Bicalcium Phosphate as an Asset in Regenerative Therapy

Abstract

After a loss of a tooth, alveolar bone resorption is immutable, leaving the area devoid of sufficient bone quality and mass for a successful and satisfactory implant or any other dental treatment. To treat this problem of irreversible bone loss, bone grafting is the primary solution and a well-accepted technique. The use of bone grafting procedures has increased in recent years. This review is about the various bone grafting techniques and best-situated material available currently along with their trump cards and limitations. In the thorough discussion regarding bone grafting materials and their substitutes, one alloplastic material has shown unbeaten and the most satisfactory properties than any other material, "bicalcium phosphate" (BCP). BCP is a mixture of hydroxyapatite (HA) and beta-tricalcium phosphate (B-TCP) usually obtained through sintering calcium-deficient apatite (CDA) at or above 700°C or by other methods such as hydrolysis or precipitation. The review also shows comparative studies done to understand the effect, most adequate balance, and impact of ratios of HA/B-TCP on the properties, structure, and success rate of this material. The objective of the review is to enlighten the principal characteristic of the most likely used bone graft material presently, i.e., BCP. The most impeccable characteristic of BCP is its capability to osteointegrate, which results in a superior interface. This interface depicts a dynamic process that includes physicochemical reactions, crystal-protein interactions, cell and tissue colonization, and bone remodeling. BCP has certain essential properties that could be put forth as its advantage over any other substitute. These properties include bioactivity, osteointegration, osteoinduction, osteogenesis, and biodegradation, which are mostly governed by modifying the HA/B-TCP ratio. Other applications of BCP are feasible, such as in drug administration and scaffolds for tissue engineering.

Keywords: alloplastic bone grafts; beta-tricalcium phosphate; bicalcium phosphate; bone grafts; hydroxyapetite.

Figure 1. Classification of Bone Graft Materials

DF DBA: demineralized freeze-dried bone allograft, FD BA: freeze-dried bone allograft, CPC: calcium phosphate cement, TCP: tricalcium phosphate, BCP: bicalcium phosphate This figure is created by the authors. Sources: [1-4]

Figure 2. Mechanism of Action of BCP

BCP: bicalcium phosphate, MSCs: mesenchymal stem cells, HA: hydroxyapatite, B-TCP: beta-tricalcium phosphate This figure is created by the author. Source: [5]

Figure 3. Various Uses of BCP

BCP: bicalcium phosphate This figure is created by the author. Source: [25,37,43-47,49,50]