Abbasi Z et al.

Journal of Dental Biomaterials. 2015;2(1)

Bioactive Glasses in Dentistry: A Review

a a a b
Abbasi Z , Bahrololoom ME , Shariat MH , Bagheri R

a. Department of Materials Science and Engineering, School of Engineering, Shiraz University, Shiraz, Iran
b. Department of Dental Materials and Biomaterial Research center, Shiraz University of Medical Sciences, Shiraz,
Iran

ARTICLE INFO Abstract

Article History Bioactive glasses are silicate-based and can form a strong chemical
Received: 2 October 2014 bond with the tissues. These biomaterials are highly biocompatible
Accepted: 2 January 2015 and can form a hydroxyapatite layer when implanted in the body or
soaked in the simulated body fluid. Due to several disadvantages,
Key words: conventional glass processing method including melting of glass
Bioglass components, is replaced by sol-gel method with a large number of
Hydroxyapatite benefits such as low processing temperature, higher purity and ho-
Sol-gel derived mogeneity and therefore better control of bioactivity. Bioactive
glasses have a wide range of applications, particularly in dentistry.
Corresponding Author: These glasses can be used as particulates or monolithic shapes and
Rafat Bagheri porous or dense constructs in different applications such as
Department of Dental Materials remineralization or hypersensitivity treatment. Some properties of
and Biomaterial Research cen- bioactive glasses such as antibacterial properties can be promoted by
ter, Shiraz University of Medi- adding different elements into the glass. Bioactive glasses can also
cal Sciences, Shiraz, Iran be used to modify different biocompatible materials that need to be
Tel: +98-71-36280119 bioactive. This study reviews the significant developments of bioac-
Fax : +98-71-36285276 tive glasses in clinical application, especially dentistry. Furthermore,
Email : bagherir@sums.ac.ir we will discuss the field of bioactive glasses from beginning to the
current developments, which includes processing methods, applica-
tions, and properties of these glasses.

Cite this article as: Abbasi Z, Bahrololoom ME, Shariat MH, Bagheri R. Bioactive Glasses in Dentistry: A Review. J Dent
Biomater, 2015;2(1):1-9.

1. Introduction of bioactive glass
Bioactive glasses are a group of biomaterials which
are used in the fields of dentistry and orthopedics.
Forty five years ago, these glasses modified the func-
tions and capabilities of biomaterials from bioinert to
bioactive by stimulating a strong response after im-
planting in the human body (e.g. osteoproductivity)
[1]. A material can be classified as bioactive if the
above-mentioned biological response results in for-
mation of a strong chemical bond between the im-
planted material and a soft or hard tissue [2]. Certain
compositions of the silicate-based glasses, with calci-
um and phosphorus in proportions identical to those of
natural bone, can form such a strong bond without an
intervening fibrous layer [3]. When the glass contains
more than 60% SiO2, bonding to tissues is no longer
observed [4]. On the other hand, it is expected that
bioactivity increases with the amount of CaO in the
composition, because the dissolution of the calcium
ion from the glass plays an important role in formation
of the chemical bond [5].
Results of in vivo implantation of bioactive glasses
show that these materials produce no toxicity, no in-
flammation, and no foreign-body response [6]. In fact,
these glasses bond with the bone through formation of
a hydroxyapatite (HAp) layer. The same HAp layer is
formed on the surfaces of these materials after soaking
in the simulated body fluid (SBF) which has ion con-
centrations similar to the human blood plasma [7].
Hench at the University of Florida introduced the
first bioactive glass in 1969 [3]. Those days, the avail-
able implant materials (metals and polymers) designed
to be bioinert had a problem; they initiated fibrous
encapsulation after implantation, rather than forming a

Jdb.sums.ac.ir J Dent Biomater 2015; 2(1) 1

 Bioactive Glasses in Dentistry: A Review

2 Jdb.sums.ac.ir J Dent Biomater 2015; 2(1)

Abbasi Z et al.
