Bioactive Glasses in Periodontal Regeneration: Existing Strategies and Future Prospects-A Literature Review

Synergistic Effect of Strontium Doping and Surfactant Addition in Mesoporous Bioactive Glass for Enhanced Osteogenic Bioactivity and Advanced Bone Regeneration

Mesoporous bioactive glass (MBG) is an advanced biomaterial widely recognized for its application in bone regenerative engineering. This study synthesized an MBG powder (80 mol% SiO2, 5 mol% P2O5, and 15 mol% CaO) using a facile sol-gel method with the non-ionic surfactant Pluronic® P123, which acted as a pore-forming agent. MBGs form bioactive surfaces that facilitate HA formation, and the presence of Pluronic® P123 increases the surface area and promotes HA nucleation. Various percentages of strontium (Sr) doping were examined to improve bioreactivity, biological response, and bone formation, with 3SMBG (3 mol% Sr) showing the highest specific surface area. In vitro biocompatibility tests revealed HA formation on all glass surfaces after immersion in simulated body fluid (SBF), indicated by sheet-like HA morphologies, the presence of PO43- and CO32- functional groups, and the amorphous structure along with SrCO3 crystalline phases corresponding to HA and Sr-HA structures. Sr doping resulted in delayed initial degradation and sustained release of Sr2+, achieving over 95% cell viability. Surfactant-induced mesoporous structure and Sr incorporation synergistically enhance osteocyte induction and formation in vitro. These findings suggest that Sr-doped MBG, particularly with P123-assisted Sr/Ca substitution, optimizes the material's properties for advanced bone regenerative applications.

Bioresorption and Biomineralization of S53P4 Bioactive Glass in Neutral Tris Buffer and Citric Acid Solution

In this study, S53P4 (53SiO2-23Na2O-20CaO-4P2O5) bioactive glass (BG) were prepared through a melt-milling process, and their bioresorption and biomineralization behavior was evaluated by in vitro dissolution under different solution conditions (neutral and acidic). The particle size of S53P4 BG was controlled by milling, and the in vitro dissolution evaluation was performed in tris buffer and citric acid solution for 21 days at 37 °C according to ISO 10993-14 (biological evaluation of medical devices). During dissolution, the ion release rate of S53P4 BG was confirmed to be three times faster in citric acid solution than that in tris buffer. Among them, the ion concentration of calcium and phosphorus initially increased and then gradually decreased, which is due to the biomineralization process. This process formed a new layer of particles on the surface of S53P4 BG, which was identified as a calcium-phosphate-based compound by X-ray diffraction analysis. Furthermore, the thickness of the layer was observed to be 273 nm in tris buffer and 34 nm in citric acid solution by focused-ion beam scanning electron microscopy, and the morphology of the particles comprising this layer was observed to be thicker and longer in tris buffer than that in citric acid solution. This difference is due to the citrate present in the citric acid solution interacting with the released calcium ions and inhibiting the formation of a new layer. Thus, the ion release of S53P4 BG was faster in citric acid solution than that in tris buffer, but the biomineralization process to form the calcium phosphate-based compound was more effective in tris buffer.

Supra-Alveolar Bone Regeneration: Progress, Challenges, and Future Perspectives

Periodontitis is a highly prevalent disease that damages the supporting tissues of a tooth, including the alveolar bone. Alveolar bone loss owing to periodontitis is broadly categorized as supra-alveolar and intra-alveolar bone loss. In intra-alveolar bone loss, the defect has an angular or oblique orientation to the long axis of the tooth in an apical direction. In contrast, the defect is perpendicular to the long axis of the tooth in supra-alveolar bone loss. Unlike intra-alveolar bone defects, supra-alveolar bone defects lack supporting adjacent space, which makes supra-alveolar bone regeneration more challenging. In addition, the limited availability of resources in terms of vascularity and underlying tissues is another obstacle to supra-alveolar bone regeneration. Currently, supra-alveolar bone loss is the least predictable periodontal defect type in regenerative periodontal therapy. In addition, supra-alveolar bone loss is much more common than other alveolar bone loss. Despite its prevalence, research on supra-alveolar bone regeneration remains sparse, indicating an unmet need for significant research efforts in this area. This review summarize recent advances, obstacles, and future directions in the field of supra-alveolar bone regeneration. We discuss the biomaterials, bioactive molecules, and cells that have been tested for supra-alveolar bone regeneration, followed by pre-clinical and clinical approaches employed in this field. Additionally, we highlight obstacles and present future directions that will propel supra-alveolar bone research forward.

