The Role of Bioactive Glasses in Caries Prevention and Enamel Remineralization

Bioactive glasses (BGs) are promising materials for enamel remineralization and caries management due to their ion-releasing ability and capacity to promote apatite formation. However, their clinical translation remains limited. Conventional BGs, such as 45S5, exhibit excellent bioactivity but are mechanically weak, prone to rapid ion burst release, and lack long-term stability. Recent advances—including secondary oxide incorporation (e.g., B2O3, ZnO), polymer–glass hybrids, and nanostructured systems like mesoporous BGs and RegeSi have improved reactivity, mechanical performance, and remineralization depth, though their durability under oral conditions is not yet established. BGs also display antibacterial activity by elevating local pH and releasing ions that inhibit cariogenic bacteria, but their broader ecological impact on the oral microbiome remains poorly understood. Emerging approaches such as halogen-modified BGs, particularly fluoride- and chloride-doped formulations, show dual benefits for remineralization and antimicrobial action, though supporting evidence is largely confined to in vitro studies. The absence of standardized protocols for assessing remineralization, ion release, and biofilm interaction further complicates cross-study comparisons and slows clinical adoption. Future progress will require interdisciplinary collaboration, standardized evaluation methods, and rigorous clinical validation to ensure that next-generation BGs can be safely and effectively integrated into dental practice.