Clinical and radiological outcomes of non-window-type bioactive glass-ceramic cage in single-level ACDF versus PEEK cage filled with autologous bone.

Bioactive glass-ceramic (BGC) cage is a substitute for polyether ether ketone (PEEK) cages in anterior cervical discectomy and fusion (ACDF). Only a few comparative studies exist using PEEK and non-window-type BGC cages (CaO-SiO2-P2O5-B2O3) in single-level ACDF. This study compared PEEK cages filled with autologous iliac bone grafts and BGC cages regarding clinical safety and effectiveness. A retrospective case series was performed on 40 patients who underwent single-level ACDF between October 2020 and July 2021 by a single orthopedic spine surgeon. The spacers used in each ACDF were a PEEK cage with a void filled with an autologous iliac bone graft and a non-window-type BGC cage in 20 cases. The grafts were compared pre-operatively and post-operatively at 6 weeks and 3, 6, and 12 months. Post-operative complications were investigated in each group. Clinical outcome was measured, including Visual Analog Scale (VAS) scores of neck and arm pains, Japanese Orthopedic Association score (JOA), and Neck Disability Index (NDI). Dynamic lateral radiographs were used to assess the inter-spinous motion (ISM) between the fusion segment and subsidence. The fusion status was evaluated using a computed tomography (CT) scan. Overall, 39 patients (19 and 20 patients in the PEEK and BGC groups, respectively) were recruited. Eighteen (94.7%) and 19 (95.0%) patients in the PEEK and BGC groups, respectively, were fused 12 months post-operatively, as assessed by ISM in dynamic lateral radiograph and bone bridging formation proven in CT scan. The PEEK and BGC groups showed substantial improvement in neck and arm VAS, JOA, and NDI scores. No substantial difference was found in clinical and radiological outcomes between the PEEK and BGC groups. However, the operation time was considerably shorter in the BGC group than in the PEEK group. In conclusion, a non-window-type BCG cage is a feasible substitute for a PEEK cage with an autologous iliac bone graft in single-level ACDF.

Efficacy of a novel dentifrice containing bioactive glass-ceramic for dentinal hypersensitivity: A double-blind randomized controlled trial in Chinese adults.

OBJECTIVE: To assess the efficacy and safety of a toothpaste containing 7.5 % HX-BGC in combating dentinal hypersensitivity. METHODS: A single-center, randomized, double-blind, three-group parallel-controlled design was employed, with Schiff Index and Yeaple Index as measurement indicators. The study evaluated the effectiveness of HX-BGC toothpaste, NovaMin toothpaste, and a negative control toothpaste without desensitizing agents. Eligible subjects underwent baseline examination after a 2-week washout period, and those meeting inclusion criteria and not meeting exclusion criteria entered the study. Participants were randomly assigned to use one of the three toothpastes. Follow-up examinations were conducted immediately after a single use and at 2, 4, and 6 weeks. Intra-group and inter-group comparisons were made for Schiff and Yeaple indices. Safety of the experimental toothpastes was assessed through participant feedbacks and oral soft tissue examinations. RESULTS: Subjects in the three groups were balanced in terms of age and gender distribution, with no baseline differences in indicators. Immediately after a single application of toothpaste, Yeaple indices increased, and Schiff indices decreased, with no significant differences among the groups. After 2 weeks of continuous use, Yeaple indices increased in all groups, with significant differences observed between the HX-BGC group and the other two groups. Schiff indices decreased in all groups, with the NovaMin group showing significant differences compared to the negative control group. At weeks 4 and 6, both indices in the HX-BGC group and the NovaMin group were significantly better than those in the negative control group, with the HX-BGC group outperforming the NovaMin group in the Yeaple index. No serious adverse reactions related to the study products were observed or reported by any participants. CLINICAL SIGNIFICANCE: This clinical trial confirmed the efficacy of HX-BGC in anti-dentinal hypersensitivity and supported the clinical application of the dentifrice containing HX-BGC. CONCLUSION: Compared to the negative control group, both HX-BGC and NovaMin toothpaste groups demonstrated more significant effects in combating dentinal hypersensitivity. No adverse reactions related to the experimental toothpastes were observed.

Effect of the use of bromelain associated with bioactive glass-ceramic on dentin/adhesive interface.

