Premixed injectable calcium phosphate cement (p-ICPC) pastes have advantages over aqueous injectable calcium phosphate cement (a-ICPC) because p-ICPC remain stable during storage and harden only after placement into the defect. This paper focused on the suspension stability of p-ICPC paste by using fumed silica as a stabilizing agent and propylene glycol (PEG) as a continuous phase. Multiple light scanning techniques were first applied to evaluate the suspension stability. The results indicated that fumed silica effectively enhanced the suspension stability of p-ICPC pastes. The stabilizing effect of fumed silica results from the network structure formed in PEG because of its thixotropy. The p-ICPC could be eventually hydrated to form hydroxyapatite under aqueous circumstances by the unique replacement between water and PEG. p-ICPC (1) not only possesses proper thixotropy and compressive strength but has good injectability as well. p-ICPC (1) was cytocompatible and had no adverse effect on the attachment and proliferation of MG-63 cells in vitro. These observations may have applicability to the development of other nonaqueous injectable biomaterials for non-immediate filling and long-term storage.

An ICPC with high structure recoverability and paste stability was successfully developed directly incorporating PEG-6000 into the liquid phase of CPC. The rheological behavior of ICPC was investigated with rheometric scientific ARES902-30004 controlled strain rheometer. Novel approaches of flow rate, shear thinning index (SI), shear stress slowdown (Δτ) and thixotropy loop area have been applied to assess the injectability and structure recoverability of the ICPC paste. The addition of PEG-6000 to ICPC resulted in a thixotrophic structure with shortened setting time, slightly increased viscosity, larger thixotropic hysteresis loop area and lower Δτ, with the improvement largely dependent on the PEG-6000 content. With acceptable injectability and shortened setting time, ICPC (1%) showed the lowest Δτ and the highest SI, endowing the paste good structure recoverability and paste stability. The ICPC (1%) was bioactive and facilitated cell attachment and proliferation. The optimized ICPC (1%) paste with a relatively good structure stability and paste stability may serve as a good candidate for tooth root-canal fillings and percutaneous vertebroplasty in microinvasive surgery.