Orientador: Cecília Amélia de Carvalho Zavaglia / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica / Made available in DSpace on 2018-08-16T10:16:29Z (GMT). No. of bitstreams: 1 Cardoso_HugoAnaniasInacio_M.pdf: 2818479 bytes, checksum: da321661ca9b0a8e7a14c33315a67151 (MD5) Previous issue date: 2010 / Resumo: Os cimentos ósseos à base de fosfato de cálcio são biomateriais cerâmicos biorreabsorvíveis utilizados na substituição e no reparo de tecido ósseo danificado. Apresentam uma série de atrativos, como excelente biocompatibilidade e capacidade de serem moldados em cavidades pequenas e complexas. Porém, sua aplicação é restringida pela sua baixa resistência mecânica e sua cinética da reação lenta. O objetivo principal deste trabalho foi desenvolver cimentos de fosfato de cálcio, baseado no sistema do alfa-fosfato tricálcico, com melhores propriedades mecânicas e cinética da reação acelerada. Para isso, obteve-se o pó de alfa-fosfato tricálcico a partir de reagentes sintetizados em laboratório a fim de se obter pureza elevada; utilizou-se hidrogeno fosfato de sódio, ácido cítrico e ácido tânico como aditivos na solução de pega a fim de melhorar suas propriedades. O método de obtenção dos reagentes mostrou-se eficaz, obtendo-se pó de alfa-fosfato tricálcico com pureza elevada. Todas as combinações de aditivos utilizadas aceleraram a cinética da reação e aumentaram a resistência mecânica do cimento de fosfato de cálcio, obtendo-se valores superiores aos reportados na literatura / Abstract: The calcium phosphate bone cements are resorbable bioceramics used for replacement and repair of damaged bone tissue. Such material has many benefits, such as excellent biocompatibility and ability to be molded into complex and small cavities. However, its application is restricted by their low mechanical strength and slow reaction kinetics. The main objective of this study was to develop calcium phosphate bone cements, based on alpha-tricalcium phosphate system, with better mechanical properties and faster reaction kinetics. Hence, the powder of alpha-tricalcium phosphate was obtained from reagents synthesized in the laboratory to get high purity powder; disodium hydrogen phosphate, citric acid and tannic acid are used as additive on setting liquid to improve the cement properties. The method to obtain the reagents was effective, resulting in a powder of alpha-tricalcium phosphate with high purity. All combinations of additives accelerated the reaction kinetics and increased the mechanical strength of the calcium phosphate cement, resulting in higher values than those reported in the literature / Mestrado / Materiais e Processos de Fabricação / Mestre em Engenharia Mecânica

Os objetivos deste trabalho foram : 1) sintetizar e caracterizar partículas de fosfato di-cálcico di-hidratado (DCPD) funcionalizadas com dimetacrilato de trietileno glicol (TEGDMA), com o propósito de reduzir a aglomeração e melhorar a interação entre as partículas e a matriz orgânica dos materiais resinosos e 2) avaliar o efeito da adição de partículas funcionalizadas em uma matriz resinosa em relação a liberação de íons, propriedades ópticas, grau de conversão, propriedades mecânicas e microestrutura do material. Na primeira etapa do trabalho foram sintetizadas pelo método sol-gel dois tipos partículas de DCPD: funcionalizadas e puras. Além dessas, caracterizou-se nesta etapa partículas comerciais do mesmo composto. As partículas foram caracterizadas por difração de raio X (DRX), espectroscopia no infravermelho com transformada de Fourier (FTIR), análise elementar, análise termogravimétrica (TGA), isortermas de adsorção de nitrogênio e método BET, microscopia eletrônica de transmissão e espalhamento de luz dinâmico (DLS). Na segunda etapa do trabalho, um novo lote de partículas funcionalizadas foi sintetizado, e como controle, sintetizou-se partículas não funcionalizadas. Quatro materiais resinosos foram formulados, um deles contendo apenas BisGMA e TEGDMA (1:1 em mols) e os demais contendo, além da matriz resinosa, 20% (em volume) de partículas funcionalizadas, partículas não funcionalizadas ou sílica coloidal silanizada. Os materiais foram avaliados quanto à liberação de íons, propriedades ópticas (transmitância total e E em relação à resina sem carga), grau de conversão (GC), resistência à flexão biaxial (RFB), módulo de elasticidade e análise microestrutural. Os dados foram submetidos à análise