Calcium silicate as a graft material for bone fractures: a systematic review

Objective: The goal of this review was to determine whether calcium silicate (wollastonite) as a bone graft material is a viable alternative to autogenous bone or whether the evidence base for its use is weak. Methods: In this systematic review, electronic databases (MEDLINE/PubMed and BVS) were searched for relevant articles in indexed journals. Articles published in a 10-year period were identified (n = 48). After initial selection, 17 articles were assessed for eligibility; subsequently, seven articles were excluded and 10 articles were included. Results: Among the studies included, 20% emphasized the importance of randomization, which adds reliability to the study, minimizing the risk of bias. High variability was observed in the material used, such as additives, amounts, dosage, and chemical alterations, rendering direct comparison among these studies impossible. The experimental periods varied considerably; one of the studies did not include statistical analysis, weakening the evaluation. Nonetheless, the true potential of wollastonite as a graft material conducive to new bone formation was reported in all studies. Conclusion: The results support the use of wollastonite as a bone graft material. The initial research question was answered despite the significant variability observed among these preclinical studies, which hindered the precision of this analysis.