A review of the bioactivity of hydraulic calcium silicate cements

Li Na Niu, Kai Jiao, Tian Da Wang, Wei Zhang, Josette Camilleri, Brian Edward Bergeron, Hai Lan Feng, Jing Mao, Ji Hua Chen, David Henry Pashley, Franklin Chi Meng Tay

Research output: Contribution to journalReview articlepeer-review

144 Scopus citations


Objectives In tissue regeneration research, the term " bioactivity" was initially used to describe the resistance to removal of a biomaterial from host tissues after intraosseous implantation. Hydraulic calcium silicate cements (HCSCs) are putatively accepted as bioactive materials, as exemplified by the increasing number of publications reporting that these cements produce an apatite-rich surface layer after they contact simulated body fluids. Methods In this review, the same definitions employed for establishing in vitro and in vivo bioactivity in glass-ceramics, and the proposed mechanisms involved in these phenomena are used as blueprints for investigating whether HCSCs are bioactive. Results The literature abounds with evidence that HCSCs exhibit in vitro bioactivity; however, there is a general lack of stringent methodologies for characterizing the calcium phosphate phases precipitated on HCSCs. Although in vivo bioactivity has been demonstrated for some HCSCs, a fibrous connective tissue layer is frequently identified along the bone-cement interface that is reminiscent of the responses observed in bioinert materials, without accompanying clarifications to account for such observations. Conclusions As bone-bonding is not predictably achieved, there is insufficient scientific evidence to substantiate that HCSCs are indeed bioactive. Objective appraisal criteria should be developed for more accurately defining the bioactivity profiles of HCSCs designed for clinical use.

Original languageEnglish (US)
Pages (from-to)517-533
Number of pages17
JournalJournal of Dentistry
Issue number5
StatePublished - May 2014


  • Bioactivity
  • Calcium silicate
  • Hydraulic cement
  • In vitro
  • In vivo

ASJC Scopus subject areas

  • Dentistry(all)


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