de variância (ANOVA), complementada pelo teste de Tukey, com nível de significância de 5 %. A composição das partículas foi confirmada por DRX e a funcionalização das mesmas foi confirmada pelas análises de FTIR, análise elementar e TGA. As partículas funcionalizadas apresentaram área superficial até 3 vezes maior quando comparadas às partículas puras e comerciais. Esses dados foram confirmados pela análise de DLS, que encontrou aglomerados maiores para as partículas dos compostos puro e comercial. Na segunda etapa do estudo, observou-se que a funcionalização das partículas não afetou a liberação de íons Ca2+ dos materiais bioativos; entretanto, a liberação de íons HPO42- foi 51% menor para o material contendo partículas funcionalizadas. Todos os materiais apresentaram GC semelhantes. O compósito com sílica apresentou valores de transmitância significantemente menores e E superior ao obtido para os demais materiais. A funcionalização das partículas aumentou a RFB em 32%, porém ainda inferior à do compósito com sílica. A funcionalização não afetou o módulo de elasticidade dos materiais. A síntese de partículas de DCPD funcionalizadas com TEGDMA foi realizada com êxito. O monômero funcionalizante contribuiu para a diminuição do tamanho dos aglomerados. Além disso, a funcionalização favoreceu a interação entre as partículas de DCPD e a matriz orgânica dos materiais, evidenciado pelo aumento no valor de resistência à flexão, sem redução substancial na liberação de íons cálcio do material. / The aims of this study were: 1) to synthesize and characterize dicalcium phosphate dihidrate (DCPD) particles functionalized with triethylene glycol dimethacrylate (TEGDMA), with the purpose of reducing agglomeration and improve the interaction between the particles and the organic matrix of resin-based materials and 2) evaluate the effect of the addition of functionalized particles in a resin matrix regarding ion release, optical properties, degree of conversion, mechanical properties and microstructure. In the first part of the study, two types of DCPD particles were synthesized by a sol-gel method: functionalized and bare. Additionally, proprietary DCPD particles were also characterized. Particles were characterized by X-ray diffraction (DRX), Fourier-transformed infrared spectroscopy (FTIR), elemental analysis, thermogravimetric analysis (TGA), Nitrogen adsorption isotherms and BET method, transmission electron microscopy and dynamic light scattering (DLS). In the second part, a new batch was synthesized and, as a control, non-functionalized nanoparticles were synthesized. Four resin-based materials were prepared, one containing only BisGMA and TEGDMA (1:1 in mols) and the other containing besides the resin, 20 % (in volume) of functionalized, non-functionalized or silanized colloidal silica particles. Materials were evaluated for ion release, optical properties (total transmittance and E, in relation to the unfilled resin), degree of conversion (DC), biaxial flexural strength (BFS), elastic modulus and microstructural analysis. Data were subjected to analysis of variance (ANOVA), complemented by Tukey test, with a global significance level of 5%. Particles composition was confirmed by DRX, while functionalization was confirmed by FTIR , elemental analysis and TGA. Functionalized particles presented surface area up to three times higher compared to bare and proprietary particles. These findings were confirmed by DLS, which found larger agglomerates for the bare and proprietary particles. In the second part of the study, it was observed that particle functionalization did not affect Ca2+ release from the bioactive materials; however, HPO42- release was 51% lower from the material containing functionalized particles. All materials presented similar DC. The silica composite presented transmittance values significantly lower and higher E than the other materials. Functionalization increased BFS in 32%, however, it remained lower than the silica-containing composite. Functionalization did not affect elastic modulus. The synthesis of functionalized particles was accomplished with success. The functionalized monomer contributed for reducing agglomerate size. Also, functionalization favored the interaction between DCPD particles and the resin matrix of the materials, evidenced by the increase in flexural strength, without substantially reducing calcium release from the material.

