Effect of temperature and mixing conditions on quality and consistency of poly(methyl methacrylate) bone cement

The mixing of poly(methyl methacrylate) (PMMA) bone cement has been studied to develop methods for preparing a consistently high quality cement. A novel droplet test experimental procedure was developed that characterised the wetting characteristics involved in bone cement mixing. Using this technique it was established that increased wetting occurred by mixing bone cement at a lower temperature (-28°C) than normal mixing at room temperature. The effect of temperature on viscosity of the cement mix was also investigated. An increase in viscosity with mixing time was found for all temperatures (owing to dissolution of PMMA in the monomer). However, the rate of increase in viscosity was a function of the initial temperature of the cement components. Cooling of the components initially to -12·6°C resulted in a better mix than room temperature samples, due to the cooled components having more mixing time at a lower viscosity (less than 1000 cP). Automated mixing of the cement was also investigated. A high speed 'figure of eight' mixing machine (Kerr® Automix™ computerised mixing dental amalgamator) was used in a comparison with traditional hand held mixing devices. The effect of initial component cooling was also investigated in the high speed unit and cement samples were analysed for porosity and homogeneity of mix (using scanning electron microscopy). Results indicate that the combined effects of low initial temperature and automated mixing produces a bone cement that is more homogeneous and of lower porosity than hand mixed cement.