Table 1. Prospective randomized clinical studies evaluating the efficacy of B-G and its variants in craniomaxillofacial bone reconstruction and oral surgery.

Title	Author	Journal	Scope	Patients and methods	Results	Conclusion
Using 45S5 Bioglass cones as endosseous ridge maintenance implants to prevent alveolar ridge resorption: a 5-year evaluation	Stanley et al	Int J Oral Maxillofac Implants 1997;12(1):95–105	To examine the effectiveness of B-G 45S5 cones as space fillers after removal of tooth roots to delay the resorption of alveolar ridges	Retrospective review of 168 implants in 20 recalled patients with a mean postimplantation interval of 63.2 mo	High rate (85.7%) of cone retention after 5 y	Placement of B-G 45S5 into fresh sockets promoted alveolar ridge preservation
Particulate bioglass as a grafting material in the treatment of periodontal intrabony defects	Zamet et al	J Clin Periodontol 1997;24(6):410–418	To evaluate the effects of B-G 45S5 in the treatment of periodontal intrabony defects	Retrospective review of 20 patients. Clinical follow-up measurements were recorded at baseline, 3 mo and 1 y. Standardized radiographs for computer-assisted densitometric image analysis (CADIA) were taken at baseline, immediately postoperatively and at 1 y	CADIA data showed a significant increase in radiographic density and volume between the defects treated with B-G 45S5 when compared with those treated with surgical debridement only. Probing pocket depth and attachment level showed significant in sites treated with B-G 45S5	Results demonstrated the efficiency of B-G 45S5 as an adjunct to conventional surgery in the treatment of intrabony defects
Comparison of Bioactive glass synthetic bone graft particles and open debridement in the treatment of human periodontal defects. A clinical study	Froum et al	J Periodontol 1998;69(6):698–709	To compare the repair response of B-G 45S5 and open debridement in the treatment of human periodontal osseous defects	Retrospective review of 16 patients. Radiographs and soft tissue presurgical measurements were repeated at 6, 9, and 12 mo. At 12 mo, all sites were surgically re-entered to record osseous measurements	Significantly greater mean probing depth reduction was noted, and clinical attachment level gain was significantly improved in the B-G 45S5 group compared with the controls. Also, there was significantly less gingival recession, and defect fill reduction was significantly greater in the B-G 45S5 sites compared with the control sites	B-G 45S5 showed significant improvements in clinical parameters compared with open flap debridement
Clinical evaluation of bioactive glass in the treatment of periodontal osseous defects in humans	Lovelace et al	J Periodontol 1998;69(9):1027–1035	To compare the use of B-G 45S5 to demineralized freeze-dried bone allograft (DFDBA) in the treatment of human periodontal osseous defects	Paired osseous defects in 15 patients with moderate to advanced adult periodontitis were randomly selected to receive grafts of B-G 45S5 or DFDBA. Clinical follow-up measurements were taken the day of surgery and at the 6-mo re-entry surgery	The results indicated that both treatments provided soft and hard tissue improvements when compared with baseline. No statistical difference was found when comparing sites grafted with B-G 45S5 to the use of DFDBA	This study showed that B-G 45S5 was capable of producing results in the short term (6 mo) similar to that of DFDBA when used in moderate to deep intrabony periodontal defects
Alveolar ridge reconstruction and/or preservation using root form bioglass cones	Yilmaz et al	J Clin Periodontol 1998;25(10):832–839	To investigate the efficacy of root form B-G 45S5 cones implanted extraction sites to avoid deformities of the residual alveolar ridge in the maxillary anterior region	Retrospective review of 16 patients. Alveolar ridge width and height measurements were obtained using study casts preoperatively, immediately postoperatively, and at 3 and 12 mo after operation	No dehiscences were detected. The differences between preoperative original ridge height and width and postoperative measurements were not statistically significant	Results demonstrated the efficiency of this method in preserving alveolar ridges following tooth extraction, particularly relevant in relation to preparation for subsequent restorative treatment
A bioactive glass particulate in the treatment of molar furcation invasions	Anderegg et al	J Periodontol 1999;70(4):384–387	To evaluate the effects of B-G 45S5 in the treatment of mandibular molar furcation invasion defects. Patients received surgical therapy using B-G 45S5 compared with open flap debridement alone	Retrospective review of 15 patients. Clinical follow-up measurements were recorded at 3 and 6 mo postoperatively	The results of therapy were statistically significant in the defects treated with B-G 45S5	Results demonstrated the efficiency of B-G 45S5 in the treatment of class II furcation defects regarding the clinical parameters of probing depth reduction and the reduction in bleeding on probing