As cerâmicas porosas empregadas na substituição óssea, são utilizadas por apresentarem características como biocompatibilidade, ter estrutura tridimensional e apresentar alta porosidade. Nesse sentido, o objetivo desse trabalho foi obter e caracterizar cerâmicas porosas de Al2O3 e Al2O3 contendo 5% em volume de inclusões de ZrO2, produzidas pelo método da réplica. Essas cerâmicas porosas tiveram sua superfície tratada quimicamente com ácido fosfórico e foram recobertos, com fosfato de cálcio usando o método biomimético, em solução de SBF 5X (Simulated Body Fluid) por um período de incubação de 14 dias. Após o recobrimento, algumas cerâmicas porosas foram tratadas quimicamente para incorporação do Sr2+. Em seguida foram caracterizadas morfologicamente e estruturalmente usando ensaios de compressão axial, porosidade aparente, microscopia eletrônica de varredura (MEV), microtomografia de Raio X (µ-CT), difratometria de Raio X (DRX), Espectroscopia de Infravermelho Próximo (NIR), emissão óptica com plasma indutivamente acoplado (ICP-OES), Energia Dispersiva de Raio-X (EDS) e por Ensaios biológicos utilizando cultura de células para análise de viabilidade celular. As cerâmicas porosas de alumina e alumina-zircônia apresentaram, respectivamente, porosidade aparente de 80,93 % e 78,82 %, resistência à compressão axial, 2,93 MPa e 6,59 MPa, além de uma ampla faixa de tamanho de poros de, desejáveis para o favorecimento de interesses biológicos destinados à regeneração e formação de tecido ósseo. O recobrimento biomimético usando SBF 5X produziu a formação das fases α-TCP, β-TCP, TTCP e Hidroxiapatita, usando período de incubação de 14 dias. A incorporação de Sr2+ na estrutura dos fosfatos mostrou-se mais eficientes nos corpos porosos de alumina-zircônia. Os ensaios in vitro mostraram a biocompatibilidade das cerâmicas porosas estudadas, demonstrando a possibilidade de sua utilização como material para substituição ou preenchimento ósseo. / The porous ceramics used in bone substitution are used because they present characteristics as biocompatibility, have a three - dimensional structure and have high porosity. In this sense, the objective of this work was to obtain and characterize porous ceramics of Al2O3 and Al2O3 containing 5% by volume of ZrO2 inclusions, produced by the replica method. These porous ceramics were chemically treated with phosphoric acid and were coated with calcium phosphate using the biomimetic method in 5X SBF solution (Simulated Body Fluid) for a 14 day incubation period. After coating, some porous ceramics were chemically treated for Sr2+ incorporation. They were then characterized morphologically and structurally using axial compression, apparent porosity, scanning electron microscopy (SEM), microtomography (µ-CT), X-ray diffractometry (XRD), Near Infrared (NIR) Coupled (ICP-OES), X-ray Dispersive Energy (EDS) and Biological Assays using cell culture for cell viability analysis. The porous ceramics of alumina and alumina-zirconia showed, respectively, 80.93% and 78.82% apparent porosity, axial compression strength, 2.93 MPa and 6.59 MPa, as well as a wide range of pore size, desirable for the promotion of biological interests destined to the regeneration and formation of bone tissue. Biomimetic coated using SBF 5X produced the formation of α-TCP, β-TCP, TTCP and Hydroxyapatite phases using a 14-day incubation period. The incorporation of Sr2+ in the phosphate structure proved to be more efficient in porous alumina-zirconia bodies. The in vitro tests showed the biocompatibility of the porous ceramics studied, demonstrating the possibility of their use as material for bone replacement or filling.

