Amplitude of movements with conical or spherical implants in anophthalmic socket.

PURPOSE: To evaluate the amplitude of movement in anophthalmic sockets reconstructed with conical or spherical orbital implants with and without an external ocular prosthesis (EOP), and whether the fornix depth could play a role. METHODS: Prospective observational study involving unilateral anophthalmic sockets evaluated the amplitude of movement with conical (20 subjects) or spherical (16) non-porous orbital implants, with and without an EOP, having the contralateral eye as the control group. Standardized photographs were obtained in the four gaze directions and measurements were performed using the Image J software. The upper and lower fornix depths were measured using rulers. RESULTS: Compared to the contralateral eye, the median movement amplitude without EOP was smaller with conical implants in supraduction (-0.88 mm, p=0.008), abduction (-2.26 mm, p<0.001) and adduction (-0.91 mm, p=0.008). Spherical implants had reduced movement only in abduction (-2.63 mm, p<0.001). Conical and spherical implants had similar amplitudes of movement in all versions, and were always smaller compared to the control. The median movement amplitude with the EOP was -3.05 mm (p=0.001) than without the EOP in abduction and -2.07 mm (p=0.020) in adduction, regardless of implant format. The fornix depth did not affect the orbital implants or EOP movement amplitude's median. CONCLUSION: Conical and spherical implants provide similar amplitude of movement and fornix depth did not have an influence on it. The amplitude of movement was significantly limited compared to the contralateral eye and was even more reduced if the EOP was in place with conical or spherical implant formats.

Conical Biosilicate Implant for Volume Augmentation in Anophthalmic Sockets.

The ideal implant for anophthalmic socket reconstruction has yet to be developed. Biosilicate, a highly bioactive glass-ceramic, has been used in the composition of conical implants, which were initially tested in rabbit orbits with excellent results. However, the use of this material and the conical shape of the implants require further study in the human anophthalmic socket. Thus, we propose the use of a new conical implant composed of Biosilicate for orbital volume augmentation in anophthalmic sockets. This prospective, randomized study included 45 patients receiving conical implants composed of either Biosilicate or polymethylmethacrylate (control). Patients were evaluated clinically before and 7, 30, 60, 120, and 180 days after implantation. Systemic evaluations, laboratory tests, and computed tomography of the orbits were performed preoperatively and 180 days postoperatively. Both groups had good outcomes with no significant infectious or inflammatory processes. Only 1 patient, in the Biosilicate group, had early implant extrusion. Laboratory tests were normal in both groups. Computed tomography scans showed that the implants in both groups were well positioned. The new conical implant composed of Biosilicate was successfully used for anophthalmic socket reconstruction. This implant may provide a good alternative to the only conical implant currently available on the market, which is composed of porous polyethylene.

Bioactivity and cytotoxicity of glass and glass-ceramics based on the 3CaO·P2O5--SiO2--MgO system.

The mechanical strength of bioactive glasses can be improved by controlled crystallization, turning its use as bulk bone implants viable. However, crystallization may affect the bioactivity of the material. The aim of this study was to develop glass-ceramics of the nominal composition (wt%) 52.75(3CaO·P2O5)-30SiO2-17.25MgO, with different crystallized fractions and to evaluate their in vitro cytotoxicity and bioactivity. Specimens were heat-treated at 700, 775 and 975 °C, for 4 h. The major crystalline phase identified was whitlockite, an Mg-substituted tricalcium phosphate. The evaluation of the cytotoxicity was carried out by the neutral red uptake methodology. Ionic exchanges with the simulated body fluid SBF-K9 acellular solution during the in vitro bioactivity tests highlight the differences in terms of chemical reactivity between the glass and the glass-ceramics. The effect of crystallinity on the rates of hydroxycarbonate apatite (HCA) formation was followed by Fourier transformed infrared spectroscopy. Although all glass-ceramics can be considered bioactive, the glass-ceramic heat-treated at 775 °C (V775-4) presented the most interesting result, because the onset for HCA formation is at about 24 h and after 7 days the HCA layer dominates completely the spectrum. This occurs probably due to the presence of the whitlockite phase (3(Ca,Mg)O·P2O5). All samples were considered not cytotoxic.

Biocompatibility analysis of bioglass® 45S5 and biosilicate® implants in the rabbit eviscerated socket.

