text: The formula of S53P4 was first developed in the early 1990s in Turku, Finland, at Åbo Akademi University and University of Turku. It has received the product claim for use in bone cavity filling in the treatment of chronic osteomyelitis in 2011. S53P4 is among the most studied bioactive glasses on the market with over 150 publications.
  When S53P4 bioactive glass is placed into the bone cavity, it reacts with body fluids to activate the glass. During this activation period, the bioactive glass goes through a series of chemical reactions, creating the ideal conditions for the bone to rebuild through osteoconduction.
  * Na, Si, Ca, and P ions are released.
  * A silica gel layer forms on the bioactive glass surface.
  * CaP crystallizes, forming a layer of hydroxyapatite on the surface of the bioactive glass.
  Once the hydroxyapatite layer is formed, the bioactive glass interacts with biological entities, i.e., blood proteins, growth factors and collagen. Following this interaction, the osteoconductive and osteostimulative processes help the new bone grow onto and between the bioactive glass structures.
  * Bioactive glass bonds to bone –facilitating new bone formation.
  * Osteostimulation begins by stimulating osteogenic cells to increase the remodeling rate of bone.
  * Radio-dense quality of bioactive glass allows for post-operative evaluation.
  In the final transformative phase, the process of bone regeneration and remodeling continues. Over time the bone fully regenerates, restoring the patient's natural anatomy.
  * Bone consolidation occurs.
  * S53P4 bioactive glass continues to remodel into bone over a period of years.
  Bioactive glass S53P4 is currently the only bioactive glass on the market which has been proven to inhibit bacterial growth effectively. The bacterial growth inhibiting properties of S53P4 derive from two simultaneous chemical and physical processes, which occurrs 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 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.