OBJECTIVES: To evaluate the effect of bromelain associated with Biosilicate on the bond strength (BS) of a universal adhesive system to sound (SD) and caries-affected dentin (CAD), and on the proteolytic activity. MATERIALS AND METHODS: Cavities were prepared in 360 molars, half submitted to cariogenic challenge. Teeth were separated into groups (n=20): Control-No treatment; CHX-0.12% chlorhexidine; NaOCl-5% sodium hypochlorite; Br5%-5% bromelain; Br10%-10% bromelain; Bio-10% Biosilicate; NaOClBio-NaOCl+Bio; Br5%Bio-Br5%+Bio; Br10%Bio-Br10%+Bio. Following treatments, the adhesive system was applied, and cavities were restored. Samples were sectioned into sticks and stored at 37 °C for 24 h, 6 months, and 1 year. Microtensile BS (2-way ANOVA, Bonferroni's test, α=0.05), fracture patterns (SEM), and adhesive interfaces (TEM) were evaluated. Bacterial collagenase assay and in situ zymography were performed. RESULTS: In CAD, Br10% presented higher BS (p=0.0208) than Br5%Bio. Br5% presented higher BS (p=0.0033) after 6 months than after 24 h; and association of treatments, higher BS (p<0.05) after aging than after 24 h. Mixed fractures were the most prevalent. Association of treatments promoted a more uniform hybrid layer with embedded Bio particles. Experimental groups presented lower (p<0.0001) relative fluorescence units than Control. Bromelain, associated or not with Bio, showed collagenolytic degradation. CONCLUSIONS: Bromelain associated with Biosilicate did not affect the BS to SD. In CAD, Br5%Bio decreased immediate BS but had no long-term influence. This association decreased the proteolytic activity. CLINICAL RELEVANCE: Bromelain and Biosilicate may enhance the longevity of adhesive restorations by inhibiting endogenous proteases.

Efficacy of Allograft Versus Bioactive Glass-Ceramic Cage in Anterior Cervical Discectomy and Fusion: A Randomized Controlled Study.

STUDY DESIGN: A randomized controlled trial. OBJECTIVE: The aim of this study is to compare the efficacy of allografts and bioactive glass-ceramic (BG) cages for anterior cervical discectomy and fusion (ACDF) in treating cervical degenerative disc disease. METHODS: We conducted a single-center, randomized controlled trial between August 2017 and August 2022. Participants were randomized into two groups, and consecutive patients requiring ACDF were randomly assigned to receive either the allograft cage or the BG cage. The surgical outcomes measured included pain levels, neck disability, surgical details, and radiological assessments. RESULTS: Of the 45 assessed, 40 participants were included, with 18 in the allograft cage group and 22 in the BG cage group. By the 12-month follow-up, both groups exhibited significant improvements in pain levels and disability scores, with no notable intergroup differences. Over 85% of patients in both groups were satisfied with their outcomes. Radiological assessments revealed stability in the cervical spine with both cage types post intervention. Although both materials showed a trend toward increased subsidence over time, the difference between them was not statistically significant. Fusion rates were comparable between the groups at 12 months, with BG cage showing a slightly higher early fusion rate at 6 months. No significant differences were observed between the two groups in terms of complications. CONCLUSIONS: Both allograft and BG cages are effective in ACDF surgeries for cervical degenerative disc disease, with both contributing to substantial postoperative improvements. Differences in disc height, interspinous motion, and subsidence were not significant in the last follow-up, indicating both materials' suitability for clinical use. Future research with a larger cohort and longer follow-up is needed to confirm these preliminary findings.

Long-term results comparison after anterior cervical discectomy with BGS-7 spacer (NOVOMAX®-C) and allograft spacer: A prospective observational study.

Introduction: In an anterior cervical discectomy and fusion (ACDF), various types of graft materials including autograft, allograft, and synthetic graft have been used to achieve adequate spinal fusion. Allograft spacer is mainly used in cervical fusion, especially in the anterior approach. The synthetic bone graft material BGS-7(CaO-SiO2-P2O5-B2O3, bioactive Glass-Ceramics) can bind with surrounding bone tissue by forming a hydroxyapatite layer bone bridge, leading to faster graft osseointegration. This study was conducted to compare long-term clinical outcome of BGS-7 spacer and allograft spacer for anterior cervical discectomy and fusion surgery. Materials and Methods: From September 2014 to December 2016, Consecutive anterior cervical discectomy and fusion surgeries using a BGS-7 spacer (N = 18) and Allograft spacer (N = 26) were compared for postoperative clinical outcomes. Radiologic assessments were performed, and Instrumental failure, including breakage, cage migration, subsidence were observed and Fusion status were analyzed. Finite element analysis was performed for simulating mechanical stress between the vertebral body and implant. Clinical outcomes were evaluated using neck VAS, NDI, and JOA on the patient's final follow-up visits. Results: Among the 44 patients who underwent an anterior cervical discectomy and fusion surgery using the BGS-7 spacer and Allograft spacer, there were 30 men and 14 women. The average age at the operation was 47.69 ± 10.49 in allograft spacer and 51.67 ± 11.03 in BGS-7 spacer. The mean follow-up period was 89.18 ± 5.44 months. Twenty three (88.46%) patients in allograft spacer and 20(100%) patients in BGS-7 spacer were demonstrated radiologic evidence of interbody fusion in last OPD, which accounts for fusion grade 4 or 5. Peak stresses were 343.85 MPa in allograft spacer, and 132.55 MPa in BGS-7 spacer. Long-term clinical outcomes including neck VAS, NDI, and JOA didn't show statistical differences between the two groups. There were no adverse events related to the BGS-7 spacer.10.3389/fbioe.2023.110046. Conclusion: The BGS-7 spacer demonstrated reliability as a spacer in anterior cervical discectomy and fusionF surgery without instrumental failure. Early stabilization with a bony bridge formation was observed at the intermediate follow-up period, and the long-term clinical outcome was favorable at more than 60 months after surgery without any adverse events. Thus, the BGS-7 spacer is a safe and effective alternative to the allograft spacer in anterior cervical discectomy and fusion surgery.

