Medication-related osteonecrosis of the jaw (MRONJ) is a complex disease affecting oral tissues and bone, particularly in patients using anti-resorptive and anti-angiogenic drugs. While its precise etiology remains debated, microorganisms play a key role in its progression. Current treatments rely on antimicrobial washes, broad-spectrum antibiotics, and surgical bone removal, but MRONJ remains an irreversible and growing clinical challenge.
This study investigates the development and characterization of antimicrobial bioactive glasses and their composites with polymethyl methacrylate (PMMA) for potential use in MRONJ management. Bioactive glasses were synthesized by substituting CaO with CuO (0, 1, 2.5, and 5 mol%) in 45S5 bioactive glass via melt processing. Structural characterization (XRF, SEM/EDS, XRD, DSC) and ion release analysis were conducted before antimicrobial and biocompatibility assessments.
Antimicrobial testing with Actinomyces oris (MF1) and a clinical MRONJ isolate showed the strongest activity in 2.5 mol% and 5 mol% Cu-substituted glasses. Prevotella buccae testing was inconclusive due to bacterial growth challenges. A PMMA-based composite (30% w/w) incorporating all glass compositions was developed, and biocompatibility studies showed that higher Cu substitution decreased cell viability. The 5 mol% Cu-glass composite killed all cells within 48 hours, likely due to Cu ion release rather than Na ion-mediated cytotoxicity.
These findings suggest that Cu-substituted bioactive glasses and their PMMA composites exhibit antimicrobial potential but require further optimization for safe biomedical applications and potential integration into advanced manufacturing techniques.
