A review of the bioactivity of hydraulic calcium silicate cements

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.

In vitro and in vivo evaluation of a nanoparticulate bioceramic paste for dental pulp repair

“…Calcium silicate ceramics have been developed for hard tissue applications including bone and dental repair and regeneration [5,6]. Among calcium silicate materials, mineral trioxide aggregate (MTA) introduced by Torabinejad et al at Loma Linda University, has been proposed as a candidate for pulp capping since the late 1990s, because of its favourable biological and physical properties [7,8].…”

Mineral deposition at dental adhesive resin containing niobium pentoxide

“…It is stated that use of SBF testing leads to false-positive results and cannot reliably mimic physiological conditions [22,23]. A review discussing the in vitro and in vivo bioactivity of calcium silicate cements showed that a material that produced an apatite layer over its surface after interacting with the ions derived from SBF did not exhibit a bone bond when inserted in living tissues [24]. Three different mechanisms of interaction with tissues could contribute to the bioactivity of materials: chemical bonds to host tissues, influence on cellular pathways and stimulus to cell differentiation by topographical features of biomaterial.…”

Classification and Nomanclature of Commercial Hygroscopic Dental Cements

“…There is a history of use in the literature for 'hydraulic silicate cement' , 'calcium silicate cement' and 'hydraulic calcium silicate cement' (13)(14)(15). The term 'hydraulic cement' is a term that originates in the engineering literature and refers to materials that react 'under water' , which can be extended to include GICs and related glass-based cements that set using acid-base aqueous reactions (16).…”