Traditional bioglasses have been investigated extensively and have shown promising remineralization capacity. However, with the evolution of biomaterials, evidence is constantly needed to reveal the properties and to suggest potential clinical uses of the current type of bioglasses. Biosilicates are the most advanced type of bioglasses but literature around iosilicates are scare and scattered. Therefore, there is a need to gather all laboratory and clinical evidence of biosilicates. This systemic review aims to assess the clinical potentials of biosilicates in a wide spectrum in the field of dentistry.

It is confirmed by many studies that biosilicates need to undergo a series of chemical reactions to become available to stimulate bone formation and dental remineralization, reduce dentin hypersensitivity, and arrest and/or reduce carious lesions. Furthermore, in vitro data suggested that biosilicates are also able to enhance adhesive bonding to dentine and enamel, facilitate orthodontic resin removal, reduce a range of bacteria, prevent and reduce gum disease, promote angiogenesis and wound healing. Frontiers in biosilicates are also discussed. Although significant in vitro evidence is available, more clinical dates are needed to validate the clinical use ofbiosilicates in dentistry – This literature review is presented in Pure Dentistry Brisbane Dentist Journal club

Initially, most materials in dentistry were limited to those available in nature. However only in the early twentieth century, the use of biomaterials has increased considerably. 1,2 Over the last few decades, some researches have been investigating the use ofbioactive glasses, mainly because of their capacity to remineralize and regenerate human hard tissues including bone and tooth.3 ,4 Bioactive glass also has shown to be a multipurpose and versatile biomaterial. 4 ,5 Recently, a newly introduced fully crystallized glass-ceramic microparticles, biosilicates, have gained considerable interest. 3•4 One of these materials is trademarked as Biosilicate®, which as a particular composition of23.75Na20-23.75Ca0-48.5Si02-4P20s (wt.%).3 ‘6 Biosilicates have a few positive features that are superior to other bioactive glasses such as excellent mechanical properties, which are due to its structural crystallinity.3,4 Therefore, researches have been conducted around biosilicates with promising results. 3 This essay will provide a general background ofbiosilicates material, the chemical reactions required in the body, clinical applications in the field of dentistry, the properties of biosilicates that makes it superior to other dental materials, as well as frontiers of biosilicates.

Evolution ofbioactive glasses involves several phases. Discovered in 1969, the first Bioglass device was used to treat hearing loss by replacing the middle ear bone. 5•6 The second generation Bioglass is mostly used to replace diseased or lost hard tissue. One of the second Bioglass devices in the market was the Endosseous Ridge Maintenance Implant introduced in 1988. 5 This device is designed to be placed in the fresh tooth extraction socket, providing a
more stable alveolar ridge for future denture construction.5,7 Third-generation biomaterials are the biomaterial that interacts with cells to direct cell proliferation and differentiation.4 The third-generation bioactive glasses are designed to activate genes that stimulate living tissue regeneration through controlling osteoblast cell cycle. 8 Biosilicates are one of the third-generation bioactive glasses. 4

Biosilicates need water to turn them into a bioactive form. When biosilicates come in contact with the body fluids, they undergo five-stage reactions, forming a hydroxycarbonate apatite layer on its surface. 4 This process takes less than 24 hours of exposure to body fluid. 9 Stage I: Silicate glasses release alkali and alkali earth ions into the fluid while H+ and H3Q+ ions from the fluid are incorporated into the glass. This process increases the local PH, with subsequent rupture of Si-0-Si bonds. Stage II: Then silicon is released into the fluid in the form of silanols (Si(OH)4). Stage III: Silanols condensates to form a polymerized silica gel layer on the surface of the glass. The ion exchange between the glass and the fluid continues, as the silica gel is an open structure. Stage IV: Calcium and phosphate ions diffuse from the glass; at the same time, the calcium and phosphate ions are released from the fluid. These ions form an amorphous calcium phosphate layer on the surface of the silica gel. Stage V: After the thickness of the silica gel and the amorphous calcium phosphate layer increases, the carbonate in the amorphous calcium phosphate layer will crystallize into hydroxycarbonate apatite. Most functions ofbiosilicates require the dissolution of ions through the above chemical reactions.

