Review Article

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

Table 1

Summary of reviewed publications with S53P4 bioactive glass used in craniofacial surgery procedures.

ReferenceClinical indicationNumber of treated patients with S53P4 implantsApplication formNumber of successful treatmentsComplications related to S53P4 implantStudy designFollow-up period [months]Examinations during follow-up

Suominen and Kinnunen [18]Facial reconstructions36 sites in 13 patientsGranules (0.63–0.8 and 0.8–1 mm) and plates ( mm, 1.5, 2.0, 2.5, or 3.0 mm thick)361 reoperation for repositioning of orbital roofProspective single centre cohort study12 (average, range: 6–26)Clinical examination, radiographs, and QCT

Aitasalo et al. [19]Orbital floor reconstructions of blowout fractures and zygomaticomaxillary fractures34Plates in 3 different sizes (diameter: 20, 25, or 30 mm, 1–1.5 mm thick)331 removal due to incorrect sizeRetrospective single centre cohort study10.9 (average, range: 6–12)Clinical examination by an ear, nose, and throat surgeon, an ophthalmologist, and a radiologist. Laboratory tests for infection, liver and kidney functions

Peltola et al. [20]Orbital floor reconstructions of blowout fractures, zygomaticomaxillary fractures, and tumour removal43Plates (sizes not reported)403 reoperations due to inappropriate size and shapeRetrospective single centre cohort study24 Clinical examination by the surgeon, ophthalmologist, examination of CT and MRI images, and laboratory tests for infection and kidney function

Stoor et al. [21]Orbital floor reconstructions of blowout factures20Drop shaped in 2 sizes (1.5 mm thick and  mm or  mm) 20NoneProspective single centre cohort study32 (average, range: 6–71) Clinical examination by the surgeon, examination CT and MRI

Peltola et al. [22]Frontal sinus obliteration42Granules (0.5–0.8 and 0.8–1.0 mm)39None, but 2 reobliteration cases due to mucocele
1 reobliteration due to insufficient closure of the nasofrontal duct
Prospective single centre cohort study73.2 (average, range: 3–13.1) Clinical evaluation by the surgeons, examination by CT

Stoor et al. [23]Septal perforation repair11Disks (200–1300 mm2, 2 mm thick)81 near total septum perforation could not be closed
2 small recurrent perforations
Prospective single centre cohort studyRange: 2–37Clinical examination not reported

Stoor and Grénman [24]Septal perforation repair23Disks (200–1300 mm2, 2 mm thick)221 near total septum perforation could not be closed
5 reoperations because of a small recurrent
perforation: closed with bioactive glass, successfully
Prospective single centre cohort study28 (average, range: 12–68)Clinical examinations

Turunen et al. [25]Maxillary sinus floor augmentation17Granules (0.8–1.0 mm) mixed with autologous bone chips17NoneProspective single centre cohort study17 (average, range: 7–30) Examination of biopsies by SEM, EDXA and histologically

Sarin et al. [26]Mastoid obliteration26Plates and granules (sizes not reported) 211 reoperation due to inadequate fascia coverage
2 postoperative otorrhea cases which were debrided
2 ears which were not dry
Prospective single centre cohort study42.5 (average, range: 1–182)Clinical examinations

Silvola [27]Mastoid obliteration16Granules (0.5–0.8 and 0.8–1.0 mm)141 revision due to ruptured skin
1 meatoplasty because of too extensive filling
Prospective single centre pilot study 26 (average, range: 7–48)Clinical outcome obtained by a grading system

Stoor et al. [28]Mastoid obliteration7Granules (0.5–0.8 mm)61 infection (related to conservative treatment instead of the S35P4)Prospective single centre case study57 (average, range: 22–98)Clinical examinations, CT imaging (1 patient) Laboratory tests for infection and kidney functions