Bioactive glass has been used in cranio-maxillofacial reconstruction especially on the repair.
of periodontal and alveolar ridge defects although its use is also extended for successful reconstruction of other areas of the head and neck. Bioactive glass has been utilized for the repair of orbital floor.
Acting as a resorbable framework in which bone cells can grow biologically active glasses are an important consideration when choosing the optimal biomaterial to be used as a bone substitute in craniomaxillofacial applications. Their bioactive properties allow for an osteoproductive environment in which the bone–biomaterial interface is uniquely stronger than it would be with other forms of alloplastic materials. A review of the present literature supports clinical applications of prefabricated implants made of B-G ceramics, as has been used in calvarial and midface bone reconstructions as well as for the repair of orbital floor fractures. Also, present experience with B-G in particulate form, preferably mixed with small amount of autogenous bone, support the convenience of this biomaterial over alternate forms of synthetic graft materials. This protocol has been highly successful for elevation of the maxillary sinus floor in preparation for titanium implant placement in the atrophic maxilla. A similar protocol may prove useful in reconstruction of other areas of the head and neck.
Preservation of the alveolar process after tooth extraction is desirable because it facilitates placement of endosseous implants and minimizes adverse esthetic results associated with fixed partial dentures. The purpose of this study was to evaluate the clinical effectiveness of bioactive glass used as a graft material combined with calcium sulphate used in the form of a mechanical barrier in preserving alveolar ridges after tooth extraction. Sixteen patients who required extraction of 2 anterior teeth or bicuspids participated in the study (split mouth design). After tooth extraction and elevation of a buccal full-thickness flap, experimental sockets were filled with bioactive glass, which in turn was covered with a layer of calcium sulphate. Control sites did not receive any graft or calcium sulphate. Titanium pins served as fixed reference points for measurements. No attempt was made to advance the flap to cover the socket areas on control or experimental sites (open socket approach). Re-entry surgeries were performed at 6 months. Re-entry surgeries showed that experimental sites presented with (1) significantly more internal socket bone fill (6.43 ± 2.78 mm vs 4.00 ± 2.33 mm on control sites), (2) less (although not statistically significantly less) resorption of alveolar bone height (0.38 ± 3.18 mm vs 1.00 ± 2.25 mm on control sites), and (3) similar degree of horizontal resorption of the alveolar bony ridge as compared with controls (3.48 ± 2.68 mm vs 3.06 ± 2.41 mm on control sites). This study suggests that treatment of extraction sockets with a combination of bioactive glass and calcium sulphate is of some benefit in preserving alveolar ridge dimensions after tooth extraction.
Camargo PM, Lekovic V, Weinlaender M, Klokkevold PR, Kenney EB, Dimitrijevic B, Nedic M, Jancovic S, Orsini M. Influence of bioactive glass on changes in alveolar process dimensions after exodontia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Nov;90(5):581-6. doi: 10.1067/moe.2000.110035. PMID: 11077380.
