Bioglass 45S5 in dentistry: Current evidence, clinical applications and future perspectives (Review)

Abstract

Bioglass 45S5 (45 wt% SiO_2, 24.5 wt% Na_2O, 24.5 wt% CaO, 6 wt% P_2O_5), developed in the early 1970s, was the first synthetic material shown to chemically bond with living bone. The present narrative review surveys the currently available evidence on its use across the major dental specialties. A literature search was conducted on the PubMed, Scopus and Web of Science databases covering publications from 1971 to March, 2026. Bioglass 45S5 forms a carbonated hydroxyapatite layer at the tissue interface through rapid ion-exchange reactions, thereby promoting cell adhesion, mineralization and tissue bonding. In periodontal surgery, it supports alveolar bone fill and attachment gain; in endodontics, it shows promise for pulp capping and root-end sealing; 45S5-containing toothpastes occlude dentinal tubules and reduce hypersensitivity; and as a coating on titanium implants it enhances early osseointegration. However, low fracture toughness, rapid degradation in some formulations, and clinical literature dominated by small, short-term trials remain key limitations. Advances in sol-gel synthesis, ion doping, nanoscale engineering and additive manufacturing continue to broaden the therapeutic scope of the material; however, further well-designed randomized clinical trials are warranted to consolidate the evidence base.