Novel Osteoinductive and Osteogenic Scaffolds of Monetite, Amorphous Calcium Phosphate, Hydroxyapatite, and Silica Gel: Influence of the Hydroxyapatite/Monetite Ratio on Their In Vivo Behavior and on Their Physical and Chemical Properties.

In this work, a new family of multiphasic materials composed of the same amount of silica gel and variable amount of three calcium phosphates with very different solubilities, monetite > amorphous calcium phosphate > hydroxyapatite (HAp), was studied. Silicon was added to calcium phosphate to increase bioactivity and osteinductivity. The influence of the HAp/monetite ratio on the material resorption and bone regeneration was investigated in critical bone defects in sheep and was related to their chemical and physical properties. It was concluded that a minimum rate of HAp/monetite is necessary to achieve an appropriate compromise between material resorption and bone regeneration. Above this minimum rate, bone regeneration and material resorbtion did not change significantly. Physical properties such as particle size, specific surface area, porosity, and granulate cohesion played a more critical role on material resorption than the solubility of their components. A huge difference between in vitro solubility and in vivo resorption was observed. It was related to the fastest cellular-mediated resorption of monetite compared to the other components. Computerized axial tomography, histology, histomorphometric, and multiple fluorochrome labeling studies showed a very advanced bone regeneration of the defects when materials with the highest HAp/monetite rate were implanted. It was also demonstrated that all materials induce bone formation and vascularization.