Investigated in this study are the changes in structure and properties of a tetracalcium phosphate/dicalcium phosphate anhydrous/calcium sulfate hemihydrate (TTCP/DCPA/CSH) cement immersed in Hanks' solution. Experimental results show that the phase transition involving the hydration of CSH and formation of calcium sulfate dihydrate (CSD) continues up to 7 d of immersion. The phase transition from TTCP/ DCPA to hydroxyapatite (HA) is substantially completed after 14 d; after that, both CSH and CSD phase largely diminished, whereas HA becomes and remains to be the only dominant phase throughout 42 d of immersion. A maximum compressive strength is reached; after that, the cement gradually decreases in strength. After 42 d, its CS value is down to 8MPa. The long-term pH value of the Hanks' solution wherein the cement is immersed remains in the range between 5.4 and 7.0. The cytotoxicity test reveals that the viability value of the cells incubated with conditioned medium of cement extraction is 85% that of Al2O3 control and 84% that of blank medium for an extraction ratio of 0.2; and 90% that of Al 2O3 control and 93% that of blank medium for an extraction ratio of 0.1.
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