stable bond with the tissues. Hench began his work to
overcome this problem by finding a material that
could bond to the bone and survive the harsh envi-
ronment of the human body. He tried making a de-
gradable glass in the Na2O-CaO-SiO2-P2O5 system
with high calcium content [3]. He discovered such
glass with the composition of 46.1 mol.% SiO2, 24.4
mol.% Na2O, 26.9 mol.% CaO and 2.6 mol.% P2O5
®
(later termed 45S5 and Bioglass ) which formed a
bond with the bone so tightly that it could not be re-
moved without breaking the bone. In fact, this glass
bonds with bone rapidly and stimulates bone growth
away from the bone-implant interface. This bone
bonding is the result of HAp layer formation on the
surface of the glass, following initial glass dissolution
[2]. This discovery was the introduction of the field of
bioactive ceramics and the beginning of the formation
of many new materials such as synthetic hydroxyap-
atite (HAp) and other calcium phosphates [8]. All
glasses, glass-ceramics and ceramics that are used as
implant materials are called “bioceramics” but
®
“Bioglass ” is referred to as the original 45S5 compo-
sition and should not be used as a general term for
bioactive glasses [9]. Table 1 presents the composi-
tions of the bioactive glasses mentioned in this review.
Table 1: Compositions of three types of bioactive glass-
es.
Name Composition
46.1 mol.% SiO2, 24.4 mol.% Na2O, 26.9
45S5 (Bioglass®) mol.% CaO and 2.6 mol.% P2O5
58S (Sol-gel 60 mol.% SiO2, 36 mol.% CaO and 4 mol.%
derived) P2O5
S53P4
53 mol.% SiO2, 23 mol.% Na2O, 20 mol.%
CaO and 4 mol.% P2O5
2. The mechanism of HAp layer formation on bio-
active glasses
Hydroxyapatite is similar to the bone mineral and can
interact with collagen fibrils of damaged bone to bond
with it. Protein adsorption, incorporation of collagen
fibrils, attachment of bone progenitor cells, cell differ-
entiation, the excretion of bone extracellular matrix
and its mineralization are involved in the formation of
HAp layer-bone bond. Osteogenesis, due to the disso-
lution products of the glass on osteoprogenitor cells,
stimulates new bone growth [10].
The mechanism of HAp layer formation on bioac-
tive glasses has been widely studied in vitro and in
vivo. This process involves different stages; calcium
ions dissolve from the bioactive glass into the body
fluid while a silica-rich interlayer forms on the glass
surfaces. The nucleation of HAp is now possible be-
cause the surrounding fluid is supersaturated with re-
spect to HAp due to the dissolution of the calcium
ions. In addition, silica-rich interlayer dissolves a con-
siderable amount of silicate ion and provides favorable
sites for the nucleation. The process of nucleation and
growth of the HAp layer continues by the reactions of
the calcium, phosphate, and hydroxide ions. It is pos-
sible that carbonate or fluoride anions incorporate in
the reactions, as well [3,9,11].
In 1980, Hench showed that the in vivo formation
of the HAp layer can be reproduced in Tris buffer
solution at pH 7.4. Later, Kokubo and Hench
independently confirmed that apatite can form on the
®
surface of Bioglass in SBF. In 1991, it was suggested
that a sim- ulated body fluid (SBF) which has the ion
concentra- tions equal to human blood plasma can
reproduce HAp formation [3]. Thin film X-ray
diffraction (TF-XRD), Fourier transform infrared
spectroscopy (FTIR), scan- ning electron microscopy
(SEM) and transmission elec- tron microscopy (TEM)
were used to confirm the simi-
larity of the composition and structure of HAp formed
in SBF to the bone mineral [12]. Hence, immersion in
SBF can be used for in vivo bone bioactivity prediction
before animal testing; this reduces the number of ani-
mals used and the duration of experiments and, there-
fore, increases the possibility of the development of
new types of bioactive materials [3].
SBF is a solution that simulates human blood
plasma with ion compositions similar to human blood,
but without any proteins, hormones, glucose, or vita-
mins [13]. During immersion in SBF, different pro-
cesses occur simultaneously which result in structural
and chemical changes to the surface of the material.
These processes are leaching, degradation, and precip-
itation [14]. In the leaching process, through the ex-
+ +
change of the cations H and H3O , metal ions like
+ 2+
Na and Ca are released and the pH at the interface
increases up to 7.4. In parallel, hydroxyl ions locally
break the silica-oxygen bonding. Then, silicon as silic-
ic acid, Si(OH)4, is released into the solution. The hy-
drated silicic acid on the surface is surrounded by at
least one hydroxy group; subsequently, a silicic acid
gel layer forms. Simultaneously, the glass releases
calcium and phosphorus and an amorphous calcium
phosphate-rich phase is formed on the surface. The
CaP phase then crystallizes into a hydroxyapatite
(HAp) structure [14].