PURPOSE: Bioactive glass and bioactive glass-ceramic cone implants were placed in the rabbit eviscerated socket to assess their biocompatibility. METHODS: Fifty-one Norfolk albino rabbits underwent evisceration of the right eye followed by implantation of cones made from Bioglass(®) 45S5 (control group) and two types of bioactive glass-ceramic (Biosilicate(®)), a single- and a two-phase bioactive glass-ceramic implants into the scleral cavity. Postoperative reactions, animal behavior and socket conditions were monitored daily. Clinical exam, biochemical evaluations, and orbit computed tomographic scan were done at 7, 90, and 180 days post-procedure. After that, the animals were euthanized, and the orbital content was removed and prepared to light microscopy with morphometric evaluation and scanning electron microscopy examination. Statistical analysis was done by parametric and non-parametric analysis of variance, complemented by Dunn's and Tukey's tests (p < 0.05). RESULTS: All animals did not develop systemic toxicity throughout the experimental period and also did not have orbit infection, implant migration or extrusion. Morphological analysis demonstrated pseudocapsule around all implants. Bioglass(®) and single-phase Biosilicate(®) implants induced less inflammation and pseudocapsule formation than two-phase Biosilicate(®) cones. Seven days post-procedure, the inflammatory reaction was intense and gradually decreased throughout the experiment. Tissue reaction was least intense in animals receiving Bioglass(®) implants. CONCLUSIONS: We observe discrete differences among the studied materials, with best responses obtained with use of Bioglass(®) 45S5 and single-phase Biosilicate(®). The authors agree these implants might be useful in the management of the anophthalmic socket.

Assessment of antimicrobial effect of Biosilicate® against anaerobic, microaerophilic and facultative anaerobic microorganisms.

This study assessed the antimicrobial activity of a new bioactive glass-ceramic (Biosilicate®) against anaerobic, microaerophilic, and facultative anaerobic microorganisms. Evaluation of the antimicrobial activity was carried out by three methods, namely agar diffusion, direct contact, and minimal inhibitory concentration (MIC). For the agar diffusion technique, bio glass-ceramic activity was observed against various microorganisms, with inhibition haloes ranging from 9.0 ± 1.0 to 22.3 ± 2.1 mm. For the direct contact technique, Biosilicate® displayed activity against all the microorganisms, except for S. aureus. In the first 10 min of contact between the microorganisms and Biosilicate®, there was a drastic reduction in the number of viable cells. Confirming the latter results, MIC showed that the Biosilicate® inhibited the growth of microorganisms, with variations between ≤ 2.5 and 20 mg/ml. The lowest MIC values (7.5 to ≤ 2.5 mg/ml) were obtained for oral microorganisms. In conclusion, Biosilicate® exhibits a wide spectrum of antimicrobial properties, including anaerobic bacteria.

Efficacy of a bioactive glass-ceramic (Biosilicate) in the maintenance of alveolar ridges and in osseointegration of titanium implants.

OBJECTIVES: The aims of this research were to evaluate the efficacy of a bioactive glass-ceramic (Biosilicate) and a bioactive glass (Biogran) placed in dental sockets in the maintenance of alveolar ridge and in the osseointegration of Ti implants. MATERIAL AND METHODS: Six dogs had their low premolars extracted and the sockets were implanted with Biosilicate, Biogran particles, or left untreated. After the extractions, measurements of width and height on the alveolar ridge were taken. After 12 weeks a new surgery was performed to take the final ridge measurements and to insert bilaterally three Ti implants in biomaterial-implanted and control sites. Eight weeks post-Ti implant placement block biopsies were processed for histological and histomorphometric analysis. The percentages of bone-implant contact (BIC), of mineralized bone area between threads (BABT), and of mineralized bone area within the mirror area (BAMA) were determined. RESULTS: The presence of Biosilicate or Biogran particles preserved alveolar ridge height without affecting its width. No significant differences in terms of BIC, BAMA, and BABT values were detected among Biosilicate, Biogran, and the non-implanted group. CONCLUSIONS: The results of the present study indicate that filling of sockets with either Biosilicate or Biogran particles preserves alveolar bone ridge height and allows osseointegration of Ti implants.

Marine spongin incorporation into Biosilicate® for tissue engineering applications: An in vivo study.

