Anti-biofilm properties of bioactive glasses embedding organic active compounds

Bioactive glasses (BGs) are promising materials for bone repair due to their desirable properties such as osteoconductivity, biodegradability, angiogenic potential, and antibacterial activity. Ionic dissolution products from bioactive glasses increase the medium pH inhibiting surrounding bacteria proliferation. The activity of BGs against biofilm formation has been enhanced by incorporating organic antibacterial compounds. The aim of this review was to summarize evidence in literature which assesses the efficacy of antibacterial and anti-biofilm compounds embedded in bioactive glasses to prevent peri-implant infection during bone healing. A PubMed bibliographical research was carried out including articles published in the last 20 years. Most previous studies evaluated antibacterial efficiency in planktonic cultures but did not investigate biofilm inhibition, underestimating biofilm clinical relevance. Multifactorial features such as biocompatibility of embedded compounds, receptor site characteristics, and drug delivery efficiency have been found to influence the bioactive glass capability of acting both as an anti-biofilm agent and as a bone repairing biomaterial. Accordingly, further in vitro and in vivo studies are required to select the most promising anti-biofilm agents which should be incorporated into bioactive glasses to counteract biofilm proliferation, without inducing toxic effects on human cells, and with the added functionality of promoting bone regeneration.