Biosilicates can stimulate more bone tissue fom1ation by enhancing revascularization, promoting osteoblast adhesion, increasing enzymic activity and stimulating osteoprogenitor cells and mesenchymal stem cells differentiation.4 ,10, 12 In the last decade, bioactive glasses are primarily used in the clinic to stimulate the body to repair its bone. 11 This is because biosilicates can form a hydroxycarbonate apatite layer with dissociated ions that activate osteogenic cells to produce more bone. 8, 12 Biosilicates are found to stimulate more rapid bone repair compared to other bioactive ceramics because the dissolution particles of biosilicates can stimulate seven families of genes in human osteoblast. 6 Moreover, Biosilicates integrate to the host bone through interaction with the collagen fibrils. 8 In the study by Moura and colleagues, 13 biosilicates crystallize into considerably larger areas of matrix composed of calcium ions as early as day seventeen of in vivo application, enhancing in vitro bone-like structures formation.
Because biosilicates promote bone formation, it has been used in bone grafting, alveolar ridges maintenance, and osseointegration after titanium dental implant placement.3 When used to coat implant, bone-bonding properties of biosilicates occur as a result of a series of chemical reactions on the implant surface after insertion. 8

Biosilicates have been used as a remineralizing agent in paediatric settings with promising results. 14 When biosilicates adhere to tissue, they constantly release calcium and phosphate irons, which increases the local PH, inducing a favorable environment for dental 1988. 5 This device is designed to be placed in the fresh tooth extraction socket, providing a more stable alveolar ridge for future denture construction.5,7 Third-generation biomaterials are the biomaterial that interacts with cells to direct cell proliferation and differentiation.4 The third-generation bioactive glasses are designed to activate genes that stimulate living tissue regeneration through controlling osteoblast cell cycle. 8 Biosilicates are one of the third-generation bioactive glasses. 4

Dentin hypersensitivity is a common condition as it is experienced by 10-20% of the population in the US and similar numbers in Europe.5 Dentin sensitivity or pain is caused by stimulation of nerves in the pulp, which happens when dentinal tubules that communicate with the pulp are exposed and transmit hot or cold sensations to the nerves.6,11 Therefore, blockage of the dentin tubules can potentially reduce dentine sensitivity. However, currently, there is no treatment protocol for dentin sensitivity though researches have been actively studying this field. 14
Tirapelli and colleagues17 found that biosilicates can reduce dentin sensitivity. Dentinal tubules were found to be occluded 24h after biosilicates application because a carbonated

Following direct topical application ofbiosilicates, the formed hydroxycarbonate apatite crystals can protect the dental surface from acid erosion, control the progression of erosion and caries lesions, prevent demineralization and promote continuous remineralization.3, 14 ,17 A study by Chinelatti and colleagues20 confirmed these effects by comparing the surface treatment of 10% topical biosilicates suspension (5min) and 1.23% acidulated phosphate remineralization. 14 The key concept of biologically active silicate is the controlled rate of release of ions, especially soluble calcium and silica ions. 5 Two mechanisms are responsible for the remineralization effects of biosilicates application. Following ion dissolution, biosilicates can form a chemical bond with dental tissue through a carbonated hydroxyapatite layer, which has a similar chemical  composition and structure to the mineral phase of bond and teeth.4 Biosilicates ions can stimulate osteoblast proliferation and differentiation. 15 The mechanism of this osteoinduction is that, as the bioactive glass contacts body fluid, ions including silicon, calcium, sodium, and phosphate are released into the medium, which activates genes responsible for osteogenesis, ultimately leading to enhanced new bone tissue formation. 15 Therefore, biosilicates are of significant potential to be used in kids with incipient carious lesions, the idea of minimally invasive treatment.16

