Efficacy of bioactive glass versus traditional bone grafts in maxillofacial reconstruction: A systematic review and meta-analysis of clinical outcomes

The aim of this article is to identify whether bioactive glass (BG) is a valid substitute for autogenic bone grafting in maxillofacial reconstruction. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched. Meta-analyses with fixed- and random-effects models were performed by using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity was assessed by using the I² statistic. The significance of results was evaluated at <i>P</i> < 0.05. The BG leads to greater total bone volume retention 6 months after surgery compared with autografts (SMD = 0.796, 95% CI = 0.445-1.147, <i>P</i> = 8.74 × 10⁻⁶, I² = 0%). The resorption rate of BG grafts (SMD = -0.768, 95% CI = -1.360 to -0.176, <i>P</i> = 0.011, I² = 3.82%) was less common, while the retention of the biomaterial (SMD = 1.165, 95% CI = 0.540-1.790, <i>P</i> = 0.00026, I² = 0%) was higher in the experimental group. Both BG and autogenic grafts result in the formation of new bone to a similar extent. However, BG is able to provide long-term stability by maintaining the graft volume, reducing resorption, and preserving the graft scaffold, representing an effective alternative to autogenous bone grafting for a durable maxillofacial reconstruction.