Biocompatibility of silicates for medical use

Implantation of commercial silicate glasses in soft or hard tissue will produce a thick non-adherent capsule consisting of scar tissue. However, special compositions of bioactive silicate glasses and crystallized glass-ceramics bond to bone and soft tissue without such a capsule. Bonding is via ion exchange and formation of active surface layers which incorporate collagen and bone mineral. These bioactive silicates have been studied in vivo and in vitro and the cellular response appears to depend on total cell surface nectin concentrations as well as on specific nectins and cellular proteins which may be silicon-sensitive. Simple amino acids polymerize and adhere strongly and randomly to binding sites on the bioactive surfaces, in contrast to their epitaxial behaviour on crystalline quartz. Toxicity tests in vivo and in vitro on powders and on solid forms show no adverse effects associated with bioactive silicates, in contrast with the marked toxicity of crystalline quartz. The bioactivity of the bioactive silicates may be destroyed by addition of small quantities of multivalent ions. The bioactive materials are currently in clinical use and being tested preclinically for a variety of surgical and dental applications.