Biomaterials and bone grafts, with the ability of stimulating tissue growth and bone consolidation, have been emerging as very promising strategies to treat bone fractures. Despite its well-known positive effects of biosilicate (BS) on osteogenesis, its use as bone grafts in critical situations such as bone defects of high dimensions or in non-consolidated fractures may not be sufficient to stimulate tissue repair. Consequently, several approaches have been explored to improve the bioactivity of BS. A promising strategy to reach this aim is the inclusion of an organic part, such as collagen, in order to mimic bone structure. Thus, the present study investigated the biological effects of marine spongin (SPG)-enriched BS composites on the process of healing, using a critical experimental model of cranial bone defect in rats. Histopathological and immunohistochemistry analyzes were performed after two and six weeks of implantation to investigate the effects of the material on bone repair (supplemental material-graphical abstract). Histological analysis demonstrated that for both BS and BS/SPG, similar findings were observed, with signs of material degradation, the presence of granulation tissue along the defect area and newly formed bone into the area of the defect. Additionally, histomorphometry showed that the control group presented higher values for Ob.S/BS (%) and for N.Ob/T.Ar (mm2) (six weeks post-surgery) compared to BS/SPG and higher values of N.Ob/T.Ar (mm2) compared to BS (two weeks post-surgery). Moreover, BS showed higher values for OV/TV (%) compared to BS/SPG (six weeks post-surgery). Also, VEGF immunohistochemistry was increased for BS (two weeks post-surgery) and for BS/SPG (six weeks) compared to CG. TGFb immunostaining was higher for BS compared to CG. The results of this study demonstrated that the BS and BS/SPG scaffolds were biocompatible and able to support bone formation in a critical bone defect in rats. Moreover, an increased VEGF immunostaining was observed in BS/SPG.

Scaffolds of bioactive glass-ceramic (Biosilicate®) and bone healing: A biological evaluation in an experimental model of tibial bone defect in rats.

This study aimed to investigate the in vivo tissue response of the Biosilicate® scaffolds in a model of tibial bone defect. Sixty male Wistar rats were distributed into bone defect control group (CG) and Biosilicate® scaffold group (BG).  Animals were euthanized 15, 30 and 45 days post-surgery. Stereomicroscopy, scanning electron microscopy, histopathological, immunohistochemistry and biomechanical analysis were used. Scaffolds had a total porosity of 44%, macroporosity of 15% with pore diameter of 230 µm. Higher amount of newly formed bone was observed on days 30 and 45 in BG. Immunohistochemistry analysis showed that the COX-2 expression was significantly higher on days 15 and 30 in BG compared with the CG. RUNX-2 immunoexpression was significantly higher in BG on days 15 and 45. No statistically significant difference was observed in RANKL immunoexpression in all experimental groups. BMP-9 immunoexpression was significantly upregulated in the BG on day 45. Biomechanical analysis showed a decrease in the biomechanical properties of the bone callus on days 30 and 45. The implantation of the Biosilicate® scaffolds was effective in stimulating newly bone formation and produced an increased immunoexpression of markers related to the bone repair.

In vitro osteogenesis on a highly bioactive glass-ceramic (Biosilicate).

One of the strategies to improve the mechanical performance of bioactive glasses for load-bearing implant devices has been the development of glass-ceramic materials. The present study aimed to evaluate the effect of a highly bioactive, fully-crystallized glass-ceramic (Biosilicate) of the system P(2)O(5)-Na(2)O-CaO-SiO(2) on various key parameters of in vitro osteogenesis. Surface characterization was carried out by scanning electron microscopy and Fourier transform infrared spectroscopy. Osteogenic cells were obtained by enzymatic digestion of newborn rat calvarial bone and by growing on Biosilicate discs and on control bioactive glass surfaces (Biosilicate) parent glass and Bioglass(R) 45S5) for periods of up to 17 days. All materials developed an apatite layer in simulated body fluid for 24h. Additionally, as early as 12 h under culture conditions and in the absence of cells, all surfaces developed a layer of silica-gel that was gradually covered by amorphous calcium phosphate deposits, which remained amorphous up to 72 h. During the proliferative phase of osteogenic cultures, the majority of cells exhibited disassembly of the actin cytoskeleton, whereas reassembly of actin stress fibers took place only in areas of cell multilayering by day 5. Although no significant differences were detected in terms of total protein content and alkaline phosphatase activity at days 11 and 17, Biosilicate supported significantly larger areas of calcified matrix at day 17. The results indicate that full crystallization of bioactive glasses in a range of compositions of the system P(2)O(5)-Na(2)O-CaO-SiO(2) may promote enhancement of in vitro bone-like tissue formation in an osteogenic cell culture system.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions.

