title: A self-reinforcing biodegradable implant made of poly(ɛ-caprolactone)/calcium phosphate ceramic composite for craniomaxillofacial fracture fixation.
abstract: OBJECTIVE
  Biodegradable polymer fixators have been used widely in oral and maxillofacial surgery for fracture management. However, short-comings such as insufficient mechanical strength, inappropriate degradation time, lack of radiolucency, and foreign body reactions during bone remodeling remain.
  
  
  METHODS
  In this study, calcium phosphate ceramic (CPC, including tricalcium phosphate [TCP] and tetracalcium phosphate/dicalcium phosphate [TTCP/DCP]) and poly(ε-caprolactone) (PCL) were used to fabricate biodegradable orthopedic fixation devices.
  
  
  RESULTS
  Different weight ratios of CPC were added to PCL, and the results showed that the PCL/CPC composites had good radiopacity, mechanical properties, and biocompatibility. CPC was transformed into hydroxyapatite when the composites were immersed in simulated body fluid. The PCL/TTCP/DCP composite had a higher compressive strength relative to PCL/TCP after setting, and this self-reinforcing property contributed to the hydration of TTCP/DCP and formation of apatite crystals. Thus, PCL/TTCP/DCP screws were prepared for animal studies. No postoperative mortality or complications were noted 6 months postsurgery. Biodegradation of the PCL/TTCP/DCP screws and newly formed bony tissue around the degraded composites were shown on both micro-computed tomography and histology. No peri-implant bone resorption was noted.
  
  
  CONCLUSIONS
  The self-reinforcing PCL/TTCP/DCP composite can be used to fabricate biodegradable fixators for fracture management in craniomaxillofacial fracture fixation.
authors.affiliation: Department of Orthopedics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; Department of Orthopedics, En Chu Kong Hospital, New Taipei City 23702, Taiwan.
authors.forename: Chang-Chin
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Diagnostic Radiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan.
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: Department of Orthopedics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; Department of Orthopedics, En Chu Kong Hospital, New Taipei City 23702, Taiwan.
authors.forename: Li-Ho
authors.initials: LH
authors.lastname: Hsu
authors.affiliation: Department of Nursing, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan.
authors.forename: Jo-Ping
authors.initials: JP
authors.lastname: Chen
authors.affiliation: Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sumi
authors.affiliation: Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan; School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan. Electronic address: pumpkin@tmu.edu.tw.
authors.forename: Kai-Chiang
authors.initials: KC
authors.lastname: Yang
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology; D001863:Bone Screws; D002130:Calcium Phosphates / Q000494:pharmacology*; D019245:Compressive Strength; D004195:Disease Models, Animal; D005269:Femur / Q000601:surgery; D006863:Hydrogen-Ion Concentration; D008422:Materials Testing; D051379:Mice; D008855:Microscopy, Electron, Scanning; D011091:Polyesters / Q000494:pharmacology*; D011817:Rabbits; D012887:Skull Fractures / Q000601:surgery*; D013499:Surface Properties; D014961:X-Ray Diffraction
chemical_list: D001672:Biocompatible Materials; D002130:Calcium Phosphates; D011091:Polyesters; C016240:polycaprolactone
keywords: Biodegradable fixator; Fracture; Osseointegration; Osteofixation