Natural Bioactive Compounds in the Management of Periodontal Diseases: A Comprehensive Review

Periodontal diseases, chronic inflammatory conditions affecting oral health, are primarily driven by microbial plaque biofilm and the body's inflammatory response, leading to tissue damage and potential tooth loss. These diseases have significant physical, psychological, social, and economic impacts, necessitating effective management strategies that include early diagnosis, comprehensive treatment, and innovative therapeutic approaches. Recent advancements in biomanufacturing have facilitated the development of natural bioactive compounds, such as polyphenols, terpenoids, alkaloids, saponins, and peptides, which exhibit antimicrobial, anti-inflammatory, and tissue regenerative properties. This review explores the biomanufacturing processes-microbial fermentation, plant cell cultures, and enzymatic synthesis-and their roles in producing these bioactive compounds for managing periodontal diseases. The integration of these natural compounds into periodontal therapy offers promising alternatives to traditional treatments, potentially overcoming issues like antibiotic resistance and the disruption of the natural microbiota, thereby improving patient outcomes.

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioral and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.

Boron-containing coating yields enhanced antimicrobial and mechanical effects on translucent zirconia

OBJECTIVES

To evaluate the mechanical and antimicrobial properties of boron-containing coating on translucent zirconia (5Y-PSZ).

METHODS

5Y-PSZ discs (Control) were coated with a glaze (Glaze), silver- (AgCoat), or boron-containing (BCoat) glasses. The coatings' antimicrobial potential was characterized using S. mutans biofilms after 48 h via viable colony-forming units (CFU), metabolic activity (CV) assays, and quantification of extracellular polysaccharide matrix (EPS). Biofilm architectures were imaged under scanning electron and confocal laser scanning microscopies (SEM and CLSM). The cytocompatibility was determined at 24 h via WST-1 and LIVE&DEAD assays using periodontal ligament stem cells (PDLSCs). The coatings' effects on properties were characterized by Vickers hardness, biaxial bending tests, and fractography analysis. Statistical analyses were performed via one-way ANOVA, Tukey's tests, Weibull analysis, and Pearson's correlation analysis.

RESULTS

BCoat significantly decreased biofilm formation, having the lowest CFU and metabolic activity compared with the other groups. BCoat and AgCoat presented the lowest EPS, followed by Glaze and Control. SEM and CLSM images revealed that the biofilms on BCoat were thin and sparse, with lower biovolume. In contrast, the other groups yielded robust biofilms with higher biovolume. The cytocompatibility was similar in all groups. BCoat, AgCoat, and Glaze also presented similar hardness and were significantly lower than Control. BCoat had the highest flexural strength, characteristic strength and Weibull parameters (σF: 625 MPa; σ0: 620 MPa; m = 11.5), followed by AgCoat (σF: 464 MPa; σ0: 478 MPa; m = 5.3).

SIGNIFICANCE

BCoat is a cytocompatible coating with promising antimicrobial properties that can improve the mechanical properties and reliability of 5Y-PSZ.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

Clinical and Radiological Outcomes for Guided Implant Placement in Sites Preserved with Bioactive Glass Bone Graft after Tooth Extraction: A Controlled Clinical Trial

The goal of the study was to evaluate marginal bone loss (MBL) after 1-year implant placement using a guided implant surgical (GIS) protocol in grafted sockets compared to non-grafted sites. We followed a parallel study design with patients divided into two groups: grafted group (Test group, n = 10) and non-grafted group (Control, n = 10). A bioactive glass bone graft was used for grafting. A single edentulous site with a minimum bone height ≥11 mm and bone width ≥6 mm confirmed by cone-beam computerized tomography (CBCT) was chosen for implant placement. Tapered hybrid implants that were sandblasted and acid-etched (HSA) were placed using the GIS protocol and immediately loaded with a provisional prosthesis. MBL and implant survival rates (ISR) were assessed based on standardized radiographs and clinical exams. Patients were followed up for 1-year post-loading. MBL after one year, in the control group, was −0.31 ± 0.11 mm (mesial) and −0.28 ± 0.09 mm (distal); and in the test group was −0.35 ± 0.11 mm (mesial) and −0.33 ± 0.13 mm (distal), with no statistical significance (p > 0.05). ISR was 100% in both groups after one year. ISR was similar between groups and the marginal bone changes were comparable one year after functional loading, without statistical significance, suggesting that bioactive glass permitted adequate bone formation. The GIS protocol avoided raising flaps and provided a better position to place implants, preserving the marginal bone around implants.