This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey's test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Bioactive gel-glasses with distinctly different compositions: Bioactivity, viability of stem cells and antibiofilm effect against Streptococcus mutans.

In this study, an evaluation was performed to determine the in vitro bioactivity, viability of stem cells, and antibiofilm effect against Streptococcus mutans of two bioactive gel-glass 60SiO2-36CaO-4P2O5 (BG-A) and 80SiO2-15CaO-5P2O5 (BG-B) compositions. Both materials were bioactive and undergo the formation of hydroxycarbonate apatite (HCA) on their surfaces when immersed in simulated body fluid (SBF) after 12h, but the BG-A composition showed a more significant formation rate. The pH variation of the samples during the test in SBF indicated that an abrupt change had occurred for the BG-A composition within the first few hours, and the pH was subsequently maintained over time, supporting its stronger antibacterial effects against S. mutans. For the in vitro viability test using mesenchymal stem cells (MSCs), the BG-B showed significantly higher cell viability compared to the BG-A composition at concentrations of 0.125, 1.25 and 12.50mg/mL for 2days. These results indicated that the higher solubility of the BG-A glass favors bioactivity and antibacterial effects. However, as a result of rapid degradation, the increase in the concentration of ions in the cell culture medium was not favorable for cell proliferation. Thus, by varying the composition of glasses, and consequently their dissolution rate, it is possible to favor bioactivity, antimicrobial activity or stem cell proliferation for a particular application of interest.

Bioactive-glass ceramic with two crystalline phases (BioS-2P) for bone tissue engineering.

We aimed to evaluate the in vitro osteogenic and osteoinductive potentials of BioS-2P and its ability to promote in vivo bone repair. To investigate osteogenic potential, UMR-106 osteoblastic cells were cultured on BioS-2P and Bioglass 45S5 discs in osteogenic medium. The osteoinductive potential was evaluated using mesenchymal stem cells (MSCs) cultured on BioS-2P, Bioglass 45S5 and polystyrene in non-osteogenic medium. Rat bone calvarial defects were implanted with BioS-2P scaffolds alone or seeded with MSCs. UMR-106 proliferation was similar for both materials, while alkaline phosphatase (ALP) activity and mineralization were higher for BioS-2P. Bone sialoprotein (BSP), RUNX2 and osteopontin (OPN) gene expression and BSP, OPN, ALP and RUNX2 protein expression were higher on BioS-2P. For MSCs, ALP activity was higher on Bioglass 45S5 than on BioS-2P and was lower on polystyrene. All genes were highly expressed on bioactive glasses compared to polystyrene. BioS-2P scaffolds promoted in vivo bone formation without differences in the morphometric parameters at 4, 8 and 12 weeks. After 8 weeks, the combination of BioS-2P with MSCs did not increase the quantity of new bone compared to the BioS-2P alone. To stimulate osteoblast activity, drive MSC differentiation and promote bone formation, BioS-2P is a good choice as a scaffold for bone tissue engineering.

Putty-like bone fillers based on CaP ceramics or Biosilicate® combined with carboxymethylcellulose: Characterization, optimization, and evaluation.

Calcium phosphates and bioactive glass ceramics have been considered promising biomaterials for use in surgeries. However, their moldability should be further enhanced. We here thereby report the handling, physicochemical features, and morphological characteristics of formulations consisting of carboxymethylcellulose-glycerol and hydroxyapatite-tricalcium phosphate or Biosilicate® particles. We hypothesized that combining either material with carboxymethylcellulose-glycerol would improve handling properties, retaining their bioactivity. In addition to scanning electron microscopy, cohesion, mineralization, pH, and viscoelastic properties of the novel formulations, cell culture experiments were performed to evaluate the cytotoxicity and cell proliferation. Putty-like formulations were obtained with improved cohesion and moldability. Remarkably, mineralization in simulated body fluid of hydroxyapatite-tricalcium phosphate/carboxymethylcellulose-glycerol formulations was enhanced compared to pure hydroxyapatite-tricalcium phosphate. Cell experiments showed that all formulations were noncytotoxic and that HA-TCP60 and BGC50 extracts led to an increased cell proliferation. We conclude that combining carboxymethylcellulose-glycerol with either hydroxyapatite-tricalcium phosphate or Biosilicate® allows for the generation of moldable putties, improves handling properties, and retains the ceramic bioactivity.

