Abstract
Bioactive glasses (BAGs) are bone substitutes with bone-bonding, angiogenesis-promoting and antibacterial properties. The bioactive process that leads to bone bonding is described through reactions at the glass surface. This chapter describes the chemical reactions following implantation of the glass that lead to the formation of silanol (SiOH) groups at the glass surface and the subsequent formation of a CaO-P 2 O 5 hydroxyapatite (HA) layer on top of the Si-rich layer. Finally, cell interactions with the HA layer are shown to initiate the bone-forming pathway. The chapter also explains and compares the antibacterial properties of different bioactive glasses, showing BAG-S53P4 to be the most effective against significant pathogens and bacteria. These findings are demonstrated in a multicentre trial involving eleven patients of osteomyelitis treated with BAG-S53P4 implants, which demonstrated the good grafting and antibacterial properties of S53P4 as an implant material and bone graft substitute. It has since been used successfully in further operations.
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