Bismuth-containing bioceramics: Multifunctional platforms for regeneration and therapy

Bismuth has recently emerged as a multifunctional element bridging the gap among bioactivity, diagnostics, and therapy in advanced glass and ceramic systems. Beyond its well-known clinical use in pharmaceutical compounds, bismuth exhibits distinctive physicochemical properties, including high atomic number, strong polarization ability, and redox versatility that enable unique biological and functional responses. This review consolidates current knowledge on the biological roles of bismuth, including its antibacterial, anticancer, hemostatic, and photothermal effects, as well as its use as a safe radiopacifier in medical imaging. Emphasis is placed on the incorporation of bismuth into bioceramics, including bioactive glasses, glass-ceramics, calcium phosphates, and piezoelectric ceramics, highlighting how Bi3+ substitution alters network structure, crystallization, and ion-release behavior. Across reported studies, Bi incorporation at levels of 1–10 mol. % has been shown to increase radiopacity by 2- to 4-fold, produce up to 90% reductions in bacterial viability, and generate photothermal heating above 50 °C under near-infrared exposure. These quantitative effects underscore how Bi-driven structural modifications translate into measurable biological and functional performance. The multifunctionality of these Bi-containing materials positions them at the forefront of next-generation biomaterials for soft and hard tissue repair, drug delivery, and image-guided therapy.