3. Processing methods
For years, conventional glass technology has been
used to produce bioactive glasses. Mixture of oxides
or carbonates grains, as the glass components, are
melted in a platinum crucible and homogenized at
high temperatures up to 1250-1400°C. Then, to pro-
duce a bulk implant, the molten glass is cast into steel
or graphite mold. For the required tolerance, a final
grind and polish is often necessary. Sometimes, bioac-
tive glass powders are required for some clinical ap-
plications such as treatment of periodontal lesions. In
conventional glass technology, the molten glass is
poured into water or other liquid medium to produce
small fragments. To achieve powders with specific
size ranges for periodontal treatment, subsequent
grinding is necessary [4].
Producing bioactive glasses by conventional glass
technology has several disadvantages as listed below
(A-D). A: Very high purity is necessary for optimal
bioactivity which is difficult to maintain in this meth-
od due to the high temperatures of processing, the low
Jdb.sums.ac.ir J Dent Biomater 2015; 2(1) 3
silica and high alkali conventional glass more rapid. The tive glass has been
content of the processing, which recognition that the conducted through sol-
traditional bioac- tive considerably reduces high surface-area is gel method [21]. Sol-
glass compositions. the costs due to favorable for the gel method allows the
Such glasses are very lowering the formation of the HAp production of other
reactive and can processing layer bonding led to glass ceramics such as
dissolve platinum and temperatures [4]. This application of the sol- SiO2–CaO–P2O5,
take other multiple process has be- come gel process to create SiO2–P2O5– Al2O3–
cat- ions as an attractive research bioactive glasses [5]. CaO–Na2O–K2O [22].
impurities [4]. Gross field during 1980s A ternary bioactive On the surface of these
and Strunz [15] have [18]. Mixing the metal glass with a starting glasses, the formation
shown that M , M ,
3+ 4+
alkoxides in the surface area greater and the rapid increase
2
and M
5+
impurity solution to synthe- size than 150 m /g was of the thickness of
cations in bio- active an inorganic network, produced by Li et al., HAp layer were
glasses have hydrolysis, gelation, [4] and used for bone observed as a result of
considerable effects on and low-temperature graft applications. contact with Tris
tissue bonding. firing are the steps for Greenspan et al. [20] buffer and simulated
Greenspan and producing a sol-gel demonstrated that body fluid (SBF). This
Hench [16] have derived glass [19]. bioactive glasses with is an indication of the
revealed how bone surface areas greater high bioactivity of the
The microscopic 2
bonding is sensitive to structure of such glass than 50 m /g could gel-derived glasses
3+
a small amount of A1 can be modified by bond to the bone and [23].
in bioactive glasses. controlling monomer soft tissue within 24 h Difficulty to obtain
Evaporation of P2O5 at precursor, reaction of in vitro experiment. crack-free bioactive
high temperatures temperatures, water to Production of a glass monoliths,
may also result in two (CaO and SiO2), greater than 1 cm in
alkoxide ratio, and
composition uncer- three (SiO2– CaO– diameter, is the disad-
catalyst [5]. In sol-gel
tainty in the P2O5 , SiO2–CaO– vantage of sol–gel
process, many disad-
conventional method Na2O , P2O5–CaO– synthesis. The large
vantages of
[17]. B: Bioactive Na2O) or even four shrinkage dur- ing
conventional method
powders are exposed (SiO2–CaO–P2O5– drying stage and the
can be eliminated and
to contaminants during Ag2O) component evaporation of the
the purity which is
the con- ventional bioac- liquid by- products are
resulted from
glass processing which two reasons of the
processing at low
exerts negative ef- cracking. The vapor
temperatures (600-
fects on bioactivity. must pass through the
C: Conventional 700ºC) can be
controlled. The interconnected pore
method imposes a network from inside to
compositional advantages of this
method include ease of the surface, which can
limitation on bioactive create capillary
glasses; this is because powder production, a
broader range and a stresses and, therefore,
of very high liquidus
better control of cracking. For powders,
temperature of SiO2
bioactivity, high these stresses are small
and very high viscosity
homogeneity, good because the path of
of silicate melts with
control of parti- cles evaporation is short
high SiO2 content. D:
size and morphology and the material can
The increased
and the easy accommodate the
production costs of
preparation of thin stresses. For
this method is
considerable which is films and coatings monoliths, the path
due to high- [4,5]. from the center to the
temperature The sol-gel derived surface is long and
processing in platinum bioactive glass has a twisty, and the drying
crucibles, multiple porous structure which stresses can lead to
handling steps, capital increases its specific fracture. Narrow
equipment, labor, surface area by two distribution pores
maintenance, quality orders of magnitude with increasing size
assurance, and quality compared to a melt- can reduce this
control [4]. derived glass of a problem [9].
