Clinical Applications of S53P4 Bioactive Glass in Bone Healing and Osteomyelitic Treatment: A Literature Review.

J J Arts,D J W Hulsen,N A P Van Gestel,J Geurts,S Hofmann,B Van Rietbergen

doi:10.1155/2015/684826

Abstract

Nowadays, S53P4 bioactive glass is indicated as a bone graft substitute in various clinical applications. This review provides an overview of the current published clinical results on indications such as craniofacial procedures, grafting of benign bone tumour defects, instrumental spondylodesis, and the treatment of osteomyelitis. Given the reported results that are based on examinations, such as clinical examinations by the surgeons, radiographs, CT, and MRI images, S53P4 bioactive glass may be beneficial in the various reported applications. Especially in craniofacial reconstructions like mastoid obliteration and orbital floor reconstructions, in grafting bone tumour defects, and in the treatment of osteomyelitis very promising results are obtained. Randomized clinical trials need to be performed in order to determine whether bioactive glass would be able to replace the current golden standard of autologous bone usage or with the use of antibiotic containing PMMA beads (in the case of osteomyelitis).

Highlights

Bone graft substitutes are commonly used to replace and regenerate bone lost due to trauma, infection, disease, or for stability around implanted devices [1]
S53P4 bioactive glass is indicated as a bone graft substitute in various clinical applications
This review provides an overview of the current published clinical results on indications such as craniofacial procedures, grafting of benign bone tumour defects, instrumental spondylodesis, and the treatment of osteomyelitis

Summary

Introduction

Bone graft substitutes are commonly used to replace and regenerate bone lost due to trauma, infection, disease, or for stability around implanted devices [1]. Bioactivity refers to any interaction or effect that materials have on cells to activate specific responses [3, 4] Such a promising biomaterial is bioactive glass, an osteostimulative material that is currently used as bone graft substitute and in the treatment of osteomyelitis. Osteostimulation should not be confused with osteoinduction, which is the ability of materials to recruit stem cells to differentiate into bone forming cells and form ectopic bone. It should not be confused with osteoconduction, which is the possibility for bone to grow along the material, in other words only providing a scaffold for bone formation [6]. Bioactive glass is an osteostimulative material; it is osteoconductive and serves as a scaffold for bone formation in vivo, but it is not fully osteoinductive since it will only form new orthotopic bone (whereas osteoinductive materials are able to form ectopic bone)

Objectives

Findings

Discussion

Conclusion