90:. S53P4 was found to be osteostimulative (non-osteoinductive), but it also had one new additional property: the composition of 53% silica and smaller weights of sodium, calcium and phosphorus gave rise to surface reactions in vitro that appeared to inhibit bacterial growth – a material that could not be infected by bacteria was discovered.
197:
The bacterial growth inhibiting properties of S53P4 derive from two simultaneous chemical and physical processes, occurring once the bioactive glass reacts with body fluids. Sodium (Na) is released from the surface of the bioactive glass and induces an increase in pH (alkaline environment), which is
148:
When S53P4 bioactive glass is implanted into a bone cavity, the glass is activated through a reaction with body fluids. During this activation period, the bioactive glass goes through a series of chemical reactions, creating the ideal conditions for bone to rebuild through osteoconduction.
860:
Rantakokko J, Frantzén JP, Heinänen J, Kajander S, Kotilainen E, Gullichsen E, Lindfors NC (2012). "Posterolateral spondylodesis using bioactive glass S53P4 and autogenous bone in instrumented unstable lumbar spine burst fractures. A prospective 10-year follow-up study".
816:
Frantzén J, Rantakokko J, Aro HT, Heinänen J, Kajander S, Gullichsen E, et al. (October 2011). "Instrumented spondylodesis in degenerative spondylolisthesis with bioactive glass and autologous bone: a prospective 11-year follow-up".
98:
Areas of use include a wide range of indications that require the filling of bone cavities, voids, and gaps as well as the reconstruction or regeneration of bone defects. Several long-term studies have shown that mastoid cavities in both
713:
Malat TA, Glombitza M, Dahmen J, Hax PM, Steinhausen E (April 2018). "The Use of
Bioactive Glass S53P4 as Bone Graft Substitute in the Treatment of Chronic Osteomyelitis and Infected Non-Unions – a Retrospective Study of 50 Patients".
198:
not favorable for the bacteria, thus inhibiting their growth. The released Na, Ca, Si and P ions give rise to an increase in osmotic pressure due to an elevation in salt concentration, i.e. an environment where bacteria cannot grow.
583:
Vos J, de Vey
Mestdagh P, Colnot D, Borggreven P, Orelio C, Quak J (December 2017). "Bioactive glass obliteration of the mastoid significantly improves surgical outcome in non-cholesteatomatous chronic otitis media patients".
273:
Virolainen P, Heikkilä J, Yli-Urpo A, Vuorio E, Aro HT (April 1997). "Histomorphometric and molecular biologic comparison of bioactive glass granules and autogenous bone grafts in augmentation of bone defect healing".
387:
Drago L, De Vecchi E, Bortolin M, Toscano M, Mattina R, Romanò CL (2015). "Antimicrobial activity and resistance selection of different bioglass S53P4 formulations against multidrug resistant strains".
132:
S53P4 has also been used successfully in the filling of benign bone tumor cavities in both adults and children, sustaining the bone cavity volume long term. Clinical experience has been gained from
344:
Leppäranta O, Vaahtio M, Peltola T, Zhang D, Hupa L, Hupa M, et al. (February 2008). "Antibacterial effect of bioactive glasses on clinically important anaerobic bacteria in vitro".
181:
In the final transformative phase, the process of bone regeneration and remodeling continues. Over time, the glass is fully remodeled into bone, restoring the patient's natural anatomy.
627:
Bigoni M, Turati M, Zanchi N, Lombardo AS, Graci J, Omeljaniuk RJ, et al. (April 2019). "Clinical applications of
Bioactive glass S53P4 in bone infections: a systematic review".
757:
Lindfors N, Geurts J, Drago L, Arts JJ, Juutilainen V, Hyvönen P, et al. (2017). "Antibacterial
Bioactive Glass, S53P4, for Chronic Bone Infections – A Multinational Study".
163:
Once the hydroxyapatite layer is formed, the bioactive glass interacts with biological entities, i.e. blood proteins, growth factors and collagen. Following this interactive,
937:
Lindfors NC, et al. (2010). "A prospective randomized 14-year follow- up study of bioactive glass and autogenous bone as bone graft substitutes in benign bone tumours".
670:
Godoy-Santos AL, Rosemberg LA, de Cesar-Netto C, Armstrong DG (January 2019). "The use of bioactive glass S53P4 in the treatment of an infected
Charcot foot: a case report".
110:
Clinical application has been gained from several extensive studies where patients with bone infections have been treated. S53P4 has shown promising results in chronic
309:
Zhang D, Leppäranta O, Munukka E, Ylänen H, Viljanen MK, Eerola E, et al. (May 2010). "Antibacterial effects and dissolution behavior of six bioactive glasses".