Subsidence Performance of the Bioactive Glass-Ceramic (CaO-SiO2-P2O5-B2O3) Spacer in Terms of Modulus of Elasticity and Contact Area: Mechanical Test and Finite Element Analysis.

OBJECTIVE: The objective of this study is to evaluate the subsidence performance of a bioactive glass-ceramic (CaO-SiO2-P2O5-B2O3) spacer in terms of its modulus of elasticity and contact area using mechanical tests and finite element analysis. METHODS: Three spacer three-dimensional models (Polyether ether ketone [PEEK]-C: PEEK spacer with a small contact area; PEEK-NF: PEEK spacer with a large contact area; and Bioactive glass [BGS]-NF: bioactive glass-ceramic spacer with a large contact area) are constructed and placed between bone blocks for compression analysis. The stress distribution, peak von Mises stress, and reaction force generated in the bone block are predicted by applying a compressive load. Subsidence tests are conducted for three spacer models in accordance with ASTM F2267. Three types of blocks measuring 8, 10, and 15 pounds per cubic foot are used to account for the various bone qualities of patients. A statistical analysis of the results is conducted using a one-way Analysis of variance and post hoc analysis (Tukey's Honestly Significant Difference) by measuring the stiffness and yield load. RESULTS: The stress distribution, peak von Mises stress, and reaction force predicted via the finite element analysis are the highest for PEEK-C, whereas they are similar for PEEK-NF and BGS-NF. Results of mechanical tests show that the stiffness and yield load of PEEK-C are the lowest, whereas those of PEEK-NF and BGS-NF are similar. CONCLUSIONS: The main factor affecting subsidence performance is the contact area. Therefore, bioactive glass-ceramic spacers exhibit a larger contact area and better subsidence performance than conventional spacers.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion

Abstract This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Resumo Este estudo avaliou o efeito da Fitoesfingosina (PHS) e da vitrocerâmica bioativa (Biosilicato) sobre o esmalte dental em termos de alteração de cor (ΔE), microdureza (KHN) e rugosidade superficial, quando submetido a desafio erosivo (DE). Sessenta espécimes de dentes bovinos (6×6×2mm) foram obtidos. Foram realizadas leituras de cor inicial (Easyshade, VITA), microdureza (HMV-2, Shimadzu) e rugosidade superfícial (SJ-201P, Mitutoyo). Os espécimes foram separados em grupos de acordo com os tratamentos: PHS, Biosilicato a 10%, PHS+Biosilicato a 10%, e saliva artificial (controle). Em seguida, foram submetidos a DE com Coca-Cola por 2 min. Esse ciclo foi repetido 4 vezes/dia por 15 dias. Entre os ciclos, as amostras foram mantidas em saliva artificial (2 h/37°C). Após os ciclos diários, os espécimes também foram armazenados em saliva artificial a 37ºC. Foram realizadas leituras finais de cor, microdureza e rugosidade superficial. Os dados de cor e microdureza foram analisados ​​por ANOVA de uma via, teste de Tukey; e dados de rugosidade superficial, por ANOVA de duas vias, teste de Tukey (p<.05). A maior ΔE ocorreu em Saliva+DE (p<.05). Grupos tratados com PHS apresentaram menor alteração de cor do que Saliva+DE (p<.05). Biosilicate+DE demonstrou valores intermediários, similar (p>.05) aos outros grupos, exceto Saliva+DE. Todos os grupos presentaram média acima dos limites 50:50% de perceptibilidade (50:50%LP) e aceitabilidade (50:50%LA) exceto o controle que demonstrou média acima do 50:50%LA mas abaixo do 50:50%LP. Biosilicate+DE mostrou maior microdureza realativa do que Saliva+DE (p<.05), mas similar a PHS+DE e PHS+Biosilicato+DE. A rugosidade de superfície do esmalte aumentou para todos os grupos, exceto para o controle que presentou a menor alteração (p<.05). O Biosilicato apode prevenir perda mineral do esmalte indizido pela erosão melhor que a saliva. O PHS associado ou não ao Biosilicato demonstrou melhor estabilidade de cor que a saliva.

