Bone graft and bone graft substitutes: A review of current technology and applications

Abstract

The morbidity associated with autogenous bone graft harvest and the recent concern regarding the transmission of live virus through use of allografts, have been the impetus for research into a variety of materials that could take the place of these standard materials for bone grafting. The positive results reported with various ceramics and/or bone derivatives suggest the possibility of a material with osteoconductive and/or osteoinductive properties for use with or in place of bone graft. This review discusses a variety of bone graft and bone graft substitute materials. Among the osteoconductive materials outlined are the hydroxyapatite and tricalcium phosphate ceramics as well as some reportedly osteoactive polymers. While osteoconduction is a favorable quality, much interest has focussed on the use of osteoinductive or osteogenic materials such as demineralized bone matrix or bone derivatives, that is, BMP, osteogenin, etc. It is increasingly apparent that these materials require a carrier vehicle for optimal expression of osteoactivity. Therefore, the review finishes with a comparison of the various materials suggested for use as carriers.Requests for reprints should be sent to

Small-sized granules of biphasic bone substitutes support fast implant bed vascularization

“…37 This biomaterial represents purified bovine extracellular calcified bone matrix and is regarded as having physicochemical properties similar to those of autologous bone grafts, which are considered to be the "gold standard" for bone regeneration. 1,2,42 As it has been shown that the resorbability of this xenogeneic material is delayed, the presented results raise the question of whether the low numbers of multinucleated giant cells in the case of the analyzed biphasic materials also lead to a low rate of degradation and therefore a prolonged material standing time. 37,43 However, the increase of the numbers of MNGCs and especially of their TRAP-positive subforms at the end of the study period in the case of the small-sized BC 400-700 are interesting.…”

“…1,2 Calcium phosphates, specifically hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP), are primarily used because of their chemical similarity to the calcified bone matrix and the related osteoconductive regeneration mechanisms. 3,4 However, it has been shown that these 2 ceramics exhibit different resorption patterns characterized by different dissolution properties and degrees of induction of phagocytosis based on mono-and multinucleated cells.…”

Osteoinduction by Ca-P biomaterials implanted into the muscles of mice

“…Ripamonti et al (1989) reported bone induction in a composite allogeneic bone/alloplastic implant; Zhang et al (1991), Osborn (1991), and Ripamonti (1991a) discovered bone formation at ectopic sites after implantation of porous calcium phosphate ceramic materials in dogs and baboons. Later, osteoinductive bioceramics began to be reported by different labs in pigs, sheep, rabbits, and other large animal models all over the world (Damien and Parsons, 1991;Toth et al, 1993;Li et al, 1994;Yuan et al, 2000;2001a;Nihouannen et al, 2005;Ye et al, 2007;Fellah et al, 2008). Since then, generous attention was paid to these kinds of biomaterials, such as synthetic hydroxyapatite ceramics (HA), porous biphasic calcium phosphate ceramics (BCP), tricalcium phosphate ceramics (TCP), calcium pyrophosphate ceramics, and coralderived hydroxyapatite.…”

Bioactivity of quaternary glass prepared from bentonite clay

“…However, these methods have severe limitations and thus impose high cost on the health care system. The shortcomings associated with autograft include severe pain, morbidity of the harvested site, structural and anatomical problems, and high rate of resorption during healing [1,2]. Likewise, allograft may elicit disease transmission and rejection, further compounded by shortage of donors [3,4].…”