Orientador: Cecilia Amelia de Carvalho Zavaglia / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica / Made available in DSpace on 2018-08-24T20:34:28Z (GMT). No. of bitstreams: 1 Cardoso_HugoAnaniasInacio_D.pdf: 8008219 bytes, checksum: ac8d13454298a5718b0e0051a87eb944 (MD5) Previous issue date: 2014 / Resumo: O fosfato tricálcico (TCP) é um dos fosfatos de cálcio mais importantes dentre os utilizados como biomateriais devido à sua biocompatibilidade, bioatividade, biorreabsorbilidade e osteocondutividade. A fase ? (?-TCP) se destaca, principalmente, devido à sua conversão em hidroxiapatita deficiente em cálcio após implantação. Entretanto, é difícil obter ?-TCP de elevada pureza, o que prejudica sua reatividade e seu desempenho in vivo. O objetivo principal deste trabalho é sintetizar ?-TCP de elevada pureza. Para isso, o pó de ?-TCP foi obtido via reação de estado sólido. Os reagentes precursores foram sintetizados em laboratório a fim de se diminuir o nível de impurezas, principalmente o magnésio. Após analisados e validados, os reagentes foram misturados nas devidas proporções e o pó de ?-TCP calcinado sob diversos protocolos: diferentes temperaturas sob mesmo tempo de patamar; mesma temperatura sob diferentes tempos de patamar; mesmo tempo e temperatura de patamar com condições de resfriamento distintas. Analisou-se a influência de cada variável na cinética da reação: tempo, temperatura, resfriamento. Foi obtido pó de ?-TCP (2g) com 100% de pureza sob temperaturas (1265ºC) e tempos (2h) menores que os registrados em literatura, sem a necessidade de choque térmico. O protocolo foi validado também para grandes quantidades de material (50g), em que o nível de pureza também foi de 100% / Abstract: Tricalcium phosphate (TCP) is one of the most important calcium phosphates used as biomaterials due to their biocompatibility, bioactivity, osteoconductivity and bioresorbability. Among them, ?-TCP goes beyond due to its conversion into calcium deficient hydroxyapatite after implantation. However, it is difficult to obtain high purity ?-TCP, which prejudices its reactivity and its performance in vivo. The main purpose of this work is to synthesize high purity ?-TCP. For this, ?-TCP powder was obtained by solid state reaction. The precursor reagents were synthesized in the laboratory in order to reduce the level of impurities, particularly magnesium. After analyzed and validated, reagents were mixed in the proper proportions and ?-TCP powder calcined under various protocols: variable temperature and constant time; constant temperature and variable time; constant time and temperature with different cooling conditions. The influence of each variable on the reaction kinetics was evaluated: time, temperature and cooling. ?-TCP powder (2g) was obtained with 100 % purity at temperatures (1265 °C) and times (2h) lower than those mentioned in the literature without thermal shock. The protocol was also validated for more material mass (50g), wherein the purity level was also 100% / Doutorado / Materiais e Processos de Fabricação / Doutor em Engenharia Mecânica

Ce travail concerne le développement d’un système de vectorisation nanoparticulaire pour l’interférence ARN, constituant une nouvelle proposition thérapeutique applicable à des pathologies virales ou tumorales, et possiblement complémentaire aux traitements existants. La vectorisation de siRNA est ici basée sur l’enrobage multicouche de nanoparticules de phosphate de calcium, la multicouche étant constituée de dépôts alternés de PEI modifié et de siRNA. Ce système permet d’obtenir une efficacité de transfection des cellulaires cibles supérieure à celle des procédés conventionnels et une rémanence fonctionnelle in vitro jusqu’à neuf jours. Les résultats d’interférence ARN obtenus ont permis notamment d’inhiber