Long-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants and highly cross-linked polyethylene: A minimum 10-year analysis.

BACKGROUND: Cementless glass ceramics containing apatite and wollastonite (AW-GC) bottom-coated titanium hip implants were developed; early excellent clinical and radiographic results have been reported previously. This study aimed to investigate the long-term clinical and radiographic outcomes in detail, and the wear rate of HXLPE. METHODS: We retrospectively evaluated 99 patients (117 hips) between November 2001 and December 2007. The survival rate was estimated using the Kaplan-Meier method. Hip joint function was evaluated using the Japanese Orthopaedic Association (JOA) score. The extent of radiographic signs was determined from the radiographs performed at the last follow-up. Polyethylene wear was measured using Martell's Hip Analysis Suite. We assessed the possible factors affecting the steady-state linear wear rate. RESULTS: The mean follow-up period was 14.8 ± 2.1 (10-18.6) years. The mean JOA score improved to 88.7 ± 9.4 (59-100) at the final follow-up from 47.8 ± 12.5 (17-76) before surgery. The overall survival rate with the end point of all-cause revision and wear-related revision was 99% and 100% respectively. There was no osteolysis or loosening of either the acetabular or femoral component. All hips were classified as having bone ingrowth fixation. The mean steady-state wear rate was 0.008 ± 0.025 mm/year. We found no significant correlation between the wear rate and age, body weight, body mass index, cup inclination and femoral head size. CONCLUSION: The combination of AW-GC bottom-coated implants and HXLPE showed excellent implant survival and wear resistance for 15 years.

Feasibility and safety of a CaO-SiO2-P2O5-B2O3 bioactive glass ceramic spacer in posterior lumbar interbody fusion compared with polyetheretherketone cage: a prospective randomized controlled trial.

PURPOSE: The CaO-SiO2-P2O5-B2O3 glass-ceramic (BGS-7) spacer is a recently developed spacer that shows chemical bonding to bone with high mechanical stability. Further, this spacer achieves similar results to those of titanium cages. However, evidence regarding the advantages of the BGS-7 spacer is weak compared to polyetheretherketone (PEEK) cage. A randomized controlled trial is therefore warranted. The purpose of this study was to compare the radiographic and clinical efficacies and safety of the BGS-7 spacer compared to those of the PEEK cage in patients who underwent posterior lumbar interbody fusion (PLIF). METHODS: The 54 participants who required one- or two-level PLIF due to lumbar degenerative disorders were randomly assigned to receive a BGS-7 spacer or PEEK cage. Visual analog scale (VAS), Oswestry Disability Index (ODI), European Quality of Life-5 Dimensions (EQ-5D), and painDETECT score were evaluated before surgery and at 3, 6, and 12 months after surgery. The fusion rate, degree of osteolysis, cage migration, and subsidence around the cage (spacer) were evaluated on computer tomography (CT) images at 12 months after surgery. RESULTS: The 12-month fusion rates were 77.8% in the BGS-7 spacer group and 81.0% in the PEEK cage group, with no significant difference (p = 0.807). The result regarding the non-inferiority of BGS-7 spacer was inconclusive. The linear mixed model showed no significant intervention effect in VAS, ODI, EQ-5D, and painDETECT score at the 3-, 6-, or 12-month follow-up. In addition, we found no significant between-group differences in the extent of osteolysis, spacer migration. However, the subsidence around the cage was significantly lower in the BGS-7 spacer group. CONCLUSIONS: This trial found similar fusion rates, and clinicoradiographic outcomes between the BGS-7 spacer and PEEK cage for PLIF. However, the non-inferiority was inconclusive. Safety concerns regarding fracture and migration of the BGS-7 spacer must be considered. Thus, the BGS-7 spacer design for PLIF surgery should be modified before further clinical use.

Bioactive fluorcanasite reinforced magnesium alloy-based porous bio-nanocomposite scaffolds with tunable mechanical properties.