Low-temperature similar composition.
sol-gel processing Therefore, the rate of 4. The
offers a favor- able the surface of HAp applic
alternative to formation for the sol- ations
gel based materials is
of be discussed. Table 2,
bioacti presents these products
ve and some of their
glass applications.
In 1986, a bioactive
glass was successfully * Medical Devices
used as middle ear with Monolithic
prosthesis to repair shape
conductive hearing In 1988, a simple
®,
loss cone of Bioglass
and it was the first termed the
clinical application of Endosseous Ridge
such materi- Maintenance Implant
®
al. In tooth (ERMI ), was the
®
extraction, bioactive commercial Bioglass
glasses have been device in dentistry. To
used to preserve the repair the tooth roots
height of the alveolar and to provide a stable
ridge [24]. Bioactive ridge for dentures,
glasses also have been such devices were
used for spinal fu- inserted into fresh
sion, reconstruction of tooth
the iliac crest extraction sites. They
following autograft were highly stable
harvesting, and for and much
filling bony defects in better than HAp tooth
a number of root implants.
orthopedic procedures. However, this product
These early clinical did not gain
applications confirmed commercial success
the benefits of this because sur- geons
material as highly prefer to be able to cut
compatible implants the implant to shape
[25]. More recent rather than be limited
applica- tion of to cones of fixed size.
bioactive glasses
include coatings for
orthope- dic metallic
implants, trabecular
coatings, bone re-
placement,
periodontology,
endodontology,
scaffolds for bone
tissue engineering,
regenerative
medicine, and
composite based
scaffolds [26,27].
Different forms of
bioactive glasses
including par- ticles,
porous scaffolds, or
dense constructs have
been used in clinical
applications, such as
dentistry [9]. In
the following section,
some applications and
products of the
®
original Bioglass , as
the first introduced
bioac- tive glass, will
Figure 1. SEM micrographs of human dentine (bar = 1 µm): (a) untreated, (b) immediately after application of NovaMin® in artifi-
®
cial saliva (AS); (c) 24 h after application of NovaMin in AS; (d) 5 days after application. SEM images are adapted from Earl et
al. [39].
Internationally, 3i, Palm Beach cyclic loading fatigue attach to the dentine.
products based on Gardens, Florida) and of the thin enamel near For in vitro trials,
® human dentine is
particles rather than BonAlive (BonAlive the cemento-enamel
monolithic shapes are Biomaterials, Turku, junction [35]. The lightly etched to reveal
in commercial use Finland) [9,34]. hydrodynamic theory the tubules. Figure 1-b
[24]. *Using Bioactive about DH mechanism shows the den- tine
* Particulates of Glass for Treatment of proposes that when ex- immediately after the
Bioactive Glass Hyper- sensitivity ternal stimuli such as application of
®
Surgeons and A very fine cold, hot, tactile or NovaMin . After 24 h,
®
dentists often prefer to Bioglass osmotic pres- sure are the particles are
use particles or particulate called applied to the exposed attached to the dentine
® and HAp layer covers
granules instead of NovaMin dentin, they cause
monoliths, as they (NovaMin fluid movement within the surface. This
®
can press them easily Technology, the dentinal tubules. shows that NovaMin
to fill a defect. In GlaxoSmithKline, These open tubules stimulates the
®
1993, Perio-Glas Florida, UK), with a allow the fluid to flow deposition of calcium
(NovaBone Products particle size of ~18 through the tubules, phos- phate over the
LLC, Alachua, µm is used as an ac- which may result in dentine tubules. In
Florida) as the first tive repair agent in pressure changes that fact, the glass disso-
particulate bioactive toothpaste. This excite the nerve lution products
glass with the particle material mineral- endings in the dental stimulate the
sizes of 90–710 µm izes tiny holes in the pulp and DH occurs mineralization.
was introduced for the dentine and reduces [36]. Dissolu- tion of the
repair of bony defects the sensitivi- When these glass in the mouth
of the jaw and bone ty of the tooth. Dentin kinds of toothpastes raises pH, which leads
loss arising from hypersensitivity (DH) ® to promotion of HAp
are used, Bioglass deposition [39].
