The biological performance of calcium phosphate ceramics in an infected implantation site. III: Biological performance of beta-whitlockite in the noninfected and infected rat middle ear.

The biological performance of macroporous beta-whitlockite implanted in the rat middle ear was evaluated. The material was studied in the non-infected middle ear and in middle ears infected by Staphylococcus aureus. beta-whitlockite was quickly covered by a normal mucosa. One week post-operatively the macropores were filled with exudate, fibrous tissue, and a small quantity of bone. Six months after the operation the greater part of the macropore area was filled with bone (74%); fibrous tissue accounted for 20%, and exudate for 5%. In histological sections, the macropore area of beta-whitlockite had increased by 68% after six months, indicating biodegradation. Macrophages and multinucleated cells were present in the vicinity of the implant and played a role in this biodegradation. Besides cytoplasmic vacuoles containing calcium phosphate, the cells showed smaller granules containing trace elements originally present in the implant material, such as silicon, titanium, aluminum, iron, and magnesium.