Histopathologic Effects of Glass Ionomer Bone Cements Application to Maxillofacial Area: An Experimental Study in Rabbits

Can glass polyalkenoate (glass-ionomer) dental cements be considered bioactive? A review

Objectives

This paper reviews the chemical behaviour of glass polyalkenoate (glass-ionomer) dental cements, both conventional and resin-modified, in contact with natural tissues, with the aim of determining whether these materials can be considered to be bioactive.

Data

Relevant papers describing the behaviour of bioactive glasses and ceramics, and glass-ionomer (glass polyalkenoate) cements have been identified using PubMed and Science Direct. This has allowed a comparison to be made between the behaviour of glass-ionomers and the speciality glasses and ceramics that are widely classified as bioactive, a designation considered valid for over fifty years. More recent papers concerning bioactive metals and polymers have also been studied and both in vitro and in vivo studies are included.

Sources

Have included general papers on the chemistry and biological behaviour of bioactive glasses and ceramics, as well as papers on glass-ionomers dealing with (i) ion release, (ii) bonding to the surface of teeth, (iii) influence on surrounding pH and (iv) interaction with bone.

Conclusion

The literature shows that glass-ionomers (glass polyalkenoates) have three types of behaviour that are similar to those of bioactive glasses as follows: Formation of direct bonds to living tissue (teeth and bones) without fibrous capsule; release of biologically beneficial ions; and change of the local pH. However, in in vitro tests, they do not cause calcium phosphate to precipitate from solutions of simulated body fluid, SBF. Despite this, studies show that, in patients, glass-ionomers interact chemically with hard tissues and this suggests that may indeed be considered bioactive.

Bioceramics in ophthalmology

The benefits of ceramics in biomedical applications have been universally appreciated as they exhibit an extraordinarily broad set of physico-chemical, mechanical and biological properties which can be properly tailored by acting on their composition, porosity and surface texture to increase their versatility and suitability for targeted healthcare applications. Bioceramics have traditionally been used for the repair of hard tissues, such as bone and teeth, mainly due to their suitable strength for load-bearing applications, wear resistance (especially alumina, zirconia and composites thereof) and, in some cases, bone-bonding ability (calcium orthophosphates and bioactive glasses). Bioceramics have been also applied in other medical areas, like ophthalmic surgery; although their use in such a context has been scientifically documented since the late 1700s, the potential and importance of ceramic ocular implants still seem to be underestimated and an exhaustive, critical assessment is currently lacking in the relevant literature. The present review aims to fill this gap by giving a comprehensive picture of the ceramic-based materials and implants that are currently used in ophthalmology and pointing out the strengths and weaknesses of the existing devices. A prospect for future research is also provided, highlighting the potential of new, smart bioceramics able to carry specific added values which could have a significant impact on the treatment of ocular diseases.