l’infection par le virus de l’hépatite C jusqu’à 99,95%, l’inhibition de l’expression d’une protéine intrinsèque jusqu’à90,5%, et le ralentissement de la croissance cellulaire dans un modèle 3D mimant une tumeur hépatique jusqu’à 46,5%. Ces nanoparticules pourraient présenter un intérêt majeur, en offrant une action à long terme et en résolvant la plupart des difficultés rencontrées en utilisant des siRNA en thérapie. / This work concerns the development of a nanoparticle vector system for RNA interference,constituting a new therapeutic option applicable to viral and tumor pathologies,and possibly complementary to existing treatments.siRNA vectorisation is here based on multi layer coating of alcium phosphate nanoparticles,the multi layer being constituted of alternate coatings of modified PEI and siRNA.This system triggers a better transfection efficiency of target cells than classic techniques,as well as a functional persistence up to 9 days in vitro.RNA interference results using CPnp allowed inhibition of hepatitis C virus infection up to 99.95%,of intrinsic protein expression up to 90.5%,and of cell growth in a 3 D model mimicking an hepatic tumor up to 46.5%.These nanoparticles could be of major interest,by offering a long term action,and resolving most of the issues found in the use of siRNA in therapy.

The chemical properties of calcium phosphate cements (CPCs) are very similar to the mineral phase of bone. CPCs are, consequently, very effective substrates (scaffolds) for tissue engineering; bone and stem cells attach readily, and can proliferate and differentiate to form new bone tissue. Unlike other CPCs that may remain largely unchanged in the body for years, such as hydroxyapatite, dicalcium phosphates are remodelled by the body and rapidly converted to new bone. Unfortunately, the dicalcium phosphates are also typically too weak to support load bearing in the human body. Our laboratory has recently developed a novel, high strength brushite CPC, (hsCPC), which can reach 10-50 fold higher failure strength than many commercially available CPCs. The aim of this thesis was to investigate the physical, chemical and biological performance of hsCPCs in physiologically relevant model of drug release, load bearing, osteoconductivity, and as a scaffold for bone tissue engineering. Multiple CPCs were compared in a model of screw augmentation to determine whether the physical properties of the cement, such as bulk strength and porosity, affected orthopedic screw holding strength. In an in vitro model of bone regeneration stem cells were grown on macroporous scaffolds that were fabricated from hsCPC. Drug releasing scaffolds were fabricated to examine whether the low porosity of hsCPC impeded drug release during a 4 week incubation period. The biological activity of an incorporated drug, Rebamipide, was examined after acute and chronic incubation periods. In the drug release study it was noted that the biological response to hsCPC was significantly better than tissue culture grade polystyrene, even in groups without drug. The mechanism underlying this biological response was further investigated by testing the effect of pyrophosphate, a common cement additive, on bone cell proliferation and differentiation. This thesis concludes that a high strength cement can produce significant improvement in screw augmentation strength, if there is sufficient cortical bone near the augmentation site. The hsCPC is also cytocompatible, and can support bone and stem cell proliferation and differentiation. hsCPC scaffolds stimulated osteogenic gene expression comparable to native bone scaffolds. hsCPC scaffolds are also capable of delivering drug for up to 4 weeks, in vitro. Finally, a cement additive, pyrophosphate, stimulated differentiation, but not proliferation of bone cells.