Bone regeneration and gene expression in bone defects under healthy and osteoporotic bone conditions using two commercially available bone graft substitutes.

Biosilicate(®) and Bio-Oss(®) are two commercially available bone substitutes, however, little is known regarding their efficacy in osteoporotic conditions. The purpose of this study was to evaluate the osteogenic properties of both materials, at tissue and molecular level. Thirty-six Wistar rats were submitted to ovariectomy (OVX) for inducing osteoporotic conditions and sham surgery (SHAM) as a control. Bone defects were created in both femurs, which were filled with Biosilicate(®) or Bio-Oss(®), and empty defects were used as control. For the healthy condition both Biosilicate(®) and Bio-Oss(®) did not improve bone formation after 4 weeks. Histomorphometric evaluation of osteoporotic bone defects with bone substitutes showed more bone formation, significant for Bio-Oss(®). Molecular biological evaluation was performed by gene-expression analysis (Runx-2, ALP, OC, OPG, RANKL). The relative gene expression was increased with Biosilicate(®) for all genes in OVX rats and for Runx-2, ALP, OC and RANKL in SHAM rats. In contrast, with Bio-Oss(®), the relative gene expression of OVX rats was similar for all three groups. For SHAM rats it was increased for Runx-2, ALP, OC and RANKL. Since both materials improved bone regeneration in osteoporotic conditions, our results suggest that bone defects in osteoporotic conditions can be efficiently treated with these two bone substitutes.

Reparación Ósea en Alvéolos de Ratas Ovariectomizadas con Biosilicato Cristalizado. Análisis Histomorfométrico / Alveolar Bone Repair in Ovarictomized Rats with Crystallized Biosilicate. Histomorphometric Analysis

RESUMEN: Evaluar el proceso de reparación alveolar en ratas sometidas a cirugía de simulacro u ovariectomizadas tras el relleno alveolar con coágulo o con biosilicato cristalino. Sesenta ratas Wistar fueron divididas en cuatro grupos (n=15) de acuerdo con el tratamiento: Grupo 1- ratas sometidas a cirugía de simulacro con alveolos rellenados con coágulo; Grupo 2- ratas sometidas a cirugía de simulacro con alveolos rellenados con biosilicato cristalino; Grupo 3- ratas ovariectomizadas con alveolos rellenados con coágulo; Grupo 4- ratas ovariectomizadas con alveolos rellenados con biosilicato cristalino. Después de 7, 14 y 28 días, los animales fueron sacrificados, se tomaron muestras óseas que fueron teñidas con hematoxilina-eosina y analizadas al microscopio para realizar un análisis histomorfométricos. Los mayores porcentajes de formación de hueso se presentaron en los grupos 1 (32 % a los 7 días, 46 % a los 14 días y 83.5 % a los 28 días) y 4 (27,1 % a los 7 días, 41,1 % a los 14 días y 79,7 % a los 28 días). En los alveolos rellenados con coágulo, las ratas sometidas a cirugía de simulacro mostraron los mejores resultados, mientras que, en los alveolos rellenados con biosilicato, las ratas ovariectomizadas tenían porcentajes significativamente mayores. En este estudio, el biosilicato cristalino se comportó como un biomaterial adecuado para la reparación ósea, favoreciendo la osteoconducción.

ABSTRACT: The objective of this study was to assess the process of alveolar bone repair in rats subjected to sham surgery or ovariectomized rats, after alveolar filling with clot or with crystalline biosilicate. Sixty Wistar rats were divided into four groups (n = 15) according to the treatment: Group 1 - rats subjected to sham surgery with sockets filled with clot; Group 2- rats submitted to sham surgery with sockets filled with crystalline biosilicate; Group 3 ovariectomized rats with sockets filled with clot; Group 4 ovariectomized rats with sockets filled with crystalline biosilicate. After 7, 14 and 28 days, the animals were sacrificed, bone samples were taken, stained with hematoxylin-eosin and analyzed under a microscope to perform a histomorphometric analysis. The highest percentages of bone formation were presented in groups 1 (32 % at 7 days, 46 % at 14 days and 83.5 % at 28 days) and 4 (27.1 % at 7 days, 41.1 % at 14 days and 79.7 % after 28 days). In the sockets filled with clot, the rats subjected to sham surgery showed the best results, while in the sockets filled with biosilicate, the ovariectomized rats had significantly higher percentages. In this study, the crystalline biosilicate behaved as an adequate biomaterial for bone repair, favoring osteoconduction.

