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J Dent. 2014 May;42(5):517-33. doi: 10.1016/j.jdent.2013.12.015. Epub 2014 Jan 15.

A review of the bioactivity of hydraulic calcium silicate cements.

Author information

1
Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
2
Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Fourth Military Medical University, Xi'an, China.
3
Department of Prosthodontics, School of Stomatology, Peking University, Beijing, China.
4
Department of Stomatology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
5
Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, Malta.
6
Department of Endodontics, College of Dental Medicine, Georgia Regents University, Augusta, GA, USA.
7
Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China. Electronic address: jhchen@fmmu.edu.cn.
8
College of Graduate Studies, Georgia Regents University, Augusta, GA, USA.
9
Department of Endodontics, College of Dental Medicine, Georgia Regents University, Augusta, GA, USA; College of Graduate Studies, Georgia Regents University, Augusta, GA, USA. Electronic address: ftay@gru.edu.

Abstract

OBJECTIVES:

In tissue regeneration research, the term "bioactivity" was initially used to describe the resistance to removal of a biomaterial from host tissues after intraosseous implantation. Hydraulic calcium silicate cements (HCSCs) are putatively accepted as bioactive materials, as exemplified by the increasing number of publications reporting that these cements produce an apatite-rich surface layer after they contact simulated body fluids.

METHODS:

In this review, the same definitions employed for establishing in vitro and in vivo bioactivity in glass-ceramics, and the proposed mechanisms involved in these phenomena are used as blueprints for investigating whether HCSCs are bioactive.

RESULTS:

The literature abounds with evidence that HCSCs exhibit in vitro bioactivity; however, there is a general lack of stringent methodologies for characterizing the calcium phosphate phases precipitated on HCSCs. Although in vivo bioactivity has been demonstrated for some HCSCs, a fibrous connective tissue layer is frequently identified along the bone-cement interface that is reminiscent of the responses observed in bioinert materials, without accompanying clarifications to account for such observations.

CONCLUSIONS:

As bone-bonding is not predictably achieved, there is insufficient scientific evidence to substantiate that HCSCs are indeed bioactive. Objective appraisal criteria should be developed for more accurately defining the bioactivity profiles of HCSCs designed for clinical use.

KEYWORDS:

Bioactivity; Calcium silicate; Hydraulic cement; In vitro; In vivo

PMID:
24440449
PMCID:
PMC3995854
DOI:
10.1016/j.jdent.2013.12.015
[Indexed for MEDLINE]
Free PMC Article

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