490:
de Veij
Mestdagh PD, Colnot DR, Borggreven PA, Orelio CC, Quak JJ (July 2017). "Mastoid obliteration with S53P4 bioactive glass in cholesteatoma surgery".
535:"Anatomical, functional and quality-of-life results for mastoid and epitympanic obliteration with bioactive glass s53p4: a prospective clinical study"
423:
Drago L, Vassena C, Fenu S, De Vecchi E, Signori V, De
Francesco R, Romanò CL (2014). "In vitro antibiofilm activity of bioactive glass S53P4".
784:
220:"In vitro antibacterial activity of bioactive glass S53P4 on multiresistant pathogens causing osteomyelitis and prosthetic joint infection"
999:
287:
82:
in the late 1960s in New York. A couple of decades later, in the 1980s, the compound S53P4 bioactive glass was developed in
534:
1006:
978:
906:"Novel bioactive glass putty (S53P4) as bone graft expander in minimally invasive lumbosacral interbody fusion"
469:
118:
surgery, segmental defect reconstructions and other infectious complications, such as sternum infections,
1033:
533:
Bernardeschi D, Pyatigorskaya N, Russo FY, De Seta D, Corallo G, Ferrary E, et al. (April 2017).
115:
133:
62:). S53P4 has been proven to naturally inhibit the bacterial growth of up to 50 clinically relevant
886:
842:
798:
739:
695:
652:
609:
565:
515:
369:
79:
174:
Osteostimulation begins by stimulating osteogenic cells to increase the remodeling rate of bone.
954:
878:
834:
790:
780:
731:
687:
644:
601:
557:
507:
440:
405:
361:
326:
291:
255:
167:
and osteostimulative process, new bone grows onto and between the bioactive glass structures.
946:
917:
870:
826:
770:
762:
723:
679:
636:
593:
549:
499:
432:
397:
353:
318:
283:
245:
235:
59:
159:
CaP crystallizes, forming a layer of hydroxyapatite on the surface of the bioactive glass.
63:
47:
50:
and also osteoproductive in the promotion, migration, replication and differentiation of
250:
231:
219:
164:
55:
1027:
743:
656:
126:
119:
111:
100:
75:
890:
846:
802:
699:
613:
373:
683:
569:
519:
104:
503:
830:
640:
761:. Advances in Experimental Medicine and Biology. Vol. 971. pp. 81–92.
137:
27:
922:
905:
874:
597:
357:
240:
51:
188:
S53P4 bioactive glass continues to remodel into bone over a period of years.
177:
Radio-dense quality of bioactive glass allows for post-operative evaluation.
43:
958:
882:
838:
794:
735:
691:
648:
605:
561:
511:
444:
409:
365:
330:
259:
766:
727:
295:
461:
35:
950:
775:
322:
87:
39:
1000:"Bacterial growth inhibition of Bonalive® granules", version 91310f/1"
553:
436:
401:
288:
10.1002/(SICI)1097-4636(199704)35:1<9::AID-JBM2>3.0.CO;2-S
31:
972:
759:
A Modern
Approach to Biofilm-Related Orthopaedic Implant Infections
83:
54:
cells and their matrix production. In other words, it facilitates
218:
Cunha MT, Murça MA, Nigro S, Klautau GB, Salles MJ (April 2018).
171:
Bioactive glass bonds to bone – facilitating new bone formation.
125:
S53P4 has gained clinical experience within spine surgery in
107:
can be successfully obliterated with S53P4 bioactive glass.
629:
European Review for
Medical and Pharmacological Sciences
156:
A silica gel layer forms on the bioactive glass surface.
904:
Saarenpää I, Hirvonen J, Rinne J, Frantzén J (2018).
346:
Journal of
Materials Science: Materials in Medicine
311:Journal of Biomedical Materials Research. Part A
74:The S53P4 bioactive glass has its roots in the
716:Zeitschrift für Orthopädie und Unfallchirurgie
974:Bonalive Smart Healing (EN), version 91308d/3
8:
819:Journal of Spinal Disorders & Techniques
586:European Archives of Oto-Rhino-Laryngology
921:
774:
249:
239:
276:Journal of Biomedical Materials Research
456:
454:
210:
7:
153:Na, Si, Ca, and P ions are released.
122:osteomyelitis and spine infections.
103:, old radical cavities, and chronic
14:
910:J Minim Invasive Spine Surg Tech
140:and nonossifying fibroma (NOF).
136:(ABC), simple bone cysts (UBC),
863:Scandinavian Journal of Surgery
684:10.12968/jowc.2019.28.Sup1.S14
193:Inhibition of bacterial growth
129:and spinal deformity surgery.
