Bioactive glasses (BAG) are surface-active glasses with which bone minerals are able to bond chemically.

The basic components of BAG are oxides of calcium, sodium, phosphorus, and silicon in proportions that
provide the material with surface activity

BAG has been found to be able to mineralize dentin disc surfaces

BAG could be used for remineralizing damaged dentin, and that it has potential as a
filler component in mineralizing restorative materials

Glass ionomer cements (gics) are adhesive, longterm fluoride-releasing, and relatively
biocompatible materials used in dentistry as liners and restorations.

Previous studies [5–9] have suggested that BAG could be used for remineralizing
damaged dentin. As BAG particles alone are easily displaced in a clinical environment
[5], a suitable carrier or matrix material is needed to facilitate its use in clinical settings.
In previous studies, GICs containing BAG have been shown to be potential candidates
for mineralizing restorative materials in vitro.

Mineral depositions close to the restoration–dentin interface and in the deeper parts of
dentin tubules, especially in the resin-modified GIC containing BAG, indicate that the
materials can induce dentin mineralization in vivo

Resin modified all the restorations appeared to be tightly bonded to the dentin, and
even at high magnifications no gap was found at the interface

creating the aqueous conditions needed for BAG particles to react with the surrounding
tissues

Nearly four times more phosphate was found on the oral surfaces of the restorations
after 6 weeks than on the cross-sectional surfaces within the restorations. The same was
found for the amount of calcium. The oral surfaces of the restorations were bathed
constantly in whole saliva. Calcium and phosphorus ions originating both from saliva and
released from the material itself can precipitate on the surface of the restorations

resin-modified GIC containing BAG also releases ions needed for cap
precipitation in vivo, as reported in vitro in an earlier study

In an aqueous environment, BAG begins to release ions, which precipitate on the glass
surface

such as base and liner materials in deep cavities, and in the treatment of
hypersensitive dentin.

There has been a recent focus on the study of “smart” materials that confer biocompatibility and
cause remineralization, while maintaining the physical properties of materials. Bioactive glass
(BAG), composed of NaO, SiO, PO, and CaO, is known to be used for the loss of osseous
tissue; therefore, a study was conducted to increase the biocompatibility of GIC by adding BAG
to GIC. Studies have also reported an increase in biocompatibility with the addition of synthetic
hydroxyapatite (HA) to the inorganic components of GIC, since HA is highly analogous to the
major components of tooth enamel or dentin in terms of structure

Resin composites and glass ionomer cements (GICs) were developed to accomplish this
goal [1]. GICs or “glass polyalkenoate cements” are direct restorative materials, which
can bond to enamel and dentin without the need for bonding agents. The ability to
prevent caries by releasing fluoride over time, biocompatibility, and chemical adhesion
to tooth structures are among the favorable features of these tooth-coloured amalgam
substitutes [2]. Having the ability to prevent water contamination in an environment
filled with moisture is essential.
BAGs are amorphous silicate-based materials which are compatible with the human
body and can stimulate new bone growth while dissolving over time

In clinical situations, BAG was first used as a biomaterial to replace the loss of osseous
tissues. BAG is able to bind strongly to bone via the formation of HA and firm bonding
between the collagen and HA, and the body therefore tolerates the material well
The BAG nanoparticle, combined with the matrix of GIC, increases surface area and biological
activity and greatly improves mechanical/biological properties as an additive per particle weight
over that of conventional micro-sized BAG particles
BAG contains silicon, sodium, calcium and phosphorus oxides with specific weight
percentagess: Na2O,24.5%; SiO2, 45%; P2O5, 6%; and CaO, 24.5%
-initially used as a biomaterial to replace the lost osseous tissues in the human body. It
produces a strong bond with bone through production of hydroxyapatite and formation
of a strong bond between the collagen and the hydroxyapatite and is not rejected by
the body.
In a study carried out by Yli-Urpo et al., too, BAG was added to (GIC). Then, the
compressive strength,
Young’s modulus and Vicker’s hardness of the composition were evaluated; it was
reported that the
experimental composition is biologically active under physiologic conditions and can
mineralize human dentin in vitro. The material had also some antimicrobial activity. Xie
used the polyacid he had invented to improve the mechanical properties of GI and BAG.
He measured the compressive strength, diametral tensile strength, and hardness of the
material and reported that its strength is comparable to that of commercially available
Fuji II LC cement.
-Given the remineralization capacity of these materials in several studies, it is highly probable that these

bioactive materials might be more effective in tooth restorations in open/close sandwich techniques or

root surface restorations compared to RMGI or conventional GI, particularly in patients at a high-risk for

caries.

BAG. They are commonly used in the reconstruction of damaged hard tissues like bone.

Rapid surface reaction results in rapid binding to the living tissues; however, due to the two-dimensional

structure of glass structure, it has relatively low mechanical properties.

When BAG is immersed in aqueous solutions such as body fluids, simulated body fluid, (SBF) or tris

buffer solution, (TBS) three main processes take place:

1)Leaching and formation of silanols: The glass network releases alkaline agents

2)Dissolution of the glass network

3)Precipitation: Calcium and phosphate ions released from the glass, along with those present in the
solution, form a layer rich in calcium and phosphate on the surface.

It became evident in 1990 that only glass components with a high reaction potential bind to soft tissues.

Generally, the higher the solubility rate is and the higher concentrations of the ions are, the more

effective the bioactive materials are.