perio- dontal disease. is an oral problem particles adhere to the
In vivo and clinical which is attributed to The sol-gel derived
dentine and form an
studies [28-30] the root surface expo- bioactive particles
HAp layer; therefore,
showed a great success sure due to periodontal are also us-
® blocking of the tubules
of Perio-Glas in disease, toothbrush relieves the pain for
treatments of defects abrasion or longer periods. In a
filled with new bone clinical trial of 100
compared to controls. volunteers who
The regenerative brushed twice daily
properties for infra- ®
with a NovaMin -
bony defects can be
containing toothpaste
enhanced with low-
over the 6-week
level laser therapy
period, gingival
post- operatively [31].
bleeding and plaque
Another application of
® growth reduced 58.8%
Perio-Glas is in and 16.4% respectively
“guided tissue in comparison with
regeneration”, which the control groups
has been used with who used normal
polymeric membranes toothpaste [37].
®
[32]. Perio-Glas can Another clinical trial
also be used to has shown improved
produce bioactive pain relief when
glass slurry with brushing with a
applica- tions in root ®
NovaMin -containing
canal sterilization toothpaste for 2-6
tools prior to insertion weeks compared to
of implants and raising brushing with a
pH to bactericidal toothpaste containing
levels in addition to its potassium nitrate [38].
bioactive properties Despite brushing
[33]. Other prod- ucts, only for a few minutes
which have been used ®
a day, the Bioglass
as bone graft in
particles stimulate
dentistry and
long-term repair,
orthopaedic, are
® which results from the
Biogran (BIOMET fact that these particles
ed in treatment of hypersensitivity. The trials have
shown that 24 h after using toothpaste containing the
sol–gel and after washing with cola, juice, coffee and
further brushing, the tubules remain occluded [40].
Toothpaste is not the only dental care application
® ®
of Bioglass ; NovaMin can repair the enamel sensi-
tivity due to bleaching treatments of the teeth [39]. For
whitening the teeth, dentists use air polishing using
particles as abrasives to remove the stains. Air polish-
®
ing with Bioglass can stimulate mineralization of the
dentine tubules in a similar mechanism to that of
®
NovaMin -containing toothpaste, which resulted in
44% reduction of tooth sensitivity compared to other
air polishing powders, such as sodium bicarbonate.
®
Teeth treated with the Bioglass were also whiter than
those
treated with sodium bicarbonate [41].
*Remineralization Using Bioactive Glass
Demineralization and remineralization are natural
processes which continuously occur for teeth. Physio-
logical processes as well as bacterial acids and foods
cause demineralization, while remineralization results
from the deposition of mineral (calcium and phospho-
rous) from saliva or oral fluid. Since natural
remineralization is not enough for having strong
enamel, bioactive glasses are used to augment the pro-
cess. Bioactive glasses have unique remineralizing
properties and are generally introduced into various
dentifrices as very fine particles to provide calcium
and phosphorus to the tooth surface [42].
The first study on dentin remineralization by a bio-
active glass was conducted by Wang et al. [43]. In this
study, after artificial demineralization with EDTA
(ethylene-diamine-tetraacetic acid), the treatment with
nanoparticulate bioactive glass was compared to the
®
(PerioGlas ). The results showed that nanoparticulate
bioactive glass resulted in a noticeable increase in
mineral content suggested a rapid remineralization of
the samples. This result confirmed the critical role of
particle size and specific surface area. However, these
samples are mechanically unstable, unless the precipi-
tated mineral forms a composite material with the col-
lagen matrix of the samples [43]. In addition, investi-
gations on bioactive glass-containing toothpaste show
significant reduction in dentine permeability and ex-
cellent resistance to acid challenge which can be bene-
ficial for hypersensitivity and remineralization treat-
ments [44].
In 2014, Mehta et al. showed that bioactive glass
®
(Novamin ) and casein phosphopeptide-amorphous
calcium phosphate (CPP-ACP) successfully
remineralized early enamel caries. However,
®
Novamin remineralized the carious lesion more ef-
fectively. CPP-ACP had an amorphous nature and
couldn’t properly adhere to the enamel surface. This
also led to lower hardness value for CPP-ACP, while
®
Novamin showed higher values of hardness because
it attached to the surface more compactly [45]. In an-
other study, it was confirmed that bioactive glass is an
effective remineralizing agent as the effects of bioac-
tive-containing products were investigated on
remineralization of artificial induced carious enamel
lesion [46].
