Calcium Sulfate Bone Substitutes in Clinical Use: History, Material Properties, Application, and Outlook for the Future.

Abstract

Calcium sulfate-based materials have been used in medicine since the 19th century. Their application makes a significant part in the field of bone regeneration in biomedical engineering. Calcium sulfate is a versatile product that is used not only in the reconstruction of bone defects but also as an antibiotic carrier. Various types of calcium sulfate-based bone grafts have demonstrated their safety, well-tolerance, biodegradability, and osteoconductive properties, making them a potential substitute for autogenous bone transplant in the treatment of bone defects. Calcium sulfate and different-sized calcium sulfate beads can be produced and loaded with different antimicrobial substances. High concentrations of antimicrobial agents can be obtained by applying these locally to affected tissue. This review aims to (1) highlight the development and milestones already achieved in the use of calcium sulfate products and (2) outline the material properties and application areas with their related advantages and disadvantages of calcium sulfate products. Lastly, (3) an outlook for the future of calcium sulfate-based biomaterials is given.