Advancements in Brushite cement formulations for bone repair

Morilla Espino, C. (2025)

Doctoral Thesis

This thesis explores the development of multifunctional brushite calcium phosphate cements (bCPCs) as synthetic bone graft materials for clinical applications in bone repair. bCPCs are biocompatible, resorbable, and suitable for drug delivery, but their use is limited by low mechanical strength, rapid setting, and inconsistent handling. Through systematic modification of cement composition and additives—including collagen, sodium alginate, α-tricalcium phosphate (α-TCP), silk fibroin, and the antibiotic tetracycline—this research demonstrates strategies to enhance both the structural and biological performance of bCPCs. The optimized formulations achieved improved compressive strength, controlled setting times, and sustained antibiotic release, maintaining antimicrobial activity for up to one week. These findings highlight that multifunctionality in biomaterials can be achieved without compromising mechanical integrity or injectability. Overall, this work provides valuable insights into the formulation–property relationships of bCPCs and contributes to the design of next-generation injectable bone grafts with tunable mechanical, biological, and drug-delivery properties for orthopedic and dental applications.

• Brushite calcium phosphate cement (bCPC)
• Bone regeneration
• Drug delivery systems
• Biomaterials
• Collagen
• Alginate
• α-tricalcium phosphate (α-TCP)
• Silk fibroin
• Mechanical properties
• Antibiotic release

• All authors: Morilla Espino, C.
• Supervisor: Geus-Oei, L.F. de; Weerd, L. van der
• Co-supervisor: Beucken, J.J.P. van den
• Committee: Sande, M. van de; Goumans, M.J.; Gawlitta, D.; Zadpoor, A.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2025-11-11
• ISBN (print): 9789465226347
• Sponsorship: Department of Radiology, Leiden University Medical Center, the Netherlands.