Magnesium (Mg) alloy-based porous bio-nanocomposite bone scaffolds were developed by powder metallurgy route. Selective alloying elements such as calcium (Ca), zinc (Zn) and strontium (Sr) were incorporated to tune the mechanical integrity while, bioactive fluorcanasite nano-particulates were introduced within the alloy system to enhance the bone tissue regeneration. Green compacts containing carbamide were fabricated and sintered using two-stage heat treatment process to achieve the targeted porosities. The microstructure of these fabricated magnesium alloy-based bio-nanocomposites was examined by Field emission scanning electron microscope (FE-SEM) and x-ray micro computed tomography (x-ray µCT), which revealed gradient porosities and distribution of alloying elements. X-ray diffraction (XRD) studies confirmed the presence of major crystalline phases in the fabricated samples and the evolution of the various combinations of intermetallic phases of Ca, Mg, Zn and Sr which were anticipated to enhance the mechanical properties. Further, XRD studies revealed the presence of apatite phase for the immersed samples, a conducive environment for bone regeneration. The fabricated samples were evaluated for their mechanical performance against uniaxial compression load. The tunability of compressive strengths and modulus values could be established with variation in porosities of fabricated samples. The retained compressive strength and Young's modulus of the samples following immersion in phosphate buffered saline (PBS) solution was found to be in line with that of natural human cancellous bone, thereby establishing the potential of the fabricated magnesium-alloy-based nanocomposite as a promising scaffold candidate for bone tissue engineering.

Effect of Incorporation of Bioactive Glass-Ceramic into Self-etch Adhesives.

PURPOSE: This study evaluated the effect of incorporating different concentrations of biosilicate in an experimental self-etch adhesive (SE). MATERIALS AND METHODS: Biosilicate microparticles (0, 2, 5, and 10 wt%) were incorporated into the primer, and degree of conversion (DC) and wettability were tested (one-way ANOVA, Tukey's test, p < 0.05). The two best concentrations were selected (2% and 5%) for µTBS evaluation. Sound human molars (n=20) were sectioned into quarters and randomly assigned to 4 experimental groups: 1. experimental SE + 0% biosilicate (Exp0%; negative control); 2. experimental SE + 2% biosilicate (Exp2%); 3. experimental SE + 5% biosilicate (Exp5%); 4. AdheSE (Ivoclar Vivadent, positive control). After adhesive application, Filtek Z350 (3M Oral Care) composite was built up incrementally to 5 mm. Each quarter tooth was sectioned into sticks (0.9 mm2) and stored in distilled water (37°C) for 24 h, 6 months, or 1 year. After storage, sticks were submitted to µTBS (0.75 mm/min). The Ca:P ratio was analyzed using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). Data were analyzed using two-way ANOVA with Bonferroni's correction, with statistical siginificance set at p < 0.05. Fracture patterns were observed under a digital microscope and adhesive interfaces with transmission electron microscopy (TEM). RESULTS: Exp2% presented the highest DC (p < 0.05), Exp5% exhibited the lowest µTBS (p < 0.05), and adhesive failures were predominant in all groups. TEM suggested remineralized areas in Exp2% and to a lesser degree in Exp5%. Exp2% and Exp5% showed a higher Ca:P ratio after aging (p < 0.05). CONCLUSION: The incorporation of biosilicate microparticles can improve the properties of self-etch adhesives. It increased the DC of the experimental adhesive as well as mineral deposition. However, the adhesive properties are concentration dependent, as a higher concentration of microparticles can adversely affect the mechanical properties of an adhesive.

Role of molybdenum in material immunomodulation and periodontal wound healing: Targeting immunometabolism and mitochondrial function for macrophage modulation.

Recently, strategies that can target the underlying mechanisms of phenotype change to modulate the macrophage immune response from the standpoint of biological science have attracted increasing attention in the field of biomaterials. In this study, we printed a molybdenum-containing bioactive glass ceramic (Mo-BGC) scaffold as an immunomodulatory material. In a clinically relevant critical-size periodontal defect model, the defect-matched scaffold featured robust immunomodulatory activity, enabling long-term stable macrophage modulation and leading to enhanced regeneration of multiple periodontal tissues in canines. Further studies demonstrated that the regeneration-enhancing function of Mo-BGC scaffold was macrophage-dependent by using canines with host macrophage depletion. To investigate the role of Mo in material immunomodulation, in vitro investigations were performed and revealed that Mo-BGC powder extract, similar to MoO42--containing medium, induced M2 polarization by enhancing the mitochondrial function of macrophages and promoted a cell metabolic shift from glycolysis toward mitochondrial oxidative phosphorylation. Our findings demonstrate for the first time an immunomodulatory role of a Mo-containing material in the dynamic cascade of wound healing. By targeting the immunometabolism and mitochondrial function of macrophages, Mo-mediated immunomodulation provides new avenues for future material design in the field of tissue engineering and regenerative medicine.