Histological observations on biopsies harvested following sinus floor elevation using a bioactive glass material of narrow size range	Tadjoedin et al	Clin Oral Implants Res 2000;11(4):334–344	To evaluate the bone augmenting capacity of B-G 45S5 particles in human sinus floor elevations	Retrospective review of 10 patients. Bilateral grafting was performed using a 1:1 mixture of autogenous bone particles (from iliac crest) and B-G 45S5 particles at one side (experimental side), and bone particles only at the other side (control side, split mouth design). Histomorphometrical measurements were repeated at 4, 6, and 16 mo from bone biopsies	B-G 45S5 particles transformed and became excavated with time, starting at 4 mo, and their centers gradually filled with bone tissue. All B-G 45S5 particles had disappeared by resorption at 16 mo after grafting and had been replaced by bone tissue. Parameters of bone turnover indicated that bone remodeling was very active at both sides	Results demonstrated that a 1:1 mixture of autogenous bone/B-G 45S5 particles seemed a promising alternative to autogenous bone only, when low amounts of bone tissue are available for sinus augmentation
Reconstruction of orbital floor fractures using bioactive glass	Kinnunen et al	J Craniomaxillofac Surg 2000;28(4):229–234	To compare the use of B-G S53P4 implants with autogenous cartilage grafts for the repair of orbital floor defects after trauma	Retrospective review of 28 patients performed from 1995 to 1999. Clinical and radiological follow-up between 2 and 5 y after surgery	Postoperative tomograms showed adequate maintenance of orbital and maxillary sinus volume without any evidence of resorption or complications in either group	Bioactive glass implants were well tolerated and seemed to be a promising repair material for orbital floor fractures as well as the use of autologous bone alone. Their use provided favorable healing, caused new bone formation, and led to less morbidity as no donor-site operation was needed
Clinical comparison of bioactive glass bone replacement graft material and expanded polytetrafluoroethylene barrier membrane in treating human mandibular molar class II furcations	Yukna et al	J Periodontol 2001;72(2):125–133	To examine the response of mandibular molar class II furcations to treatment with either B-G 45S5 or expanded polytetrafluoroethylene (ePTFE) barrier membrane	Retrospective evaluation until surgical reentry at 6 mo in 27 pairs of mandibular molars in 27 patients with moderate to advanced periodontitis	Follow-up measurements demonstrated essentially similar clinical results with both treatments for bone and soft tissue changes	Equal clinical results with B-G 45S5 and ePTFE barriers. B-G 45S5 was associated with simpler application and required no additional material removal procedures
Maxillary sinus floor augmentation using bioactive glass granules and autogenous bone with simultaneous implant placement	Cordioli et al	Clin Oral Implants Res 2001;12(3):270–278	To evaluate the use of B-G 45S5 combined with autogenous bone (4:1 ratio) as grafting material for maxillary sinus augmentation with simultaneous implant placement	Unilateral or bilateral sinus augmentation was performed in 12 patients. Presurgical CT scans and core biopsy specimens were evaluated between 9 and 12 mo	An increase in mineralized tissue height of 7.1 ± 1.6 mm was evident when comparing the presurgical and 9–12 mo CT scans. Histological evaluation yielded a mean of 30.6 ± 5.7% of bone tissue in the grafted sites	B-G 45S5 with autologous bone graft used in one-stage sinus augmentation yielded sufficient quality and volume of mineralized tissue for predictable simultaneous implant placement in patients with 3–5 mm of bone height before grafting
Effects of pretreatment clinical parameters on bioactive glass implantation in intrabony periodontal defects	Park et al	J Periodontol 2001;72(6):730–740	To examine the effectiveness of B-G 45S5 implantation in intrabony periodontal defects	Retrospective evaluation 6 mo after surgery in 38 intrabony defects from 38 patients with chronic periodontitis	Comparative observation between preoperative and postoperative clinical parameters (probing depth, clinical attachment level, bone probing depth, and gingival recession) showed significantly greater improvements after B-G 45S5 implantation	Use of B-G 45S5 in flap operations resulted in significantly greater improvements over flap operation alone
Repair of orbital floor fractures with bioactive glass implants	Aitasalo et al	J Oral Maxillofac Surg 2001;59(12):1390–1395; discussion 1395–1396	To examine the effectiveness of B-G S53P4 implants for the repair of orbital floor defects caused by blunt facial trauma	Retrospective review of 36 patients performed from 1995 to 1999. Clinical and radiological follow-up at 1, 3, and 12 mo after surgery	No foreign body reaction and no inflammation in the bone or soft tissue. No sign of resorption or infection, nor postoperative extrusion, hemorrhage, or displacement. New bone formation around the implants. Good functional and cosmetic results at the 1-y follow-up	B-G S53P4 well-tolerated material in orbital floor reconstruction. It provided a favorable environment for an uncomplicated healing process