1:
504:10.1080/00016489.2017.1279346
831:10.1097/BSD.0b013e31822a20c6
641:10.26355/eurrev_201904_17498
462:"Our story, Glass into bone"
1050:
923:10.21182/jmisst.2018.00332
875:10.1177/145749691210100113
185:Bone consolidation occurs.
1007:Bonalive Biomaterials Ltd
979:Bonalive Biomaterials Ltd
598:10.1007/s00405-017-4757-7
470:Bonalive Biomaterials Ltd
358:10.1007/s10856-007-3018-5
241:10.1186/s12879-018-3069-x
542:Clinical Otolaryngology
224:BMC Infectious Diseases
492:Acta Oto-Laryngologica
767:10.1007/5584_2016_156
728:10.1055/s-0043-124377
672:Journal of Wound Care
466:Bonalive Biomaterials
134:aneurysmal bone cysts
20:Bioactive glass S53P4
635:(2 Suppl): 240–251.
951:10.1002/jbm.b.31636
425:Future Microbiology
390:Future Microbiology
323:10.1002/jbm.a.32564
144:Mechanism of action
939:J Biomed Mater Res
58:and regeneration (
786:978-3-319-52273-9
678:(Sup1): S14–S17.
592:(12): 4121–4126.
554:10.1111/coa.12748
437:10.2217/fmb.14.20
402:10.2217/FMB.15.57
1041:
1018:
1017:
1015:
1013:
1004:
996:
990:
989:
987:
985:
969:
963:
962:
934:
928:
927:
925:
901:
895:
894:
857:
851:
850:
813:
807:
806:
778:
754:
748:
747:
710:
704:
703:
667:
661:
660:
624:
618:
617:
580:
574:
573:
539:
530:
524:
523:
487:
481:
480:
478:
476:
458:
449:
448:
420:
414:
413:
384:
378:
377:
341:
335:
334:
306:
300:
299:
270:
264:
263:
253:
243:
215:
116:septic non-union
64:bacteria strains
60:osteostimulation
1049:
1048:
1044:
1043:
1042:
1040:
1039:
1038:
1024:
1023:
1022:
1021:
1011:
1009:
1002:
998:
997:
993:
983:
981:
971:
970:
966:
936:
935:
931:
903:
902:
898:
859:
858:
854:
815:
814:
810:
787:
756:
755:
751:
712:
711:
707:
669:
668:
664:
626:
625:
621:
582:
581:
577:
537:
532:
531:
527:
489:
488:
484:
474:
472:
460:
459:
452:
422:
421:
417:
386:
385:
381:
343:
342:
338:
308:
307:
303:
272:
271:
267:
217:
216:
212:
207:
201:
195:
165:osteoconductive
146:
96:
72:
48:osteoconductive
17:
12:
11:
5:
1047:
1045:
1037:
1036:
1026:
1025:
1020:
1019:
991:
964:
929:
896:
852:
808:
785:
749:
722:(2): 152–159.
705:
662:
619:
575:
548:(2): 387–396.
525:
498:(7): 690–694.
482:
450:
431:(5): 593–601.
415:
379:
336:
301:
265:
232:BioMed Central
209:
208:
206:
203:
194:
191:
190:
189:
186:
179:
178:
175:
172:
161:
160:
157:
154:
145:
142:
95:
92:
71:
68:
56:bone formation
30:consisting of
15:
13:
10:
9:
6:
4:
3:
2:
1046:
1035:
1032:
1031:
1029:
1008:
1001:
995:
992:
980:
976:
975:
968:
965:
960:
956:
952:
948:
944:
940:
933:
930:
924:
919:
915:
911:
907:
900:
897:
892:
888:
884:
880:
876:
872:
868:
864:
856:
853:
848:
844:
840:
836:
832:
828:
825:(7): 455–61.
824:
820:
812:
809:
804:
800:
796:
792:
788:
782:
777:
772:
768:
764:
760:
753:
750:
745:
741:
737:
733:
729:
725:
721:
717:
709:
706:
701:
697:
693:
689:
685:
681:
677:
673:
666:
663:
658:
654:
650:
646:
642:
638:
634:
630:
623:
620:
615:
611:
607:
603:
599:
595:
591:
587:
579:
576:
571:
567:
563:
559:
555:
551:
547:
543:
536:
529:
526:
521:
517:
513:
509:
505:
501:
497:
493:
486:
483:
471:
467:
463:
457:
455:
451:
446:
442:
438:
434:
430:
426:
419:
416:
411:
407:
403:
399:
396:(8): 1293–9.