Biological and bioactivity assessment of dextran nanocomposite hydrogel for bone regeneration.

Insufficient biological and bioactive properties of dextran hydrogels limit their applications as promising scaffolds for tissue engineering. We developed nanocomposite dextran hydrogels comprised of bioactive glass (nBGC: 64% SiO2, 31% CaO, 5% P2O5) nanoparticles with an average particle size of 77 nm using a chemical crosslinking of dextran chains to form 3D hydrogel networks. In the current study; bioactivity of the obtained nanocomposite hydrogels was evaluated through the formation of apatite crystal structures after the incubation in simulated body fluid (SBF) at various submersion periods and nBGC content. The scanning electron microscopy (SEM) micrographs represented an enhanced hydroxyapatite formation on the cross section of nanocomposite comprising of nBGC content from 2 to 8 (% by wt). Biomineralization results of Dex-8 (% by wt) composite during 7, 14 and 28 days immersion indicated the apatite layer formation and the growth of apatite crystal size on the surface and cross section of the nanocomposite. Moreover, MTT assessments indicated that human osteosarcoma cells (SaOS-2) were able to adhere and spread within the dextran hydrogels reinforced with the bioactive glass nanoparticles. With regard to enhanced bioactivity and biocompatibility, the developed dextran-nBGC hydrogel could be considered as a suitable candidate for bone tissue engineering application.

Optimizing the microstructure of a new machinable bioactive glass-ceramic.

OBJECTIVES: This study aimed to optimize the crystallization process and the microstructure of a new bioactive glass-ceramic (GC) previously developed by our research group to obtain machinable glass-ceramics. METHODS: Differential scanning calorimetry (DSC) analyses were conducted to explore the characteristic temperatures and construct a semi-quantitative nucleation curve. The GC specimens were characterized by X-ray diffraction (XRD) and Rietveld refinement. Their brittleness index (B) and machinability were characterized and compared with IPS e.max-CAD®. Their Young's modulus, fracture toughness, and hardness were assessed. RESULTS: We found that the maximum crystal nucleation rate temperature of this GC is ~470 °C. Treatments were designed based on the 1st DSC peak onset (570 °C), 1st peak offset (650 °C), and 2nd peak offset (705 °C) crystallization temperatures of lithium metasilicate (LS, LiSi2O3) and lithium disilicate (LS2, Li2Si2O5). Rietveld refinement indicated an increase in LS2 and a reduction in LS and amorphous phase for increased temperatures and longer treatment times. Their B values indicate good machinability compared with that of the control group based on statistical analyses. As expected, lower levels of LS2 increase the machinability regardless of the rotation speed adopted, leading to a greater depth of cut and reduced Edge Chipping Damage Depth (ECDD). CONCLUSION: This bioactive GC with optimized microstructure presents high machinability. For treatment temperatures above 570 °C, the number of elongated LS2 crystals increases and decreases the amorphous phase content, which reduce the machinability of the GC, and should therefore be avoided. The best results were obtained using heat treatment at 570 °C, which produces LS crystals embedded in a glassy matrix (67%) with small contents of secondary phases.

New sol-gel-derived magnetic bioactive glass-ceramics containing superparamagnetic hematite nanocrystals for hyperthermia application.

Although the three main phases of iron oxide - hematite, maghemite, and magnetite - exhibit superparamagnetic properties at the nanoscale, only maghemite and magnetite phases have been explored in magnetic bioactive glass-ceramics aimed at applications in cancer treatment by hyperthermia. In this work, it is reported for the first time the superparamagnetic properties of hematite nanocrystals grown in a 58S bioactive glass matrix derived from sol-gel synthesis. The glass-ceramics are based on the (100-x)(58SiO2-33CaO-9P2O5)-xFe2O3 system (x = 10, 20 and 30 wt%). A thermal treatment leads to the growth of hematite (α-Fe2O3) nanocrystals, conferring superparamagnetic properties to the glass-ceramics, which is enough to produce heat under an external alternating magnetic field. Besides, the crystallization does not inhibit materials bioactivity, evidenced by the formation of calcium phosphate onto the glass-ceramic surface upon soaking in simulated body fluid. Moreover, their cytotoxicity is similar to other magnetic bioactive glass-ceramics reported in the literature. Finally, these results suggest that hematite nanocrystals' superparamagnetic properties may be explored in multifunctional glass-ceramics applied in bone cancer treatment by hyperthermia allied to bone regeneration.

Effect of natural primer associated to bioactive glass-ceramic on adhesive/dentin interface.