Ce travail porte sur la mise au point, le développement et l’étude de la dégradation et de la biocompatibilité d’un nouveau ciment phosphocalcique modifié par ajout de strontium. Un ciment composite formé par l’insertion de microsphère de PLAGA a aussi été développé. Ces ciments ont un intérêt thérapeutique en orthopédie et en chirurgie maxillo-faciale pour le comblement ou le renforcement osseux. Les caractéristiques mécaniques, rhéologiques et radiologiques du ciment et du composite ont été évaluées et optimisées pour rendre leurs formulations à la fois résistantes, injectables et radio-opaque. Un travail de développement à été mené pour répondre au mieux au cahier des charges clinique de ce type de substitut osseux. La chimie de la réaction au sein du ciment à été étudiée pour connaître les mécanismes réactionnels, l’évolution et le produit final de la réaction de prise. Des tests in vitro sur la dégradation par dissolution passive des constituants du ciment et du composite ont été réalisés ainsi que l’étude de la biocompatibilité sur des cultures cellulaires. Des expérimentations animales sur la peau de souris et sur le tibia de lapin ont permis de confirmer la biocompatibilité du ciment et du composite et de donner une première évaluation de sa résorption et de son remplacement par du tissu osseux néo formé. / The aim of this thesis is to design and develop a new calcium phosphate cement modified by addition of strontium and a composite cement formed by the insertion of PLAGA microspheres.These cements have a therapeutic interest in orthopaedic and maxillofacial surgery for bone filling or reinforcement.The mechanical, rheological and radiological properties of cement and composite were evaluated and optimized to improve their mechanical strength, injectability and radio-opacity. Development works were conducted to meet clinical specifications required for this type of bone substitute.The cement chemistry was studied to determine the reaction mechanisms, evolution and the final product of the setting reaction. In vitro tests on the degradation of cement components and composites were performed and the biocompatibility was studied by cell cultures.Animal experiments on mouse skin and rabbit tibia have confirmed the biocompatibility of these cements and provide a preliminary assessment of its resorption and replacement by newly formed bone tissue.

Os cimentos de fosfato de cálcio (CFCs) têm atraído grande interesse para uso em ortopedia e odontologia como substitutos para partes danificadas do sistema esquelético, mostrando boa biocompatibilidade e osteointegração, permitindo sua utilização como enxerto ósseo. As características que determinam os CFCs biomateriais atrativos para a reconstituição ou remodelação óssea, são a facilidade de manipulação e moldagem, sem ter de dar forma prévia ao implante, adaptando-se totalmente à forma da cavidade óssea. Diversos estudos, têm mostrado que a adição de aditivos poliméricos tem uma forte influência sobre as propriedades do cimento. A baixa resistência mecânica é o principal obstáculo a uma maior utilização de CFC como material de implante. O objetivo deste trabalho foi avaliar as propriedades de um cimento com base em α-fosfato tricálcico (α -TCP ), adicionado de PVA (poli (álcool vinílico)) (10%, 8%, 6%), hidrogel de PVA (10%,8%,6%) reticulado com ácido cítrico (10%), hidrogel de alginato de sódio (2%) e poliacrilato de amônia (1%), todos em massa, foram adicionados ao pó de α -TCP sintetizado. As amostras foram moldadas e avaliadas quanto à densidade, porosidade, teste ―in vitro‖ (Simulated Body Fluid), fases cristalinas e propriedades mecânicas. Os resultados mostram o aumento das propriedades mecânicas do cimento, quando adicionado destes polímeros. A reticulação dos hidrogéis de PVA com ácido cítrico foi eficiente.O hidrogel de PVA, o hidrogel de alginato de sódio e o poliacrilato de amônia agiram como redutor de líquido. / The calcium phosphate cements (CPCs) have great interest for use in orthopedics and dentistry as replacements for damaged parts of the skeletal system, showing good biocompatibility and osseointegration, allowing its use as a bone graft. The characteristics that determine CPCs attractive biomaterials for bone remodeling or rebuilding, is ease of handling and molding, without having to shape prior to implantation, adapting itself fully to the shape of the bone cavity. Several studies in literature have shown that the addition of polymeric additives has a strong influence on the mechanical properties of cement. The low mechanical strength is the main impediment to a broader use of calcium phosphate bone cement as implant material. The aim of this work was evaluate the strength of a CPC based on α-tricalcium phosphate, with polymeric additions. CPC was synthesized and PVA (poli (vinyl alcohol)) (10%, 8%, 6%), sodium alginate hydrogel (2%) and ammonium polyacrylate (1%), all by weight, were added to the powder. Specimens were molded and evaluated for density, porosity, in vitro test (Simulated Body Fluid), crystalline phases and mechanical properties. The results show the increase of the mechanical properties of cement when added of polymeric additives. The crosslinking of PVA hydrogels with citric acid was effective. The PVA hydrogel, the hydrogel sodium alginate and ammonium polyacrylate acted as a reducing liquid.

