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. 2025 Jul 29;36(1):61.
doi: 10.1007/s10856-025-06911-5.

An injectable calcium sulfate-monetite biphasic cement for the treatment of critical-sized calvarial defects

Jianzhong Bai #  1 , Dachuan Liu #  1 , Luguang Ding  1 , Guoping Liu  1 , Jiaying Li  1 , Huan Wang  1 , Li Dong  1 , Chen Cui  1 , Youzhi Hong  1 , Shuangjian He  2 , Song Chen  3 , Hongtao Zhang  4
Affiliations

An injectable calcium sulfate-monetite biphasic cement for the treatment of critical-sized calvarial defects

Jianzhong Bai et al. J Mater Sci Mater Med. .

Abstract

The critical bone defect is a common clinical challenge worldwide, characterized by long recovery times, a substantial risk of infection, and high disability rates. There remains a significant demand for synthetic bone-repairing materials to address this issue. In this study, porous monetite was synthesized through the reaction between monocalcium phosphate monohydrate and β-tricalcium phosphate, using paraffin microspheres as pore-forming agents. An injectable biphasic cement was then developed by blending the monetite granules with hemihydrate calcium sulfate, designed for minimally invasive surgical applications. The cement demonstrated excellent biocompatibility and osteogenic properties in vitro. Furthermore, in vivo studies confirmed the cement's superior bone repair capabilities, indicating its promising potential for the treatment of critical bone defects.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The authors declare no competing interests.

Figures

None
A highly porous composite with gradient degradation was developed by mixing porous monetite granules and hemihydrate calcium sulfate, and the composite has the effect of promoting the formation of new bone.
Scheme 1
Scheme 1
CSH/porous monetite granules composite promotes critical bone defects repair
Fig. 1
Fig. 1. Preparation and characterization of porous scaffolds.
a Appearance of paraffin microspheres. b Diameter of paraffin microspheres. c, d The SEM amd Micro-CT images of porous brushite. e 3D reconstruction images of the porous brushite. f Porous monetite granules
Fig. 2
Fig. 2. Characterization of monetite.
a XRD image of monetite. b SEM image of monetite. c EDX image of monetite
Fig. 3
Fig. 3. Biocompatibility evaluation of the CSH, M/CSH.
a The morphology of BMSCs seeded on porous monetite. b The images of cytoskeleton staining. c Live/dead staining at 3 days for BMSCs. d Optical density values (450 nm) of CCK-8 assay. e Quantitative analysis of live/dead staining
Fig. 4
Fig. 4. Osteogenesis experiment in vitro.
a ALP staining (day 7) and Alizarin red staining (day 14). b Quantitative analysis of alizarin red staining. *p < 0.05
Fig. 5
Fig. 5. Construction of calvarial defect model, and osteogenesis evaluation in vivo.
a Injectability of the monetite composites. b The construction of rat skull defect model. c The monetite composites were filled into the skull defect. d Micro-computed tomography of skull defect. e Quantitative analysis of newly regenerated bone tissues. *p < 0.05
Fig. 6
Fig. 6. The results of histological staining.
a H&E staining of critical-sized skull defects in rats. b Masson staining of skull defects in rats. NB new bone
See this image and copyright information in PMC

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