Particulate Bioglass Compared With Hydroxyapatite as a Bone Graft Substitute

TLDR

Bioactive ceramics, especially hydroxyapatite, are clinically used for bone augmentation, yet particulate forms show variable success. The study compares 45S5 Bioglass with hydroxyapatite in an animal model to determine if Bioglass can overcome hydroxyapatite’s major disadvantages. Bioglass is easy to manipulate, hemostatic, and fully resorbs, avoiding the placement difficulties and composite‑formation problems that limit hydroxyapatite. Bioglass achieved complete bone restoration in 2 weeks, compared to 12 weeks for hydroxyapatite, offering a clinically advantageous rapid response.

Abstract

Bioactive ceramics, notably hydroxyapatite, have been used clinically in various situations in which bone augmentation and restoration are required. Particulate material has been used either alone or in conjunction with freeze dried or autologous bone, with variable clinical success. In this study a bioactive glass, 45S5 Bioglass, has been compared with hydroxyapatite in an animal model to discover whether the 2 major disadvantages of hydroxyapatite may be overcome. These are the difficulty of placing and retaining the particulate in the defect and the length of time needed before full bony restoration is achieved. Bioglass is shown to be easy to manipulate and hemostatic and allows full restoration of bone in 2 weeks, rather than the 12 weeks needed for the particulate hydroxyapatite to produce a comparable response. The Bioglass particulate is used up in the process, and any problems that may be associated with the production of a composite of bone and biomaterial are avoided in the fully restored bone. In any procedure that requires bony augmentation, this rapid response to Bioglass is expected to provide a clinical advantage.