Clinical study results have shown that many of bonded restorations are placed on cariesaffected dentin, which has a much lower strength value compared to the interface of resin and healthy dentin. 21-23 Therefore, it has been ofresearchers’ interest to either promote remineralization of caries affected dentin and/or the defective interface created with resin and affected dentin to enhance the longevity of teeth and restoration. 3,24 Aiming for this, some researchers have investigated the therapeutic effects of applying biosilicates suspension before bonding of sound of demineralized dentin. 3,25 Morais and colleagues3 found a higher bond strength values after application of bioactive suspension. A recent study by Chinelatti and colleagues26 also found higher dentin adhesive strength after surface treatment with either biosilicates microparticles blasting or paste. The same finding was supported by a few previous studies.5 ,9 ,19 , 27

As discussed above, biosilicates microparticles induce carbonated hydroxyapatite deposition,
which then forms a mineralized surface layer on dentin surface, in the presence of oral
fluids. 14,17 This mineralized layer can adhere to dentin and continuously release calcium and phosphate irons, which promotes tooth remineralization. 3,20,28 Moreover, this augmented hydroxyapatite layer is precipitated, covering the entire dentin surface. 17 Furthermore, biosilicates can react rapidly with peritubular and intratubular dentin to form this hydroxyl carbonate apatite in the open dentinal tubules. 18 Upon investigation, mineral precipitations of Si4+, OH-, Na+, Ca2+, and P04 3- were found on the tooth surface that blocks dentinal tubules.
Scanning electron microscopy studies by Gillam and colleagues19 demonstrated that, although Biosilicates particles that covered the dentine surface and occluded dentine tubules were easily dislodged, dentifrices that have added biosilicates still provide greater dentine surface coverage and tubule occlusion than dentifrices with no biosilicates.

Therefore, suitably formulated biosilicates can be used as a vehicle to treat dentine sensitivity especially in paediatric patients. 19 This property is confirmed by a few more recent studies. 8 When very fine (less than 20 micros) biosilicates are incorporated into toothpaste and applied to exposed root dentine, they adhere to the exposed collagen fibrils, rapidly forming a hydroxyl-carbonate apatite layer which occludes the dentin tubules and relieves the pain. 11 It is proposed that brushing twice a day with biosilicates toothpaste is sufficient to eliminate hypersensitivity. 8

Soon after tooth eruption, pits and fissures are prone to rapid carious attack. Dental sealant is widely accepted to prevent against occlusal caries. 33 But the challenges are they must be applied on a reasonably dry surface and ideally should be applied soon after tooth eruption to prevent plaque accumulation early on. 34 -36 To improve the bonding of sealant to teeth, acid etching becomes a routine in dental practice to increase the micro-porosity in enamel and improve the micromechanical retention of sealants. 4 ,37 However, when teeth erupt, patients are in the age when cooperation is weak, moisture control is difficult, and the risk of contamination during swallowing and tongue movement is high. 18 ,27 ,38 Moreover, newly erupted teeth have complex occlusal surface morphology. 35 Therefore, additional protection is necessary.

It is proposed that, if sealants are associated with remineralizing agent, bioglass, sealant placement will have an added prevention of demineralization through deposition of carbonated hydroxyapatite on the enamel surface. 5 To investigate this property, Silveira and colleagues34 found that, after biosilicates pre-treatment, bond strength value of enamel to adhesive material was increased, but only if the surface was pre-treated with acid etching (total-etch system) before the application ofbiosilicate. Biosilicates also create microporosities on the enamel surface, increasing the retention of sealant, without interfering with the penetration of resins. 4,39 ,4° Furthermore, the increase in bond strength is not influenced by saliva contan1ination, which makes it superior and more clinically practical to other conventional sealants, especially in paediatric settings.6,34

mineral content on dentine surface can form chemical bonds with a functional adhesive copolymer and phosphoric acid esters, creating a complex that resembles those created by glass ionomer cement on dentin after conditioned with polyacrylic acid.29 This chemical bond on the resin-dentin interface also helps to stabilizes the hybrid layer.29 SEM micrographs verified the presence of biosilicates microparticles incorporation in dentinal tubules and on the dentin surface mainly in the groups treated with biosilicates.26 This result was also confirmed by several previous studies.3 Even so, the morphology of the adhesive/dentin interface is not interfered in the SEM micrographs, probably because uniform tags were formed in the hybridized layer.26