Clinical evaluation of an enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans	Sculean et al	J Periodontol 2002;73(4):401–408	To compare the treatment of deep intrabony defects with a combination of enamel matrix protein derivative (EMD) and B-G 45S5 to B-G 45S5 alone	Retrospective review of 28 patients with chronic periodontitis. Soft tissue measurements (evaluation of probing depth, clinical attachment level, and gingival recession) were made at baseline and at 1 y following therapy	No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 y after therapy, no statistically significant differences in any of the investigated parameters were observed between the test and control groups	The combination of EMD and B-G 45S5 did not seem to additionally improve the clinical outcome of the therapy with B-G 45S5 alone
Bioactive glass granules as a bone adjunctive material in maxillary sinus floor augmentation	Turunen et al	Clin Oral Implants Res 2004;15(2):135–141	To compare the use of B-G S53P4 granules mixed with autologous bone (AB) chips harvested from the iliac crest (1:1 mixture) to bone alone in bilateral sinus floor augmentation procedure	Retrospective review of 17 patients. Biopsies for histological, scanning electron microscopy (SEM), and energy dispersive X-ray (EDX) analyses were taken after 21, 34, 49, and 62 wk	Histological evaluation and histomorphometrical analysis performed from the SEM images revealed similar results between the two groups. EDX analysis showed a tight contact and chemical bonding between the glass and bone	B-G S53P4 granules could be used together with AB chips as bone adjunctive material in maxillary sinus floor augmentation procedures, thus decreasing the amount of bone needed
Bioactive glass S53P4 in frontal sinus obliteration: a long-term clinical experience	Peltola et al	Head Neck 2006;28(9):834–841	To use B-G S53P4 as obliteration material in a series of osteoplastic frontal sinus operations on patients suffering from chronic frontal sinusitis	Retrospective review of 42 patients. Clinical and histopathologic follow-up at 1, 5, and 10 y after surgery	Histopathologic samples revealed bone formation. Fourier-transform infrared (FTIR) studies showed bone produced by B-G S53P4 to be similar to natural frontal bone. Microbiologic cultures obtained with histologic samples revealed no growth of bacteria	Accurate obliteration of sinuses achieved in 39 patients and uneventful recovery in 92% of the patients showed that B-G S53P4 was a reliable frontal sinus obliteration material, providing favorable conditions for total bony sinus obliteration
Bioabsorbable membrane and bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis: results of a 5-year clinical and radiological study	Mengel et al	J Periodontol 2006;77(10):1781–1787	To compare the long-term effectiveness of bioabsorbable membrane Gore Resolut XT (RXT) (Gore Resolut® XT W.L. Gore & Associates Inc., Newark, DE) and B-G 45S5 in the treatment of intrabony defects in patients with generalized aggressive periodontitis	Clinical and radiological evaluation before surgery, at 6 mo and every year for 5 y after surgery of 16 patients: 22 intrabony defects treated with RXT and 20 treated with B-G 45S5	Comparative observation of clinical parameters (plaque index, gingival index, probing depth, bleeding on probing, gingival recession, clinical attachment level, and tooth mobility) at baseline and every year for 5 y showed highly significant improvements with both groups	No significant difference between the use of RXT membrane and B-G 45S5 in the treatment of intrabony defects in patients with generalized aggressive periodontitis. Both regenerative materials gave good results in the treatment of intrabony periodontal defects
Four-year results of a prospective-controlled clinical study evaluating healing of intrabony defects following treatment with an enamel matrix protein derivative alone or combined with a bioactive glass	Sculean et al	J Clin Periodontol 2007;34(6):507–513	To evaluate the 4-y results following regenerative periodontal surgery at intrabony defects with either a combination of enamel matrix protein derivative (EMD) and B-G 45S5 or with EMD alone	Retrospective review of 25 patients randomly treated with either EMD or B-G 45S5, 13 treated with EMD alone (control). Measurements were recorded at baseline, at 1 and 4 y following therapy	Evaluation of clinical attachment level, probing depth, and gingival recession showed no statistically significant differences in any of the investigated parameters at 1 and 4 y between the treatment groups	Results indicated that the clinical improvements obtained with both regenerative modalities could be maintained over a period of 4 y