*Bioactive Glass Coatings
As metals are bioinert, the metallic implants are
encapsulated with fibrous tissue after implantation and
cannot attach to tissue which shows serious need of
such implants to bioactive coatings. The hydroxyap-
atite layer forms on bioactive glass coatings as a result
of dissolution and improves the bonding of implants to
the host bone. The problem is that a highly bioactive
coating may degrade over time and result in instability
of the metallic implant in the long term. Perhaps, the
dental field is the best application for bioactive glass
coatings, e.g. on titanium implants with screw threads.
However, it should be noted that the thermal expan-
sion coefficient of the glass and the metal must match
to prevent the glass pulling away from the metal dur-
ing the processing [47]. For instance, the thermal ex-
®
pansion coefficient of the Bioglass and titanium
don’t match. In order to address such problem, for
example, in the SiO2–CaO–MgO–Na2O–K2O–P2O5
system, the Na2O and CaO are replaced with K2O and
MgO, respectively to modify the thermal expansion
coefficient [48]. Another example is coating with the
following composition (by weight): 53% SiO2, 6%
Na2O, 22% CaO, 11% K2O, 5% MgO, 2% P2O5, and
1% B2O3 on titanium implants, which were first test-
ed in rabbit femurs [49]. Compared to non-coated im-
plants, more bone grew on the coated implants. By
using appropriate compositions, the mismatch of
thermal expansion coefficients doesn’t make any
problem and bioactive glasses can successfully be
used as coatings.
Table 2: Name and application of some products of the
original Bioglass® and their applications
Product Applications
ERMI® Repair of the tooth roots and providing a sta-
ble ridge for dentures
Perio- Repair of bony defects of the jaw and bone
Glas® loss arising from periodontal disease- Guided
tissue regeneration- Root canal sterilization
tools
Biogran® Bone graft
BonAlive® Bone graft
NovaMin® Active repair agent in toothpaste for hypersen-
sitivity treatment- Repair of the enamel sensi-
tivity due to bleaching treatments of the teeth-
Remineralizing agent
5. Antibacterial properties
During dissolution of bioactive glass, the pH rises due
to cation release and such condition can kill the mi-
crobes [1]. For instance, an in vitro study showed that
S53P4, as one kind of bioactive glass, can kill patho-
gens connected with enamel caries (Streptococcus
mutans), root caries (Actinomyces naeslundii, S.
mutans) and periodontitis (e.g. Actinobacillus
actinomycetemcomitas) [50]. S53P4 and other compo-
sitions of bioactive toxic to human effect of en- dogenous with 2% zinc citrate
glass with osteoblasts [53]. growth factors, which have been used in the
concentrations higher Silver-containing sol- makes it a perfect treatment of poor
-1
than 50 mg ml in the gel glasses have a additive for blood gingival health [61].
broth cultures of 16 limitation in their vessel ingrowth [57].
different bacteria synthesis as it must be Cellular cop- per can 6
showed antibacterial conducted under be regarded as an .
properties due to the infrared radiation and angiogenic agent
pH increase [50]. It is the glass must be because of its M
postulated that an ideal stored in the dark to remarkable e
bioactive glass prevent the silver distributions in human c
material includes nitrate precursor and endothelial cells h
antibacterial elements Ag2O reducing to during their a
which prevent silver metal. This not angiogenesis. This ion n
infections and reduce only increases the cost can also stimulate the i
the post-operative of pro- duction, but endothelial cell c
sensi- tivity. The also complicates the proliferation and a
widely considered surgical procedures. suppress osteo- clast l
elements for this pur- Silver-doped melt- activity [58].
pose are metals which derived glasses have Moreover, elastin
have bioactivity also improved p
matrix deposition can
against micro- bactericidal properties r
be stimulated by this
organisms and can compared to silver-free o
metal because elastin
overcome the equiva- lent glasses. p
fibrils can aggregate
problems related with Nanoparticles of e
into mature fibers
the low stability of ®
Bioglass can kill En- r
when copper ions are
other organic terococcus faecalis, a t
released from
antimicrobial micro-organism i
nanoparticles [59].
