Abstract: Recent studies have revealed that the ability of a calcium phosphate cement paste to harden in a physiological environment without desintegrating into small particles might be a key property to ensure a safe and reliable clinical use of calcium phosphate cements. However, this property called cohesion is not well understood and has not been studied extensively. The goal of the present study was to better understand which factors affect the cohesion of a calcium phosphate paste using the combination of a theoretical and experimental approach. In the theoretical approach, factors expected to influence the paste cohesion such as Van der Waals forces, electrostatic and steric interactions, as well as osmotic effects were listed and discussed. In the experimental approach, a new method to measure the cohesion of a non-setting calcium phosphate paste was presented and used to assess the effects of various factors on this property. The new method allowed a continuous measurement of cohesion and gave reproducible results. The experimental results confirmed the theoretical predictions: an increase of the liquid-to-powder ratio of the paste and of the powder particle size, as well as the addition of citrate ions and in limited cases dissolved xanthan polymer chains reduced the paste cohesion.

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