However, because there are five stage reactions need to happen to make biosilicates bioactive, the formation of a hydroxycarbonate apatite layer on the dentine resin interface takes time.4 The study found that augmented strength value between sound dentin and resin versus affected dentin and resin was more significant after six months of aging.4

Besides, more differences were found with total-etch adhesive systems than self-etch
system.3 This is because that total-etch system completely dissolves the smear layer and
expose more collagen fibers, enabling greater precipitation ofbiosilicates particles and
subsequently promoting greater quantity of hydroxycarbonate apatite bond with dentin
collagen.3’4 On the contrary, the self-etch system only modifies the smear layer and leaves fewer exposed collagen fibers to bond to biosilicates particles, resulting in lower performance.30, 31 Besides, demineralized dentin is less susceptible to acid etching, and the self-etch system has lower acidity, preventing effective chemical action of the biosilicates particles and resulting in reduced bond strength. 32

fluoride gel (4min) on bovine teeth. Their study found that (1) Biosilicates showed fewer values of surface loss; (2) Biosilicates produced shallower lesion depth for both enamel and dentin; (3) Biosilicates had higher long term retention on tooth surface after cycles of acid attacks; (4) Biosilicates showed significantly higher microhardness of enamel surface.5 ,20 This founding reveals promising clinical application potential of biosilicate to slow down and/or reverse dental erosion and caries in both paediatric and adult teeth.

Biosilicates exhibits a wide spectrum of bactericidal properties, including anaerobic bacteria.9 ,42•43 When biosilicates contact body fluid and cations are released during dissolution, PH in the environment is increased microbes are decreased. 8 Besides, the release of silver irons, Ag, has an antimicrobial effect in the oral environment as well. 8

A study found that only a low concentration of glass in culture is needed to have bactericidal effects on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecalis. 8 Products derived from biosilicates in the form of either powders or scaffolds can release Ag ions in a controlled manner (parts per million level), providing bacteriostatic and bactericidal effects without damaging human cells. 5 Furthem1ore, this antimicrobial effect was observed as early as the first ten minutes of contact between the biosilicates and the microorganisms and the reduction of bacteria was significant.9,42 Therefore, biosilicates potentially can be used in paediatric patients with oral bacteria overload.

Orthodontic brackets removal can cause damage to the enamel and therefore need to be quantified and minimized. 41 Removal of the resin adhesive by biosilicates air-abrasion causes less physical damage to the enamel and results in a smoother surface finish, compared to slow-speed tungsten carbide bur or alumina air-abrasion. 41 Therefore it is recommended to use biosilicates air-abrasion to remove orthodontic resin adhesives in paediatric patients.

Implications for future use ofbiosilicates are based on the cellular and molecular design for tissue engineering and in situ tissue regeneration and repair. 5 Some researchers proposed that biosilicates and its dissolution particles might be able to stimulate stem cells to differentiate into osteoblast-like cells.6 ,11 Other investigations are exploring using bioactive glass as scaffolds for tissue growth while providing space for vascularization. 10

Furthermore, using bioactive as a template for tissue growth can be extrapolated in tissue engineering, maintaining a stable vascular construct in culture before implantation.44 Another frontier is the use of biosilicates to construct load-bearing scaffolds medical devices that can be used in orthopaedics.44 However, future study needs to find out the specific ion/ions released, the quantity of them, the release kinetics and the induced biological effect so that a valid platform can be utilized to deliver tailored concentrations of specific ions to target at specific cell pathways.10

