use in spinal arthrodesis, this study demonstrates the value of cryopreserved allograft bone alone and in combination with tricalcium phosphate in promoting spinal fusion.

Bioceramics of aluminum oxide and calcium phosphate have a wide range of applications in orthopedic surgery. Each type of bioceramic is substantially different from the other, and variations exist within each type depending on the source and intended application. The physical, mechanical, chemical, and biologic properties are specific to each bioceramic. Significantly different tissue responses have been demonstrated among the various aluminum oxide, hydroxylapatite, and tricalcium phosphate bioceramics. Since the prospects for expanded clinical applications are excellent, the clinical community should become better acquainted with these types of biomaterials.

Calcium hydroxylapatite (HAP), tricalcium phosphate (TCP), and Bioglass (BG) were implanted in the spines of dogs to determine their potential in augmenting and enhancing spinal fusion. HAP and TCP showed continuous bone to biomaterial interfaces of varying degrees. Trabecular bone surrounded and incorporated the particulate hydroxylapatite. Tricalcium phosphate ceramic showed little evidence of resorption. The glass particulate, BG, showed a thin, fibrous encapsulation with some adjacent bony trabeculae. Decortication and autogenous bone enhanced incorporation. This multivariant initial study showed that trends found for the biomaterials implanted independently were similar to those used in combination. No adverse tissue reactions were noted for the combination of materials.