Objectives: To determine whether treatment of demineralized enamel white spot lesions with CPP-ACP paste, CPP-ACFP paste or microabrasion technique decreases lesion depth in vitro. Additionally, to determine whether treatment of demineralized enamel white spot lesions with microabrasion technique in combination with CPP-ACP paste or CPP-ACFP paste decreases lesion depth greater than any of the three techniques alone. Background: White spot lesions (WSLs) after the removal of orthodontic appliances remain a problem for clinicians and patients. Previous studies suggest that application of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) may promote enamel remineralization. Recently, microabrasion of enamel was proposed as another treatment modality of white spot lesions. A review of literature showed that there was no comprehensive in vitro study that combined microabrasion, casein phosphopeptide amorphous calcium phosphate and casein phosphopeptide amorphous calcium fluoride phosphate for treatment of WSLs. Methods: A total of one hundred and twelve bovine incisor teeth were randomly assigned to seven treatment groups: 1. Control 1 (demineralization control), 2. Control 2 (remineralization solution control), 3. CPP-ACP paste, 4. CPP-ACFP paste, 5. Microabrasion, 6. Microabrasion with CPP- ACP paste, and 7. Microabrasion with CPP-ACFP paste. Teeth in all groups were placed in demineralizing solution for 96 hours to produce artificial caries-like lesions. At the end of the 96 hr period, teeth in Control 1 group were sectioned to establish adequate amount of demineralization. The rest of samples were treated with assigned regimen once a day for 10 days and stored in remineralization solution. At the end of ten days, teeth were sectioned with a hard tissue microtome and observed under polarized microscopy to analyze enamel lesion depth. One-way ANOVA at α=0.05 was performed to assess difference in lesion depth between groups followed with post hoc Tukey's test. Results: Statistical analysis showed a significant difference between groups (pConclusions: Based on the results from this study, we can conclude that: (1) treatment of WSLs with CPP-ACP paste, CPP-ACFP paste or microabrasion decreases lesion depth in vitro; (2) microabrasion in combination with CPP-ACP paste or CPP-ACFP paste did not decrease lesion depth greater than that observed with either paste technique alone; (3) both CPP-ACP and CPP-ACFP pastes in combination with microabrasion treatments showed greater decrease in lesion depth than microabrasion alone.

One of the major health problems in western societies is back pain, with a prevalence rate of 49%–80%. In many cases, the back pain is due to degenerated discs. The gold standard to treat a severely degenerated disc is spinal fusion, where the vertebral disc is replaced with a cage structure. However, fusion cages have a failure rate of 30%, hence the need for further development. The focus of this thesis is to evaluate the combination of calcium phosphate cement with titanium, for a spinal application. Mechanical tests in the form of tensile, compression and 4-point-bending were performed to study the different material properties. The obtained results was applied as material parameters for isotropic linear elastic material models, using ANSYS. This was then used to develop a cage design through topology optimisation which was further evaluated by using Finite Element Analysis. From the tensile testing of the titanium, isotropic behaviour was found. It was also found that a longer mixing time of the cement resulted in poorer mechanical properties of the calcium phosphate, however, no conclusive results were obtained from the 4-point-bending tests. The final cage geometry filled with calcium phosphate was tested under compression to see whether the cage could protect the calcium phosphate or not. MicroCT after the test confirmed that no larger cracks developed during the testing, suggesting that the cage is strong enough to protect the calcium phosphate from mechanical failure.