395:
391:
383:
380:
375:
371:
367:
363:
359:
355:
352:(2): 547–51.
351:
347:
340:
337:
332:
328:
324:
320:
317:(2): 475–83.
316:
312:
305:
302:
297:
293:
289:
285:
281:
277:
269:
266:
261:
257:
252:
247:
242:
237:
233:
229:
225:
221:
214:
211:
204:
202:
199:
192:
187:
184:
183:
182:
176:
173:
170:
169:
168:
166:
158:
155:
152:
151:
150:
143:
141:
139:
135:
130:
128:
127:spine fusions
123:
121:
120:diabetic foot
117:
113:
112:osteomyelitis
108:
106:
102:
101:cholesteatoma
93:
91:
89:
85:
81:
78:developed by
77:
76:bioglass 45S5
69:
67:
65:
61:
57:
53:
49:
45:
41:
37:
33:
29:
25:
21:
1034:Biomaterials
1010:. Retrieved
994:
982:. Retrieved
973:
967:
945:(1): 57–64.
942:
938:
932:
913:
909:
899:
869:(1): 66–71.
866:
862:
855:
822:
818:
811:
776:10138/252437
758:
752:
719:
715:
708:
675:
671:
665:
632:
628:
622:
589:
585:
578:
545:
541:
528:
495:
491:
485:
473:. Retrieved
465:
428:
424:
418:
393:
389:
382:
349:
345:
339:
314:
310:
304:
279:
275:
268:
227:
223:
213:
200:
196:
180:
162:
147:
131:
124:
109:
105:otitis media
97:
94:Applications
73:
23:
19:
18:
916:(2): 52–8.
282:(1): 9–17.
138:enchondroma
80:Larry Hench
46:. S53P4 is
28:biomaterial
16:Biomaterial
205:References
52:osteogenic
744:263428196
657:109940029
114:surgery,
44:phosphate
24:BAG-S53P4
1028:Category
1012:June 12,
959:20524190
891:38296163
883:22414472
847:28088570
839:21909036
803:22072415
795:28050878
736:29665602
700:73428010
692:30724119
649:30977891
614:20851852
606:28956143
562:27608143
512:28125327
445:24957087
410:26228640
374:21444777
366:17619981
331:19582832
260:29614973
36:silicate
984:May 11,
570:1060470
520:4520396
475:May 11,
296:9104694
251:5883601
234:: 157.
88:Finland
70:History
40:calcium
26:) is a
957:
889:
881:
845:
837:
801:
793:
783:
742:
734:
698:
690:
655:
647:
612:
604:
568:
560:
518:
510:
443:
408:
372:
364:
329:
294:
258:
248:
32:sodium
1003:(PDF)
887:S2CID
843:S2CID
799:S2CID
740:S2CID
696:S2CID
653:S2CID
610:S2CID
566:S2CID
538:(PDF)
516:S2CID
370:S2CID
230:(1).
84:Turku
1014:2020
986:2020
955:PMID
879:PMID
835:PMID
791:PMID
781:ISBN
732:PMID
688:PMID
645:PMID
602:PMID
558:PMID
508:PMID
477:2020
441:PMID
406:PMID
362:PMID
327:PMID
292:PMID
256:PMID
42:and
947:doi
943:94B
918:doi
871:doi
867:101
827:doi
771:hdl
763:doi
724:doi
720:156
680:doi
637:doi
594:doi
590:274
550:doi
500:doi
496:137
433:doi
398:doi
354:doi
319:doi
284:doi
246:PMC
236:doi
1030::
1005:.
977:.
953:.
941:.
912:.
908:.
885:.
877:.
865:.
841:.
833:.
823:24
821:.
797:.
789:.
779:.
769:.
738:.
730:.
718:.
694:.
686:.
676:28
674:.
651:.
643:.
633:23
631:.
608:.
600:.
588:.
564:.
556:.
546:42
544:.
540:.
514:.
506:.
494:.
468:.
464:.
453:^
439:.
427:.
404:.
394:10
392:.
368:.
360:.
350:19
348:.
325:.
315:93
313:.
290:.
280:35
278:.
254:.
244:.
228:18
226:.
222:.
86:,
66:.
38:,
34:,
1016:.
988:.
961:.
949::
926:.
920::
914:3
893:.
873::
849:.
829::
805:.
773::
765::
746:.
726::
702:.
682::
659:.
639::
616:.
596::
572:.
552::
522:.
502::
479:.
447:.
435::
429:9
412:.
400::
376:.
356::
333:.
321::
298:.
286::
262:.
238::
22:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.