compounds during the associated with failed e
Zinc is another
biomaterial processing root canal treatments s
metal which is thought
[51]. [54]. The application of
to have an- tibacterial bioactive glasses,
Silver is one of the Copper and its properties and
elements known as alloys, such as brass, due to their low
beneficial cellular mechanical strength
antimicro- bial. Silver bronz, copper- nickel response, but it can
ions can easily be and copper-nickel-zinc and inherent
also cause toxicity brittleness, has been
introduced into a glass can also be used in an- [60]. Because of anti- limited to non-load-
and then released timicrobial inflammatory and bearing parts such as
during dissolution. applications. The antimicrobial ossicles in the middle
The sol-gel- derived strong antimicrobial properties, dentifrices ear. Incorporation of
composition of 76 % ions of copper can be
SiO2, 19% CaO, 2% doped to different nitrogen into the sili-
P2O5 and 3% Ag2O matrices such as cate network can
(by weight) is the first address the problem of
polymers or ceramics
antibacteri- low strength in
[55,56]. Copper not
al glass which glasses. When oxygen
only is an excellent
contains silver [52]. is replaced by nitrogen
- antimicrobial agent but
Less than 1 mg ml in alumino-silicate
1 also has an essential
of this glass in glasses, elastic
role in bone
culture is needed to modulus and hardness
formation and
kill bacteria such as increase linearly with
healing. This metal
Escherichia coli, nitrogen content;
can also stimulate
Pseudomonas however, glass
wound healing
aeruginosa and transition temperature
responses and increases, as well.
Staphylococcus
improves the vascular Incorporation of
aureus, compared to
-1 density in and around nitrogen also results in
50 mg ml of silver-
subcutaneously greater slow crack
free glasses to be
implanted allografts growth resistance,
bactericidal. It is
and hyaluronan based modest gains in
noteworthy
hydrogel. Copper fracture resistance, and
that the low
sulfate can induce the increased viscosities
concentrations of the
formation of cord-like [62]. Addition of
sol-gel glass that can
and tubular structures both fluorine and
be bactericidal are not
and potentiate the
nitrogen can increase present in bioactive
the mechanical glasses as
properties as fluorine orthophosphate, aids in
induces considerable maintaining the
reductions in both network connectivity.
glass melting In fluoride-containing
temperatures (Tm) and glasses, the formation
glass transition of flourapatite at low
temper- atures (Tg) pH is favored by
while elastic modulus increasing P2O5 and
and hardness in- crease this is more favorable
with nitrogen for clinical
incorporation but they applications of
are unaf- fected by dentistry and
fluorine incorporation. orthopedics [65].
The dissolution of *Effect of fluoride
nitrogen into the glass Fluoride can inhibit
melt is also facilitated the demineralization of
by fluo- rine [63]. the enamel and dentin,
enhance
7. Effects of different remineralization, and
ion doping on other in- hibit bacterial
proper- ties of enzyme; hence, it
bioactive glass prevents dental decay
In addition to and improves the oral
antibacterial and health [66].
mechanical properties *Effect of zinc
of bioactive glass, Zinc is a
other properties can fundamental ion that
also be affected by improves bone-
adding different ions bonding of glass,
which make the inhibits bone
material more resorption, controls
compatible for cell growth,
different clinical differentiation, and
applications. development and
*Effect of strontium stimulates protein
Strontium is a synthesis. Slow
bone-seeking agent, skeletal growth and
able to impact bone alterations in bone
cells which can be calcification can result
substituted for from zinc deficiency
calcium in bioactive [60].
glass for better bone
bonding and osteoblast
stimulation, with
anabolic and anti-
catabolic proper-
ties. For treatment of
osteoporosis, strontium
ranelate and strontium
chloride can be used.
Osteoblast prolif-
eration can be
promoted by
strontium-substituted
®
Bioglass which also
decreases the
osteoclast activity in
the cell culture [64].
*Effect of phosphate
Increasing
phosphate which is
8. Modification of not bioactive. before, bioactive ceramic was coated by
dental ceramics with Consequently, if these glasses can restore a bioactive glass and
a bioactive glass ceramics would be osseous defects and after im- mersion in
Dental ceramics modified in a way that develop a new SBF, the growth of a
should have specific they could stimulate attachment on tooth well-attached apatite
properties, such bioactive behavior surfaces. The strong layer on the surface
as high strength, around the fixed and stable bonding was observed [70].
fracture toughness, restora- tions margins results from Moreover, it was
wear resistance, and provide a development of a reported that the
similarity with natural bioactive surface, hydroxyapatite layer, attachment and
tooth structure and through the tissue similar to that of the proliferation of human
long life in the oral regenerative bone, on the surface periodontal ligament
environment, in order techniques, they could after inclusion into cells can be supported
to be used in develop periodontal biological by dental ceramic–
restorative dentistry. tissue attachment and environment. bioactive glass
To successfully place create complete Sometimes, biological mixtures [71].
