thumb|Molecular structure of Bioglass

Bioglass 45S5 or calcium sodium phosphosilicate, is a bioactive glass specifically composed of 45&nbsp;wt% SiO<sub>2</sub>, 24.5&nbsp;wt% CaO, 24.5&nbsp;wt% Na<sub>2</sub>O, and 6.0&nbsp;wt% P<sub>2</sub>O<sub>5</sub>.

Bioactive glass was applied to medical devices to help restore the hearing to a deaf patient using Bioglass 45S5 in 1984. The patient went deaf due to an ear infection that degraded two of the three bones in her middle ear. An implant was designed to replace the damaged bone and carry sound from the eardrum to the cochlea, restoring the patient's hearing. Before this material was available, plastics and metals would be used because they did not produce a reaction in the body; however, they eventually failed because tissue would grow around them after implantation. A prosthesis made up of Bioglass 45S5 was made to fit the patient and most of the prosthesis that were made were able to maintain functionality after 10 years. The Endosseous Ridge Maintenance Implant made of Bioglass 45S5 was another device that could be inserted into tooth extraction sites that would repair tooth roots and allow for a stable ridge for dentures. Bioactive glasses that are sol-gel derived, such as CaPSiO and CaPSiO II, have also exhibited antibacterial properties. Studies done with S. epidermidis and E. coli cultured with bioactive glass have shown that the 45S5 bioactive glass have a very high antibacterial resistance. It was also observed in the experiment that there were needle-like bioglass debris which could have ruptured the cell walls of the bacteria and rendered them inactive.

GlaxoSmithKline is using this material as an active ingredient in toothpaste under the commercial name NovaMin, which can help repair tiny holes and decrease tooth sensitivity.

Mechanism of action

thumb|381x381px|The integration of Bioglass with bone. The reaction with surrounding physiological fluid at the surface of Bioglass is shown in first two steps, and the formation of new bone is shown in the last two stages.

When implanted, Bioglass 45S5 reacts with the surrounding physiological fluid, causing the formation of a hydroxyl carbonated apatite (HCA) layer at the material surface. The HCA layer has a similar composition to&nbsp;hydroxyapatite, the mineral phase of bone, a quality which allows for strong interaction and integration with bone. The process by which this reaction occurs can be separated into 12 steps. The first 5 steps are related to the Bioglass response to the environment within the body, and occur rapidly at the material surface over several hours. Reaction steps 6–10 detail the reaction of the body to the integration of the biomaterial, and the process of integration with bone. These stages occur over the scale of several weeks or months. The steps are separated as follows:

  1. Triggered by M2 macrophage activation,&nbsp;mesenchymal stem cells&nbsp;and&nbsp;osteoprogenitor cells&nbsp;migrate to the Bioglass surface and attach to the HCA layer.
  2. Stem cells and osteoprogenitor cells at the HCA surface differentiate to become osteogenic cells typically present in&nbsp;bone tissue, particularly&nbsp;osteoblasts.
  3. The attached and differentiated osteoblasts generate and deposit&nbsp;extracellular matrix&nbsp;(ECM) components, primarily&nbsp;type I collagen, the main protein component of bone.
  4. The collagen ECM becomes&nbsp;mineralized&nbsp;as normally occurs in native bone. Nanoscale hydroxyapatite crystals form a layered structure with the deposited collagen at the surface of the implant.
  5. Following these reactions, bone growth continues as the newly recruited cells continue to function and facilitate tissue growth and repair. The Bioglass implant continues to degrade and be converted to new ECM material.

Manufacturing

There are two main manufacturing techniques that are used for the synthesis of bioglass. The first is melt quench synthesis, which is the conventional glassmaking technology used by Larry Hench when he first manufactured the material in 1969. This method includes melting a mixture of oxides such as SiO<sub>2</sub>, Na<sub>2</sub>O, CaO and P<sub>2</sub>O<sub>5</sub> at high temperatures generally above 1100–1300&nbsp;°C. Platinum or platinum alloy crucibles are used to avoid contamination, which would interfere with the product's chemical reactivity in organism. Annealing is a crucial step in forming bulk parts, due to high thermal expansion of the material. Heat treatment of Bioglass reduces the volatile alkali metal oxide content and precipitates apatite crystals in the glass matrix. However, the scaffolds that result from melt quench techniques are much less porous compared to other manufacturing methods, which may lead to defects in tissue integration when implanted in vivo.

The second method is sol-gel synthesis of Bioglass. This process is carried out at much lower temperatures than the traditional melting methods. It involves the creation of a solution (sol), which is composed of metal-organic and metal salt precursors. A gel is then formed through hydrolysis and condensation reactions, and it undergoes thermal treatment for drying, oxide formation, and organic removal. Because of the lower fabrication temperatures used in this method, there is a greater level of control on the composition and homogeneity of the product. In addition, sol-gel bioglasses have much higher porosity, which leads to a greater surface area and degree of integration in the body. Microwave synthesis is a rapid and low-cost powder synthesis method in which precursors are dissolved in water, transferred to an ultrasonic bath, and irradiated.

Shortcomings

A setback to using Bioglass 45S5 is that it is difficult to process into porous 3D scaffolds. These porous scaffolds are usually prepared by sintering glass particles that are already formed into the 3D geometry and allowing them to bond to the particles into a strong glass phase made up of a network of pores. Since this particular type of bioglass cannot fully sinter by viscous flow above its Tg, and its Tg is close to the onset of crystallization, it is hard to sinter this material into a dense network.

Another study carried out by Li et al. looked into different properties, such as the fracture toughness and wear resistance of Bioglass 45S5. The authors loaded graphene nanoplatelets (GNP) into the glass structure through a spark plasma sintering method. Graphene was chosen because of its high specific surface area and strength, as well as its cytocompatibility and lack of interference with Bioglass 45S5's bioactivity. The composites that were created in this experiment achieved a fracture toughness of more than double the control. In addition, the tribological properties of the material were greatly improved.