OBJECTIVES: This study evaluated the effect of propolis associated with Biosilicate on the bond strength (BS) and gelatinolytic activity at the adhesive/dentin interface. METHODS: Occlusal cavities were prepared in 320 human molars. Half of them were submitted to cariogenic challenge. All the teeth were separated into eight groups (n = 20): Control - Adhesive System (Single Bond Universal, 3 MESPE); CHX - 0.12 % Chlorhexidine; Bio - 10 % Biosilicate; P16 - Propolis with low levels of polyphenols; P45 - Propolis with high levels of polyphenols; CHX Bio - CHX + Bio; P16 Bio - P16+Bio; P45 Bio - P45+Bio. The adhesive was applied (self-etch mode) after treatments. Restorations (Filtek Z350, 3 MESPE) were performed and samples sectioned into sticks, separated and stored in distilled water at 37 °C for 24 h, 6 months and 1 year. Microtensile BS (0.5 mm/min) was tested and analyzed (2-way ANOVA, Bonferroni's Test, p < .05 and Weibull analysis). Fracture patterns (VH-M100, Keyence) and adhesive interfaces (SEM, EVO-MA10, ZEISS and TEM, JEM-1010, JEOL) were observed; and biodegradation and in situ zymography performed. RESULTS: P16 presented the highest BS values on sound dentin after 6 months. In caries-affected dentin (CAD), the association of treatments promoted the highest BS after 24 h. Sound dentin obtained significantly higher Weibull modulus than CAD. SEM displayed resin tags in P16, P45 and association of treatments. TEM showed good interaction between adhesive and dentin. According to the in situ zymography and biodegradation assay all natural primers reduced the gelatinolytic activity. P45 presented the lowest biodegradation and enzymatic activity. CONCLUSIONS: Propolis and the association of treatments promoted the highest bond strength results and preserved the dentin. All the experimental groups exhibited low gelatinolytic activity. CLINICAL SIGNIFICANCE: Propolis and the association of treatments with Biosilicate could preserve the dentin substrate and improve the longevity of composite restorations.

3D printed bioactive and antibacterial silicate glass-ceramic scaffold by fused filament fabrication.

The fused filament fabrication (FFF) technique was applied for the first time to fabricate novel 3D printed silicate bioactive and antibacterial Ag-doped glass-ceramic (Ag-BG) scaffolds. A novel filament consisting primarily of polyolefin and Ag-BG micro-sized particles was developed and its thermal properties characterized by thermogravimetric analysis (TGA) to define the optimum heat treatment with minimal macrostructural deformation during thermal debinding and sintering. Structural characteristics of the Ag-BG scaffolds were evaluated from macro- to nanoscale using microscopic and spectroscopic techniques. The compressive strength of the Ag-BG scaffolds was found to be in the range of cancellous bone. Bioactivity of the 3D printed Ag-BG scaffolds was evaluated in vitro through immersion in simulated body fluid (SBF) and correlated to the formation of an apatite-like phase. Methicillin-resistant Staphylococcus aureus (MRSA) inoculated with the Ag-BG scaffolds exhibited a significant decrease in viability underscoring a potent anti-MRSA effect. This study demonstrates the potential of the FFF technique for the fabrication of bioactive 3D silicate scaffolds with promising characteristics for orthopedic applications.

Phosphate/oxyfluorophosphate glass crystallization and its impact on dissolution and cytotoxicity.

The role of fluorine in bioactive glasses is of interest due to the potential of precipitating fluorapatite, a phase with higher chemical resistance than the typical hydroxyapatite precipitated from oxide bioactive glasses. However, the introduction of fluorine in silicate bioactive glasses was found deleterious to the bioactivity of the glass. Here, phosphate glasses with the composition 75NaPO3-(25-x) CaO-xCaF2 (in mol%), with x = 0-20 and glass-ceramics were investigated to evaluate their potential as substitutes to the traditional silicate bioactive glass. An increase in CaF2 substitution for CaO led to an increase in the glass solubility, due to an increase in highly soluble F(M)n species (where M is a cation) and to an increased polymerization of the phosphate network. Structural analysis reveals the formation of FP bonds, in addition to the F(M)n species, in the glass with the higher CaF2 content. Furthermore, with heat treatment, CaF2 crystals precipitate within the bulk in the newly developed glass, when x = 20. This bulk crystallization reduces the glass dissolution without compromising the precipitation of a reactive layer at the glass surface. Finally, in vitro cell tests were performed using MC3T3 pre-osteoblastic cells. While the substitution of CaF2 for CaO led to an increased cytotoxicity, the controlled crystallization of the fluorine containing glasses decreased such cytotoxicity to similar values than traditional bioactive phosphate glass (x0). This study reports on new oxyfluorophosphate glass and glass-ceramics able, not only, to precipitate a Ca-P reactive layer but also to be processed into glass-ceramics with controlled crystal size, density and cellular activity. STATEMENT OF SIGNIFICANCE: Uncontrolled crystallization of bioactive glasses has negative effect on the materials' bioactivity. While in silicate glass the bioactivity is solely reduced, in phosphate glasses it is often completely suppressed. Furthermore, the need for fluorine containing bioactive glasses, not only for use in bone reconstruction but also in toothpaste as emerged. The addition of F in both silicate and phosphate has led to challenges due the lack of Si-F or P-F bonds, generally leading to a decrease in bioactivity. Here, we developed a bioactive invert phosphate glass where up to 20 mol% of CaO was replaced with CaF2. In the new developed glasses, NMR demonstrated formation of P-F bonds. The content of fluorine was tailored to induce CaF2 bulk crystallization. Overall an increase in F was associated with an increase network connectivity. In turns it led to an increased dissolution rate which was linked to a higher cytotoxicity. Upon (partial to full) surface crystallization of the F-free glass, the bioactivity (ability to form a reactive layer) was loss and the cytotoxicity again increased due to the rapid dissolution of one crystal phase and of the remaining amorphous phase. On another hand, the controlled bulk precipitation of CaF2 crystals, in the F-containing glass, was associated with a reduced cytotoxicity. The new oxyfluorophosphate glass-ceramic developed is promising for application in the biomedical field.