the fixed restorations sealing of the marginal apatites include traces As expected, sol-
in the oral gap. This sealing could of inorganic elements gel method can create
environment, it is prevent the failure of that can be substituted a more po- rous
necessary to keep fixed ceramic in the apatite lattice or surface which raises
perio- dontal tissues restorations by adsorbed on the apatite the dissolution rate and
healthy. Fixed eliminating secondary surface. Bioactive promotes apatite
restorations increase caries, materials can form this formation, so dental
the local plaque micropenetration of bio- logical apatite on ceramic- bioactive
accumulation, the oral bacteria and their surface in vitro glass mixture prepared
especially with poor their adhesion on under various soaking by such method can
oral hygiene, and lead cement surface [68]. conditions [7]. accelerate the onset of
to inflammation, loss It is expected that Development of HAp formation [72].
of attachment and utilization of guided apatite on the dental In 2010, two sol–gel
eventually periodontal tissue re- generation ceramic sur- faces derived materials were
tissue’s breakdown. techniques in the field through modification successfully pro-
Exist- ence of a of dental ceramics can with bioactive glasses duced for dental
marginal gap between provide solutions to has been tried by applications: a novel
the tooth and restora- address fixed several researchers. ceramic and a
tion which is exposed prosthetic resto- In 2003, a dental bioactive mixture
to oral bacteria results rations failure. This (ceramic 30 wt.%-
in pulp irritation or technique can result in bioactive glass
necrosis, secondary formation of new 58S 70 wt.%) with
caries and cement attachments on the better control of
dissolution, all being tooth surfaces (e.g. composition, mi-
the common reasons cementum) or on crostructure and
of fixed prosthetic implant surfaces properties due to high
restoration failure (Titanium, hydrox- homogeneity provided
[67]. yapatite, etc.). by the sol-gel method,
It is impossible for Therefore, if dental compared to melt-
ceramic materials to ceramics could exhibit derived ceramics [22].
develop new a cement-like In melting powder
attachment on their behavior, the preparation techniques,
surface. Therefore, in biological surface the sur- face reactivity
spite of the ability of required for of ceramics has been
fixed ceramic attachment of the cells weakened by high
restorations to would be provided and reaction temperature,
regenerate the tissue attachment which results in high
morphology and would be promoted. heteroge-
function of the Formation of apatite neity and loss of
damaged struc- ture, on the dental ceramic porosity and their
they cannot surface can enhance surface area de-
completely attach to the tissue attachment pends only on the
the periodontal tissue. because cementum particle size of the
In fact, conventional consists of biological powders [21]. On the
dental ceramics are hydroxyapatite [69]. other hand, the sol-gel
bio- compatible but As mentioned method provides
control over the are used for
textural properties hypersensitivity
(specific surface area treatment. One of the
and porosity) and most im- portant
crystal structure which properties of bioactive
develops an op- glasses is their ability
timized bioactive to exhibit antibacterial
surface and also activity, which creates
maintains the sur- face a bacte- ria-free
bioactivity over a environment while
wider composition healing and
range of silica content regenerating the defect
[73]. area. The promotion of
this ability is possi- ble
C by doping antibacterial
o elements, such as
n silver, copper or zinc
c to such glasses.
l Another property of
u bioactive glasses is
s mechanical property
i which can be improved
o by introducing
n nitrogen and fluorine
s to the silicate network
of the glasses. The
Bioactive glasses are other properties of
able to bond to both bioactive glasses can
soft and hard tissue also be altered by
and promote the bone incorporation of
growth. The bioac- different ions such as
tivity behavior of these strontium and
glasses is related to the phosphates. These
for- mation of a potentials of bioactive
biologically active glass make it a unique
hydroxyapatite layer material to be widely
on the surface of the used in dentistry. For
glasses. The example,
mechanism of bonding
of bioactive glasses to
tissues includes a
series of sur- face
reactions that occur
when the glass is
exposed to an aqueous
environment. These
glasses are produced
via two main methods,
melting and sol-gel
processing. The latter
has many advantages
which make it a fa-
vorable method in
order to provide
glasses with fine
porous textures and
enhanced bioactivity.
Bioactive glasses have
a wide range of
applications, such as
bone grafts, scaffolds,
coating materials, and
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