Abstract
The use of bone scaffolds to replace injured or diseased bone has many advantages over the currently used autologous and allogeneic options in clinical practice. This systematic review evaluates the current evidence for non-cellular scaffolds containing bioactive glass on osteogenesis and angiogenesis in animal bone defect models. Studies that reported results of osteogenesis via micro-CT and results of angiogenesis via Microfil perfusion or immunohistochemistry were included in the review. A literature search of PubMed, EMBASE and Scopus was carried out in November 2019 from which nine studies met the inclusion and exclusion criteria. Despite the significant heterogeneity in the composition of the scaffolds used in each study, it could be concluded that scaffolds containing bioactive glass improve bone regeneration in these models, both by osteogenic and angiogenic measures. Incorporation of additional elements into the glass network, using additives, and using biochemical factors generally had a beneficial effect. Comparing the different compositions of non-cellular bioactive glass containing scaffolds is however difficult due to the heterogeneity in bioactive glass compositions, fabrication methods and biochemical additives used.
Highlights
Bones are composed of a dense connective tissue and they serve a large variety of functions
Seven out of the nine papers included in this review studied bioactive glass scaffolds with added non-cellular components as outlined below
It was later shown that the dissolution of the bioactive glass particles releases ions that acted as signals into the cells, prompting upregulation of certain genes and subsequent increases in nuclear transcription factors, cell cycle regulators, and growth factors such as insulin-like growth factor II (IGF-II) (Xynos et al, 2000, 2001)
Summary
Bones are composed of a dense connective tissue and they serve a large variety of functions. These include mechanical functions such as internal organ protection, synthetic functions such as hematopoiesis within the bone marrow and metabolic functions such as acting as reservoirs for minerals (Taichman, 2005). Many methods to achieve regeneration have been investigated, including the “gold standard” autologous bone grafting, allograft implantation, or autologous bone transplantation. These methods are not without their limitations, especially with regards to cost-effectiveness and even efficacy (Dimitriou et al, 2011). Scaffolds can be seeded with cells and growth factors in order to aid this process
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