Biosilicates promote angiogenesis through the stimulation of cytokine production in cells, increasing available vascular endothelial growth factor and basic fibroblast growth factor in humans. 7,s Biosilicates also promote wound healing and function as a potential hemostatic agent as they increase the surface areas and encourage faster coagulation ofblood.7

Furthermore, biosilicates promote the proliferation of connective tissue through an elevated update of calcium by fibroblasts. 7 Prepared biosilicates can be used as fibers to engineer soft tissues with a high degree of anisotropy, including muscle, tendon and, ligaments.43 Therefore, biosilicates are of potential clinical value in promoting wound healing in cases of paediatric trauma or surgery.

Biosilicates containing toothpaste can bond to tissue and provide in situ stimulation to promote tissue regeneration.44 Therefore, biosilicates can be used in paediatric dentistry to prevent gum disease and periodontal bone loss. 44

Although significant evidence exists regarding the clinical application ofbioglasses, the data available for biosilicates are mostly from in vitro studies. Appealing results of biosilicates occur mostly as a consequence of the dissolution of ions after biosilicates contact body fluid.

Biosilicates potentially can be used in paediatric dentistry to reduce bone and dental remineralization, decrease dentin hypersensitivity, reduce carious lesions, enhance bonding of adhesives to dentine and enamel, facilitate orthodontic resin removal, decrease oral bacteria, reduce gum disease and promote wound healing. However, more clinical data are needed to confirm the in vivo applications.

1. Huebsch N, Mooney DJ. Inspiration and application in the evolution ofbiomaterials.
Nature. 2009;462(7272):426-32.
2. Abou Neel EA, Pickup DM, Valappil SP, Newport RJ, Knowles JC. Bioactive
functional materials: a perspective on phosphate-based glasses. J Mater Chem.
2009; 19( 6):690-701.
3. de Morais RC, Silveira RE, Chinelatti M, Geraldeli S, de Carvalho Panzeri Pires-deSouza
F. Bond strength of adhesive systems to sound and demineralized dentin treated with
bioactive glass ceramic suspension. Clin Oral Investig. 2018;22(5):1923-31.
4. Crovace MC, Souza MT, Chinaglia CR, Peitl 0, Zanotto ED. Biosilicate®-A
multipurpose, highly bioactive glass-ceramic. In vitro, in vivo and clinical trials. Journal of
Non-Crystalline Solids. 2016;432:90-110.
5. Hench LL. The story ofBioglass®. Journal of Materials Science: Materials in
Medicine. 2006; 17 ( 11 ):967-78.
6. Hench LL. Bioglass: 10 milestones from concept to commerce. Journal ofNon-
Crystalline Solids. 2016;432:2-8.
7. Miguez-Pacheco V, Hench LL, Boccaccini AR. Bioactive glasses beyond bone and
teeth: emerging applications in contact with soft tissues. Acta Biomater. 2015;13:1-15.
8. Jones JR. Review ofbioactive glass: from Hench to hybrids. Acta Biomater.
2013;9(1 ):4457-86.
9. Renno AC, Bossini PS, Crovace MC, Rodrigues AC, Zanotto ED, Parizotto NA.
Characterization and in vivo biological performance of biosilicate. Bio med Res Int.
2013;2013:141427.