Effects of biosilicate(®) scaffolds and low-level laser therapy on the process of bone healing.

OBJECTIVE: This study aimed to investigate the in vivo tissue performance of the association of Biosilicate(®) scaffolds and low-level laser therapy (LLLT) in a tibial bone defects model in rats. BACKGROUND DATA: Many studies have been demonstrating the osteogenic potential of Biosilicate and LLLT. However, there is a need to investigate the effects of both treatments for bone consolidation. METHODS: The animals were divided into control group (CG), Biosilicate scaffold group (BG), and Biosilicate scaffolds plus LLLT group (BLG). Animals were euthanized after 15, 30, and 45 days post-injury. RESULTS: The histological analysis revealed that all the experimental groups showed inflammatory infiltrate and granulation tissue, at the area of the defect at day 15. After 30 days, CG still showed granulation tissue and bone ingrowth. Both Biosilicate groups presented newly formed bone and interconected trabeculae. At 45 days, CG showed immature newly formed bone. A more mature newly formed bone was observed in BG and BLG. On day 15, BG demonstrated a statistically higher expression of cyclooxygenase (COX)-2 compared with CG and BLG. No statistically significant difference was observed in COX-2 immunoexpression among the groups at 30 and 45 days. Similar expression of bone morphogenetic protein (BMP)-9 was demonstrated for all experimental groups at 15 and 30 days. At 45 days, the BMP-9 immunoexpression was statistically upregulated in the BLG compared with the CG and BG. No statistically significant difference was observed in the receptor activator of nuclear factor kappa-B ligand (RANKL) immunoexpression among the groups in all periods evaluated. Biosilicate groups presented a decrease in biomechanical properties compared with CG at 30 and 45 days post-surgery. CONCLUSIONS: Our findings suggest that Biosilicate presented osteogenic activity, accelerating bone repair. However, laser therapy was not able to enhance the bioactive properties of the Biosilicate.

Compositional and microstructural design of highly bioactive P2O5-Na2O-CaO-SiO2 glass-ceramics.

Bioactive glasses having chemical compositions between 1Na(2)O-2CaO-3SiO(2) (1N2C3S) and 1.5Na(2)O-1.5CaO-3SiO(2) (1N1C2S) containing 0, 4 and 6 wt.% P(2)O(5) were crystallized through two stage thermal treatments. By carefully controlling these treatments we separately studied the effects on the mechanical properties of two important microstructural features not studied before, crystallized volume fraction and crystal size. Fracture strength, elastic modulus and indentation fracture toughness were measured as a function of crystallized volume fraction for a constant crystal size. Glass-ceramics with a crystalline volume fraction between 34% and 60% exhibited a three-fold improvement in fracture strength and an increase of 40% in indentation fracture toughness compared with the parent glass. For the optimal crystalline concentration (34% and 60%) these mechanical properties were then measured for different grain sizes, from 5 to 21 µm. The glass-ceramic with the highest fracture strength and indentation fracture toughness was that with 34% crystallized volume fracture and 13 µm crystals. Compared with the parent glass, the average fracture strength of this glass-ceramic was increased from 80 to 210 MPa, and the fracture toughness from 0.60 to 0.95 MPa.m(1/2). The increase in indentation fracture toughness was analyzed using different theoretical models, which demonstrated that it is due to crack deflection. Fortunately, the elastic modulus E increased only slightly; from 60 to 70 GPa (the elastic modulus of biomaterials should be as close as possible to that of cortical bone). In summary, the flexural strength of our best material (215 MPa) is significantly greater than that of cortical bone and comparable with that of apatite-wollastonite (A/W) bioglass ceramics, with the advantage that it shows a much lower elastic modulus. These results thus provide a relevant guide for the design of bioactive glass-ceramics with improved microstructure.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions

Abstract This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey's test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Resumo Este estudo avaliou o efeito de uma vitrocerâmica bioativa para o controle de lesões de erosão e cárie. Fragmentos (n=10) de esmalte bovino e dentina radicular receberam aplicação diária de diferentes tratamentos (Biosilicato; Fluoreto de Fosfato Acidulado - APF; não tratado - controle) durante a realização de ciclos erosivos. As superfícies foram analisadas com profilometria óptica 3D para quantificar a perda superficial em quatro períodos (1, 7, 14 e 21 dias), bem como a profundidade da lesão com microscopia confocal de varredura a laser. Para a avaliação da progressão de cárie, foi obtida a microdureza Knoop inicial de fragmentos de esmalte bovino. As lesões cariosas iniciais foram desenvolvidas e os espécimes foram divididos em três grupos (n =10), de acordo com a aplicação tópica diária (Biosilicato; APF; sem aplicação - controle) durante os ciclos de desmineralização por 14 dias. A microdureza final foi obtida para calcular a perda da microdureza superficial. A desmineralização sub-superficial foi analisada utilizando microdureza transversal (profundidades 10, 30, 50, 70, 90, 110 e 220 μm). Os dados foram testados utilizando ANOVA e teste de Tukey (α=5%). Os resultados da avaliação erosiva mostraram que o Biosilicato promoveu os menores valores (p <0,05) de perda superficial, independente do tempo, tanto para o esmalte como para a dentina; APF promoveu menor (p <0,05) perda de superfície do que controle; analisando os períodos de tempo, APF não mostrou diferença (p>0,05) entre 14 e 21 dias de desmineralização. Os resultados da avaliação da cárie no esmalte mostraram que o Biosilicato resultou em maiores (p<0,05) valores de microdureza superficial e subsuperficial do que as aplicações APF e controle. Pode-se concluir que a aplicação de Biosilicato apresentou maior potencial de redução da perda superficial e desenvolvimento de lesões de erosão e cárie.

Biosilicate® and low-level laser therapy improve bone repair in osteoporotic rats.

The aim of this study was to investigate the effects of a novel bioactive material (Biosilicate®) and low-level laser therapy (LLLT) on bone fracture consolidation in osteoporotic rats. Forty female Wistar rats were submitted to ovariectomy (OVX) to induce osteopenia. Eight weeks after surgery, the animals were randomly divided into four groups of 10 animals each: a bone defect control group (CG); a bone defect filled with Biosilicate group (BG); a bone defect filled with Biosilicate and irradiated with LLLT at 60 J/cm(2) group (BG60); and a bone defect filled with Biosilicate and irradiated with LLLT at 120 J/cm(2) group (BG120). Bone defects were surgically performed on both tibias. The size of particle used for Biosilicate was 180-212 µm. Histopathological analysis showed that bone defects were predominantly filled with the biomaterial in specimens treated with Biosilicate. LLLT with either 60 or 120 J/cm(2) was able to increase collagen, Cbfa-1, VGEF and COX-2 expression in the circumjacent cells of the biomaterial. A morphometric analysis revealed that the Biosilicate + laser groups showed a higher amount of newly formed bone. Our results indicate that laser therapy improves bone repair process in contact with Biosilicate as a result of increasing bone formation, as well as COX-2 and Cbfa-1 immunoexpression, angiogenesis and collagen deposition in osteoporotic rats.

In vivo biological performance of a novel highly bioactive glass-ceramic (Biosilicate®): A biomechanical and histomorphometric study in rat tibial defects.

This study aimed to investigate bone responses to a novel bioactive fully crystallized glass-ceramic of the quaternary system P(2)O(5)-Na(2)O-CaO-SiO(2) (Biosilicate®). Although a previous study demonstrated positive effects of Biosilicate® on in vitro bone-like matrix formation, its in vivo effect was not studied yet. Male Wistar rats (n = 40) with tibial defects were used. Four experimental groups were designed to compare this novel biomaterial with a gold standard bioactive material (Bioglass® 45S5), unfilled defects and intact controls. A three-point bending test was performed 20 days after the surgical procedure, as well as the histomorphometric analysis in two regions of interest: cortical bone and medullary canal where the particulate biomaterial was implanted. The biomechanical test revealed a significant increase in the maximum load at failure and stiffness in the Biosilicate® group (vs. control defects), whose values were similar to uninjured bones. There were no differences in the cortical bone parameters in groups with bone defects, but a great deal of woven bone was present surrounding Biosilicate® and Bioglass® 45S5 particulate. Although both bioactive materials supported significant higher bone formation; Biosilicate® was superior to Bioglass® 45S5 in some histomorphometric parameters (bone volume and number of osteoblasts). Regarding bone resorption, Biosilicate® group showed significant higher number of osteoclasts per unit of tissue area than defect and intact controls, despite of the non-significant difference in the osteoclastic surface as percentage of bone surface. This study reveals that the fully crystallized Biosilicate® has good bone-forming and bone-bonding properties.