# Bioactive glasses as bone substitutes for animal critical defects: A systematic review

## TL;DR

This review examines how bioactive glasses help repair severe bone defects in animals, finding they promote bone growth but with inconsistent results.

## Contribution

The study systematically reviews animal studies on bioactive glasses for bone repair, highlighting the need for standardized methods.

## Key findings

- Bioactive glasses improve bone formation in critical defects in rats and rabbits.
- Key metrics like bone volume and density are used to assess effectiveness.
- Study inconsistencies suggest a need for standardized assessment methods.

## Abstract

Bioactive glasses (BGs) have garnered attention for their ability to bond with native bone tissue and exhibit osteoconductive properties. Despite studies investigating BGs for bone repair, results have been inconsistent, and an ideal formulation for regenerating critical defects has not been established. This systematic review aimed to analyze evidence regarding BG-based biomaterials for bone regeneration in animals with critical defects. The review followed PRISMA guidelines and was registered in PROSPERO (CRD42022325250). A literature search was conducted using PubMed, Web of Science, and Scopus, based on inclusion and exclusion criteria. The risk of bias was assessed using the SYRCLE RoB Tool for Animal Studies. Nine of the 1,467 identified studies were included. Most studies have indicated that bone defects created in rats and rabbits, and treated with BG-based biomaterials, show improved bone formation compared to untreated defects. Key parameters included bone volume, percentage of bone volume, bone mineral density, trabecular number, thickness, and separation. Although most studies indicate that BG-based biomaterials enhance bone formation in critical-sized defects compared to empty controls, study heterogeneity prevents the drawing of definitive conclusions. This review emphasizes the importance of standardized assessment methods to produce reliable research reports that provide robust evidence, ensuring accurate efficacy assessments and ultimately leading to more effective clinical interventions.