10. Hoppe A, Guldal NS, Boccaccini AR. A review of the biological response to ionic
dissolution products from bioactive glasses and glass-ceramics. Biomaterials.
2011;32(11):2757-74.
11. Hench LL. Opening paper 2015- Some comments on Bioglass: Four Eras of
Discovery and Development. Biomedical glasses. 2015;1(1).
12. Fangel R, Bossini PS, Renno AC, Ribeiro DA, Wang CC, Toma RL, et al. Low-level
laser therapy, at 60 J/cm2 associated with a Biosilicate((R)) increase in bone deposition and
indentation biomechanical properties of callus in osteopenic rats. J Biomed Opt.
2011;16(7):078001.
13. Moura J, Teixeira LN, Ravagnani C, Peitl 0, Zanotto ED, Beloti MM, et al. In vitro
osteogenesis on a highly bioactive glass-ceramic (Biosilicate ). J Biomed Mater Res A.
2007;82(3):545-57.
14. Tirapelli C, Panzeri H, Lara EH, Soares RG, Peitl 0, Zanotto ED. The effect of a
novel crystallised bioactive glass-ceramic powder on dentine hypersensitivity: a long-term
clinical study. J Oral Rehabil. 2011;38(4):253-62.
15. Roriz VM, Rosa AL, Peitl 0, Zanotto ED, Panzeri H, de Oliveira PT. Efficacy of a
bioactive glass-ceramic (Biosilicate) in the maintenance of alveolar ridges and in
osseointegration of titanium implants. Clin Oral Implants Res. 2010;21(2):148-55.
16. Narayana SS, Deepa VK, Ahamed S, Sathish ES, Meyappan R, Satheesh Kumar KS.
Remineralization efficiency ofbioactive glass on artificially induced carious lesion an invitro
study. J Indian Soc Pedod Prev Dent. 2014;32(1):19-25.
17. Tirapelli C, Panzeri H, Soares RG, Peitl 0, Zanotto ED. A novel bioactive glassceramic
for treating dentin hypersensitivity. Brazilian oral research. 2010;24(4):381-7.
18. Zhong Y, Liu J, Li X, Yin W, He T, Hu D, et al. Effect of a novel bioactive glassceramic
on dentinal tubule occlusion: an in vitro study. Aust Dent J. 2015;60(1):96-103.

19. Gillam D, Tang J, Mordan N, Newman H. The effects of a novel Bioglass® dentifrice
on dentine sensitivity: a scanning electron microscopy investigation. Journal of Oral
Rehabilitation. 2002;29( 4):305-13.
20. Chinelatti MA, Tirapelli C, Corona SAM, Jasinevicius RG, Peitl 0, Zanotto ED, et al.
Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions.
Braz Dent J. 2017;28(4):489-97.
21. Neves AdA, Coutinho E, Cardoso MV, De Munck J, Van Meerbeek B. Micro-tensile
bond strength and interfacial characterization of an adhesive bonded to dentin prepared by
contemporary caries-excavation techniques. dental materials. 2011;27(6):552-62.
22. Nakajima M, Ogata M, Okuda M, Tagami J, Sano H, Pashley DH. Bonding to cariesaffected
dentin using self-etching primers. American Journal of Dentistry. 1999;12(6):309-14.
23. Yoshiyama M, Tay F, Doi J, Nishitani Y, Yamada T, Itou K, et al. Bonding of selfetch
and total-etch adhesives to carious dentin. Journal of dental research. 2002;81(8):556-60.
24. Sauro S, Osorio R, Watson TF, Toledano M. Influence of phosphoproteins’
biomimetic analogs on remineralization of mineral-depleted resin-dentin interfaces created
with ion-releasing resin-based systems. Dental Materials. 2015;31(7):759-77.
25. Juric H. Current possibilities in occlusal caries management. Acta medica academica.
2013;42(2):216.
26. Chinelatti MA, Santos EL, Tirapelli C, Pires-de-Souza FCP. Effect of Methods of
Biosilicate Microparticle Application on Dentin Adhesion. Dent J (Basel). 2019;7(2).
27. Pires-de-Souza FdC, Marco FFd, Casemiro LA, Panzeri H. Desensitizing bioactive
agents improves bond strength of indirect resin-cemented restorations: preliminary results.
Journal of Applied Oral Science. 2007;15(2):120-6.