Effect of Sintering Temperature of Bioactive Glass Nanoceramics on the Hemolytic Activity and Oxidative Stress Biomarkers in Erythrocytes.

INTRODUCTION: The nature of the surface is critical in determining the biological activity of silica powders. A novel correlation between toxicity and surface properties of bioactive glass ceramics (BGCs) synthesized via the sol-gel method was attempted in this study. METHODS: The behavior of BGCs after their attachment to the surface of red blood cells (RBCs) was evaluated and their toxic effects were determined based on hemolysis, membrane injury via anti-phosphotyrosine immunoblot of Band 3, lipid peroxidation, potential to generate reactive oxygen species, and antioxidant enzyme production. In particular, three BGCs were synthesized and treated at three sintering temperatures (T1 = 835 °C, T2 = 1000 °C and T3 = 1100 °C) to investigate possible relation between surface charge or structure and hemolytic potential. RESULTS: Their toxicity based on hemolysis was dose dependent, while BGC-T2 had the best hemocompatibility in compare with the other BGCs.No BGCs in dosages lower than 0.125 mg/mL could damage erythrocytes. On the other hand, all BGCs promoted the production of reactive oxygen species in certain concentrations, with the BGC-T2 producing the lowest ROS and increasing the glutathione levels in RBCs protecting their damage. CONCLUSIONS: The results suggest that various factors such as size, a probable different proportion of surface silanols, a balanced mechanism between calcium and magnesium cellular uptake or the different crystalline nature may have contributed to this finding; however, future research is needed to clarify the underlying mechanisms.

Feasibility of CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramic Cage in Anterior Cervical Diskectomy and Fusion.

BACKGROUND: CaO-SiO2-P2O5-B2O3 bioactive glass ceramic (BGC) is known to chemically bond with bones by forming a hydroxyapatite layer and inducing osteoblastic differentiation. This study was conducted to compare the clinical outcomes, radiographic outcomes, and safety of a CaO-SiO2-P2O5-B2O3 BGC cage in anterior cervical diskectomy and fusion (ACDF) with those of an allograft interbody spacer. METHODS: A total of 63 patients who underwent 2-level ACDF to treat degenerative cervical radiculopathy/myelopathy were reviewed. Results from 26 patients who were recruited prospectively using CaO-SiO2-P2O5-B2O3 BGC as a cage material (BGC group) were compared with a historical control group of 37 patients who underwent surgery using an allograft (allograft group). Fusion rates, subsidence, and adjacent segment degeneration were compared between the groups. Demographic data, fusion rates, visual analog scale (VAS) scores for neck or arm pain, Neck Disability Index (NDI) scores, and complications were also compared. RESULTS: Fusion rates were 88.5% when assessed by interspinous motion and 92.3% when assessed by intragraft bone bridging in the BGC group at 12-month follow-up. The neck pain or arm pain VAS scores and NDI scores significantly improved in both groups. No material-related complications were observed in the BGC group, such as graft resorption and breakage. Fusion rates, subsidence, neck pain or arm pain VAS scores, and NDI scores did not significantly differ between the BGC and allograft groups. CONCLUSIONS: CaO-SiO2-P2O5-B2O3 BGC cage was effective and safe when used in ACDF, conferring a high fusion rate and favorable clinical outcomes similar to those of the allograft.