A clinical follow-up method was developed to investigate the behavior of a
massive amount of bioactive glass S53P4 (BG) clinically used in frontal sin
us obliteration. Two sizes of granules (0.63-0.8 mm or 0.8-1.0 mm) in 16 se
parate BG amounts, weight 25 g, were tested both in simulated body fluid (S
BF) and in a buffer containing tris-hydroxymethyl aminomethane citric acid
(TRIS-c,a) in standard conditions. The dissolution of silicon (Si) and phos
phate (P) was detected with direct current plasma atom emission spectroscop
y (DCP-AES) monthly up to 6 months, The BG masses were scanned both wet in
the solutions and dried by computer tomography (CT), and the scans were ana
lyzed by Region of Interest (ROI) technique. Calcium phosphate (CaP)- and s
ilica (Si)-gel-layers were studied by scanning electron microscopy (SEM) at
1, 3, and 6 months. Cumulative loss of Si and P was stronger in TRIS-c,a t
han in SBF (p < 0.0001), and it was higher with smaller than with larger gr
anules in both solutions p < 0.0001). This was shown correspondingly by the
decrease of Hounsfield units (HUs) in ROI analysis (p < 0.0001). The level
of HUs was lower with dried than with wet BG p < 0.0001). The results were
compared for clinical ROI analysis of patients with obliterated frontal si
nuses up to 48 months and they were parallel, The follow-up method seems to
indirectly reveal the behavior of BG and the healing process in the oblite
rated cavity. (C) 2000 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Bio
mater) 58: 54-60. 2001.