28. Kokubo T, Takadama H. How useful is SBF in predicting in vivo bone bioactivity?
Biomaterials. 2006;27(15):2907-15.
29. Sezinando A, Serrano ML, Perez VM, Munoz RA, Ceballos L, Perdigao J. Chemical
Adhesion of Polyalkenoate-based Adhesives to Hydroxyapatite. J Adhes Dent.2016;18(3):257-65.
30. Perdigao J, Lopes M. Dentin Bonding-Questions for the New Millennium. Journal of
Adhesive Dentistry. 1999;1(3).
31. Pashley DH, Tay FR, Breschi L, Tjiiderhane L, Carvalho RM, Carrilho M, et al. State
of the art etch-and-rinse adhesives. Dental materials. 2011;27(1):1-16.
32. Preston K, Smith P, Higham S. The influence of varying fluoride concentrations on in
vitro remineralisation of artificial dentinal lesions with differing lesion morphologies.
archives of oral biology. 2008;53(1 ):20-6.
33. Beslot-Neveu A, Courson F, Ruse ND. Physico-chemical approach to pit and fissure
sealant infiltration and spreading mechanisms. Pediatric dentistry. 2012;34(3):57E-61E.
34. Silveira RE, Vivanco RG, de Morais RC, Da Col Dos Santos Pinto G, Pires-de-Souza
FCP. Bioactive glass ceramic can improve the bond strength of sealant/enamel? Eur Arch
Paediatr Dent. 2019;20(4):325-31.
35. Barroso JM, Torres CP, Lessa FCR, Pecora JD, Palma-Dibb RG, Borsatto MC. Shear
bond strength of pit-and-fissure sealants to saliva-contaminated and noncontaminated
enamel. Journal of dentistry for children. 2005;72(3):95-9.
36. Tulunoglu 0, Bodur H, Dc;ta~li M, Alacam A. The effect of bonding agents on the
microleakage and bond strength of sealant in primary teeth. Journal of oral rehabilitation.
1999;26(5):436-41.
37. Condo R, Cioffi A, Riccio A, Totino M, Condo S, Cerroni L. Sealants in dentistry: a
systematic review of the literature. ORAL & implantology. 2013;6(3):67.

38. Eskandarian T, Baghi S, Alipoor A. Comparison of clinical success of applying a kind
of fissure sealant on the lower permanent molar teeth in dry and wet conditions. Journal of
Dentistry. 2015;16(3):162.
39. Correr GM, Caldo-Teixeira AS, Alonso RCB, Puppin-Rontani RM, Sinhoreti MAC,
Correr-Sobrinho L. Effect of saliva contamination and re-etching time on the shear bond
strength of a pit and fissure sealant. Journal of Applied Oral Science. 2004;12(3):200-4.
40. Askarizadeh N, Norouzi N, Nemati S. The effect of bonding agents on the
microleakage of sealant following contamination with saliva. Journal oflndian Society of
Pedodontics and Preventive Dentistry. 2008;26(2):64.
41. Banerjee A, Paolinelis G, Socker M, McDonald F, Watson TF. An in vitro
investigation of the effectiveness ofbioactive glass air-abrasion in the ‘selective’removal of
orthodontic resin adhesive. European Journal of Oral Sciences. 2008;116(5):488-92.
42. Martins CH, Carvalho TC, Souza MG, Ravagnani C, Peitl 0, Zanotto ED, et al.
Assessment of antimicrobial effect of Biosilicate(R) against anaerobic, microaerophilic and
facultative anaerobic microorganisms. J Mater Sci Mater Med. 2011;22(6):1439-46.
43. Neel EAA, Pickup DM, Valappil SP, Newport RJ, Knowles JC. Bioactive functional
materials: a perspective on phosphate-based glasses. Journal of Materials Chemistry.
2009; 19( 6):690-701.
44. Hench LL, Jones JR. Bioactive Glasses: Frontiers and Challenges. Front Bioeng
Biotechnol. 2015;3:194.