No abstract

Calcium phosphates are among the most common biomaterials employed in orthopaedic and dental surgery. The efficacy of such systems as bone substitutes and bioactive coatings on metallic prostheses has been proved by several clinical studies. Among these materials, hydroxyapatite (HA) and tricalcium phosphate (TCP) play a prominent role in medical practice since the '80s. In the last years, numerous attempts to combine HA or TCP with bioactive glasses have been made. There are two main motivations for sintering calcium phosphates with a glassy phase: on the one hand, it is possible to tune the dissolution of the final system and to enhance its biological response through the synergistic combination of two bioactive phases; on the other hand, the glass acts as a sintering aid with the aim to increase the densification of the composite and thus its mechanical strength. In this sense, TCP and HA are penalized by their relatively poor fracture toughness and tensile strength compared to natural bone, which makes it impossible to use them in load-bearing applications. Moreover, the bioactivity index of pure calcium phosphates is typically lower with respect to that of many bioactive glasses. In this review, the state of the art and current applications of composites, based on HA or TCP with bioactive glass as second phase, are presented and discussed. A special emphasis is given to the processing and mechanical behaviour of these systems, together with their biological implications, as a function of the composition of the glass employed as second phase.

No abstract

Bioactive glasses, discovered by Hench and co-workers at the end of the 1960s, are among the most promising biomaterials for bone repair and reconstruction, mainly thanks to their high bioactivity index. Unfortunately, due to their brittleness and relatively poor mechanical properties, their clinical applications are limited to non-load bearing implants. However, bioactive glasses can be successfully employed as coatings on bioinert metallic substrates, in order to combine high bioactivity with mechanical strength. After a brief introduction to the main properties of biomaterials and bioactive glasses, the present paper provides an overview of the different approaches and available techniques to realise bioactive glass coatings, with a particular emphasis on thermal spray, which is nowadays one of the most popular coating procedures.

No abstract

Since the 1970s, various types of ceramic, glass and glass-ceramic materials have been proposed and used to replace damaged bone in many clinical applications. Among them, hydroxyapatite (HA) has been successfully employed thanks to its excellent biocompatibility. On the other hand, the bioactivity of HA and its reactivity with bone can be improved through the addition of proper amounts of bioactive glasses, thus obtaining HA-based composites. Unfortunately, high temperature treatments (1200°C÷1300°C) are usually required in order to sinter these systems, causing the bioactive glass to crystallize into a glass-ceramic and hence inhibiting the bioactivity of the resulting composite. In the present study novel HA-based composites are realized and discussed. The samples can be sintered at a relatively low temperature (800 °C), thanks to the employment of a new glass (BG_Ca) with a reduced tendency to crystallize compared to the widely used 45S5 Bioglass®. The rich glassy phase, which can be preserved during the thermal treatment, has excellent effects in terms of in vitro bioactivity; moreover, compared to composites based on 45S5 Bioglass® having the same HA/glass proportions, the samples based on BG_Ca displayed an earlier response in terms of cell proliferation.

a b s t r a c tHighly porous biocompatible composites made of polycaprolactone (PCL) and 45S5 Bioglass Ò (BG) were prepared by a solid-liquid phase separation method (SLPS). The composites were obtained with BG weight contents varying in the range 0-50%, using either dimethylcarbonate (DMC) or dioxane (DIOX) as solvent, and ethanol as extracting medium. The porosity of the scaffolds was estimated to be about 88-92%. Mechanical properties showed a dependence on the amount of BG in the composites, but also on the kind of solvent used for preparation, composites prepared with DIOX showing enhanced stress at deformation with respect to composites prepared with DMC (stress at 60% of deformation being as high as 214 ± 17 kPa for DIOX-prepared composites and 98 ± 24 kPa for DMC-prepared ones, with 50 wt/wt PCL % of glass), as well as higher elastic modulus (whose value was 251 ± 32 kPa for DIOX-prepared scaffolds and 156 ± 36 kPa for DMC-prepared ones, always with 50 wt/wt PCL % of glass). The ability of the composites to induce precipitation of hydroxyapatite was positively evaluated by means of immersion in simulated body fluid and the best results were achieved with high glass amounts (50 wt/wt PCL %). In vitro tests of cytotoxicity and osteoblast proliferation showed that, even if the scaffolds are to be considered non-cytotoxic, cells suffer from the scarce wettability of the composites.

The use of bioactive glasses in dentistry, reconstructive surgery, and in the treatment of infections can be considered broadly beneficial based on the emerging literature about the potential bioactivity and biocompatibility of these materials, particularly with reference to Bioglass® 45S5, BonAlive® and 19-93B3 bioactive glasses. Several investigations have been performed (i) to obtain bioactive glasses in different forms, such as bulk materials, powders, composites, and porous scaffolds and (ii) to investigate their possible applications in the biomedical field. Although in vivo studies in animals provide us with an initial insight into the biological performance of these systems and represent an unavoidable phase to be performed before clinical trials, only clinical studies can demonstrate the behavior of these materials in the complex physiological human environment. This paper aims to carefully review the main published investigations dealing with clinical trials in order to better understand the performance of bioactive glasses, evaluate challenges, and provide an essential source of information for the tailoring of their design in future applications. Finally, the paper highlights the need for further research and for specific studies intended to assess the effect of some specific dissolution products from bioactive glasses, focusing on their osteogenic and angiogenic potential.