ABSTRACT

Bone apatite is not hydroxyapatite (HAp), it is carbonate apatite (CO₃Ap), which contains 6–9 mass% carbonate in an apatitic structure. The CO₃Ap block cannot be fabricated by sintering because of its thermal decomposition at the sintering temperature. Chemically pure (100%) CO₃Ap artificial bone was recently fabricated through a dissolution–precipitation reaction in an aqueous solution using a precursor, such as a calcium carbonate block. In this paper, methods of fabricating CO₃Ap artificial bone are reviewed along with their clinical and animal results. CO₃Ap artificial bone is resorbed by osteoclasts and upregulates the differentiation of osteoblasts. As a result, CO₃Ap demonstrates much higher osteoconductivity than HAp and is replaced by new bone via bone remodeling. Granular-type CO₃Ap artificial bone was approved for clinical use in Japan in 2017. Honeycomb-type CO₃Ap artificial bone is fabricated using an extruder and a CaCO₃ honeycomb block as a precursor. Honeycomb CO₃Ap artificial bone allows vertical bone augmentation. A CO₃Ap-coated titanium plate has also been fabricated using a CaCO₃-coated titanium plate as a precursor. The adhesive strength is as high as 76.8 MPa, with excellent tissue response and high osteoconductivity.

摘要

骨磷灰石不是羟基磷灰石 (HAp)，而是碳酸盐磷灰石 (CO ₃ Ap)，在磷灰石结构中含有 6-9 质量％的碳酸盐。CO ₃ Ap 块不能通过烧结制造，因为它在烧结温度下会发生热分解。最近通过使用前体（例如碳酸钙块）在水溶液中的溶解-沉淀反应制造了化学纯（100%）的 CO ₃ Ap 人造骨。本文综述了CO ₃ Ap 人造骨的制备方法及其临床和动物实验结果。CO ₃ Ap 人造骨被破骨细胞吸收并上调成骨细胞的分化。因此，CO ₃Ap 表现出比 HAp 高得多的骨传导性，并通过骨重塑被新骨取代。颗粒型CO ₃ Ap 人造骨于2017 年在日本获准用于临床。蜂窝型CO ₃ Ap 人造骨采用挤出机和CaCO ₃蜂窝块作为前体制成。蜂窝状 CO ₃ Ap 人造骨可实现垂直骨增量。还使用CaCO ₃涂覆的钛板作为前体制造了CO ₃ Ap涂覆的钛板。粘合强度高达76.8 MPa，具有优异的组织反应和高骨传导性。