Bioactive glass for bone replacement in craniomaxillofacial reconstruction

Bioactive glass particles are an important consideration when choosing the optimal biomaterial to be used as a bone substitute in craniomaxillofacial applications. The bioactive properties of these particles allow for an osteoproductive environment in which the bone-biomaterial interface is uniquely stronger than it would be with other forms of biomaterials. A review of the present literature supports clinical applications of bioactive glasses in particulate form, preferably mixed with 10 to 20 percent autogenous bone particles. This protocol has been highly successful for dental and periodontal reconstruction, augmentation of the alveolar ridge, and elevation of the maxillary sinus floor in preparation for titanium implant placement in the atrophic maxilla. A similar protocol may prove useful in reconstruction of full-thickness calvarial defects. However, present experience with prefabricated implants made of bioactive glass ceramics, as has been used for augmentation of the facial skeleton, does not support an additional advantage of this biomaterial over alternate forms of pre-fabricated implants.