Bioactive glass bone grafts: History and clinical applications

Abstract

The second generation of biomaterials concept, based upon a unique composition range of calcium, sodium phosphosilicate (CSPS) glasses, and glass-ceramics, involved bonding of the implant material to the bone. It is essential to recognize that no man-made material can respond to changing physiological loads or biochemical stimuli, as do living tissues. This compromise limits the lifetime of all man-made body parts. Recognizing this fundamental limitation also signals that we have reached a limit to current medical practice that emphasizes replacement of tissues. For the twenty-first century, it is critical to emphasize a more biologically based method of repair-regeneration of tissues. Third-generation bioactive materials with controlled release of biochemical stimuli provide the starting point for this shift toward a more biologically based approach to repair of diseased or damaged tissues, e.g., regeneration of tissues. Bioactive glass bone grafts are based upon this concept of in situ regeneration of bone with structure, architecture, and mechanical strength equivalent to normal cortical and cancellous bone. We need to remember that only a little more than 40 years ago, the concept of a material that would not be rejected by living tissues also seemed impossible. This is now a clinical reality that has benefited tens of millions of people and should stimulate new concepts in the years ahead.