Clinical evaluation of platelet-rich plasma and bioactive glass in the treatment of intra-bony defects	Demir et al	J Clin Periodontol 2007;34(8):709–715	To evaluate the effect of B-G 45S5 with and without platelet-rich plasma (PRP) on the clinical healing of intrabony defects	Retrospective review of 29 patients. Intrabony defects were randomly treated with either PRP/B-G 45S5 or B-G 45S5 alone. Clinical parameters were recorded at baseline and repeated 9 mo after surgery and surgical re-entries were also performed	Pocket depth reduction, clinical attachment gain, and defect fill were noted in both groups. None of the differences between the two treatment modalities were statistically significant	Results showed that both treatment modalities were effective in the treatment of intrabony defects. The results also showed that using PRP with B-G 45S5 has no additional benefit in the reduction of pocket depth, clinical attachment gain, and defect fill
A cost-effectiveness evaluation of enamel matrix derivatives alone or in conjunction with regenerative devices in the treatment of periodontal intra-osseous defects	Listl et al	J Clin Periodontol 2010;37(10):920–927	To identify the most cost-effective approach to treatment of infrabony lesions with enamel matrix derivatives (EMD)	Costs and clinical outcomes of 12 different treatment techniques (including flap operation, EMD alone, and EMD in association with B-G 45S5) were compared	The most cost-effective treatment option was identified on the basis of the maximum net benefit criterion. The maximum net benefit was achieved by treatment with EMD in conjunction with B-G 45S5	If EMD use is indicated, EMD in conjunction with either B-G 45S5 is more cost effective than EMD alone
Comparison of bioactive glass coated and hydroxyapatite coated titanium dental implants in the human jaw bone	Mistry et al	Aust Dent J 2011;56(1):68–75	To evaluate and compare the behavior of hydroxyapatite and B-G 45S5 coated implants (62 implants) in osseous tissue following implantation in 31 patients	B-G 45S5 coating was applied by vitreous enameling technique. The outcome was assessed up to 12 mo after prosthetic loading using different clinical and radiological parameters	B-G 45S5 coating materials were nontoxic and biocompatible. Overall results showed that B-G 45S5 coated implants were as equally successful as hydroxyapatite in achieving osseointegration and supporting final restorations	B-G 45S5 is a good alternative coating material for dental implants, possibly allowing wider case selection criteria together with improved integration rates even in the more challenging osteoporotic and medically compromised patients
Autogenous cortical bone and bioactive glass grafting for treatment of intraosseous periodontal defects	Sumer et al	Eur J Dent 2013;7(1):6–14	To compare the effectiveness of autogenous cortical bone (ACB) and B-G 45S5 grafting for the regenerative treatment of intraosseous periodontal defects	Via a split-mouth design, 15 chronic periodontitis patients who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to receive two treatments in contralateral areas of the dentition: ACB grafting and B-G 45S5 grafting. The parameters compared in the patients were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights	Both treatment modalities resulted in significant changes in postoperative measurements when compared with preoperative values. PPDs were decreased, CALs were increased, and radiographic alveolar bone heights were increased in patients treated with both ACB grafting and B-G 45S5 grafting. Differences between the treatments were not statistically significant	Both ACB and B-G 45S5 grafting led to significant improvements in clinical and radiographic parameters 6 mo postoperatively. These results suggest that either an ACB graft, which is completely safe with no associated concerns about disease transmission and immunogenic reactions, or a B-G 45S5 graft, which has an unlimited supply, can be selected for regenerative periodontal treatment
Adipose stem cells used to reconstruct 13 cases with cranio-maxillofacial hard-tissue defects	Sándor et al	Stem Cells Transl Med 2014;3(4):530–540	To examine the effectiveness of B-G 45S5 scaffolds seeded with adipose-derived stem cells (ASCs) for the repair of craniomaxillofacial hard-tissue defects. Autologous adipose tissue was harvested from the anterior abdominal wall, and adipose-derived stem cells were cultured, expanded, and then seeded onto resorbable scaffold materials for subsequent reimplantation into hard-tissue defects	Retrospective review of 13 patients. Hard-tissue defects at four anatomically different sites, namely, frontal sinus (3 cases), cranial bone (5 cases), mandible (3 cases), and nasal septum (2 cases). Follow-up time ranged from 12 to 52 mo	Successful integration of the construct to the surrounding skeleton was noted in 10 of the 13 cases. Two cranial defect cases in which nonrigid resorbable containment meshes were used sustained bone resorption to the point that they required the procedure to be redone. One septal perforation case failed outright at 1 y because of the postsurgical resumption of the patient's uncontrolled nasal picking habit	Results indicated that the clinical improvements obtained with the use of (ASCs) seeded in B-G 45S5 scaffolds could be maintained over a period of 4 y