Novel Biocement/Honey Composites for Bone Regenerative Medicine

New biocements based on a powdered mixture of calcium phosphate/monetite (TTCPM) modified with the honey addition were prepared by mixing the powder and honey liquid components at a non-cytotoxic concentration of honey (up to 10% (w/v)). The setting process of the cements was not affected by the addition of honey, and the set-ting time of ~4 min corresponded to the fast setting calcium phosphate cements (CPC´s). The cement powder mixture was completely transformed into calcium-deficient nanohydroxyapatite after 24 hours of hardening in simulated body fluid, and columnar growth of long needle-like nanohydroxyapatite particles around the original calcium phosphate particles was observed in honey cements. The compressive strength of honey cements was reduced with the content of honey in the cement. The comparable antibacterial activity of cements with honey solutions was found on Escherichia coli, but very low antibacterial activity was found for Staphylococus aureus for all cements. The enhanced antioxidant inhibitory activity of composite extracts was verified. In vitro cytotoxicity testing verified the non-cytotoxic nature of honey cement extracts, and the addition of honey promoted alkaline phosphatase activity, calcium deposit production, and upregulation of osteogenic genes (osteopontin, osteocalcin, and osteonectin) by mesenchymal stem cells, demonstrating a positive synergistic effect of honey and CPC on the bioactivity of cements that could be promising therapeutic candidates for the repair of bone defects.