The effects of initial hemostatic period on the mechanical strength and transformation of apatite cement

It is well known that apatite cement causes inflammatory response if it is exposed to blood before setting. In this respect, the hemostatic procedure is very important. However, it has not been clarified how initial hemostasis affects the other basic properties of apatite cement. In the present study, the effect of initial hemostasis on the setting reaction was simulated by allowing the apatite cement paste to be hardened in an incubator for 1 to 30 minutes and then immersed in saline up to 7 days. We found faster transformation of apatite cement to apatitic mineral and higher mechanical strength of the set mass when the cement paste underwent a longer pre-hardening period. We also found that earlier exposure of apatite cement to saline resulted in a set mass with larger porosity. It is thought that the larger porosity of the cement is caused by the penetration of liquid into the cement paste, thus leading to lower mechanical strength and slower transformation of the apatite cement to apatitic mineral. We concluded, therefore, that hemostatic procedure is important not only to prevent inflammatory response but also to obtain a set mass with higher mechanical strength and faster transformation to apatitic mineral.