-Another interesting characteristic of these glasses is the fact that it appears if these glasses break
during placement and the fractured surfaces remain in contact with each other, it is possible that they
will be able to join together through the surface layer of apatite via self-repair capacity.

-New generation of biomaterials (third generation):

These bioactive materials release chemical agents in the form of dissolved ions or growth factors such

as bone morhogenic protein, which stimulate and activate cells. The cells produce more growth factors,

which induce cell proliferation and regeneration.

Some third generation BAG materials include Nova Bone, Nova Min and Nova Thera.

-Recently, bioglass has been used in the treatment of dentinal hypersensitivity; bioglass fine particles

have been incorporated into toothpastes or they are applied to tooth surfaces with an aqueous vector.

Bioglass particles attach to dentin surfaces and rapidly form a hydroxycarbonapatite layer, sealing the

tubules and relieving pain. Recent studies have shown that bioglass has a better function compared to

other commonly used treatment modalities.[45,46] In addition, the Orative commercial product, which

contains Nova Min particles with the chemical composition of calcium sodium phosphosilicate decreases

dentin hypersensitivity by precipitating calcium phosphate.

-The additives to increase the bioactivity and antibacterial properties often have adverse effect on

mechanical strength.

It has been reported that CaO-P2O5-SiO2 (-MgO) glass possessed a superior bioactivity
through forming an apatite layer on the surface of the glass both in vivo and in vitro1
Substitution of magnesium for calcium did not affect the peak position but resulted in a
wider half width.
brackets
Recently, BAG was used as a therapeutic substance in areas at high risk of microbial infections. It has a
wide-range of antibacterial activity against supragingival and subgingival bacteria.
The bonding agent containing BAG significantly prevented enamel softening around brackets compared
to the conventional bonding agents.
It seems that addition of BAG to RMGIC provides a rich source of calcium, phosphate and fluoride ions to
prevent enamel demineralization around orthodontic brackets.

Hidroxi apatite

 Recent advances in the synthesis of HA in various sizes and forms have enabled
HA to be used as a biocompatible filler for natural tooth materials. In addition, HA
showed excellent biological activity and played an important role in orthopedics
because of its bone-inducing and bioactive properties

he result of this work refers to that, the addition of nano-HA to GIC enhance its fluoride
ion release, compressive strength and antibacterial effect against Streptococcus mutans
Improvement of the mechanical properties of polymeric materials by nanoparticles
incorporation was studied [10,11]. Hydroxyapatite [Ca10(PO4)6(OH)2] is a natural
mineral and called “bone mineral” and have feature properties that are favourable in
dental restoration. It is utilized in enhancement of surface hardness, toughness and
biocompatibility because Hydroxyapatite structure looks like natural tooth.
Hydroxyapatite nanoparticles addition to R-GIC was used for production of materials
similar to human hard tissues used in dental restoration

It is known that nano HA particles have a large surface area due its small size, and its
addition to C-GIC led to increasing the acid-base reaction activity, then, increasing the
release of fluoride ion
Moreover, nano-apatite containing glass ionomers are expected to have superior bonding to the
tooth surface due to the possibility of the formation of the strong ionic linkages between the
apatite crystals/particles in the cement and Ca-ions in the tooth structure. Additionally,
decreasing the particle size of apatites from micrometer scale to nanometer scale increases the
surface area remarkably, and infiltration of the crystals into demineralised dentine as well as
enamel pores; this may enhance bonding at the tooth-ionomer interface

 A few studies have attempted to evaluate the in vitro toxicity of modified GICs.
nTiO2-containing GICs have been seen to stimulate the production of
inflammatory factor prostaglandin E2 comparable to unmodified GICs
  GICs containing 1% MgO nanoparticles showed an improvement in the compressive and
diametral tensile strength and the highest SBS values for both adhesions to enamel and dentin.

Ceramics

The bioactive nature of BAG and glass-ceramics is related to their ability to form a bone-like apatite layer
on their surfaces in the body environment

Nano-modification of conventional GICs and resin modified GICs (RMGICs) can be achieved by
incorporation of nano-sized fillers to RMGICs, reducing the size of the glass particles, and introducing
nano-sized bioceramics to the glass powder

Conversely, incorporation of nano-sized apatite crystals not only increases the mechanical
properties of conventional GICs, but also can enhance fluoride release and bioactivity. By
increasing the crystallinity of the set matrix, apatites can make the set cement chemically more
stable, insoluble, and improve the bond strength with tooth structure
Bioactivity implies the induction of cellular growth, proliferation and tissue formation by a
biomaterial.Additionally, bioactivity also signifies an anti-bacterial effect of a material to prevent
or cure infection in the tissues.

Glass ionomer cements are being used for a wide range of applications in dentistry. Due to their
high fluoride release and white color, dental applications of GICs include restoration of
deciduous teeth, anterior class III and V restorations, cementation (luting) of crowns, bridges,
and orthodontic appliances, restorations of non-carious teeth with minimal preparation,
temporary cementation of crowns and other indirect restorations, restoration of teeth via the
sandwich technique, and as materials for atraumatic restorative therapy

Concluzii

RMGIC with BAG showed highest bioactivity

Bioactive glass can enhance mineral formation in the dentin and it has potential as a filler component in
mineralizing restorative materials. • Incorporation of bioactive glass into glass ionomer cements
enhanced their remineralization property. • Resin-modified GIC containing BAG has significant potential
in clinical applications where enhanced mineralization is expected. • Incorporation of BAG into RMGIC
improved its mechanical property in aqueous environment, although it was less than RMGIC.