Bone Graft Substitutes

Bone grafts are used for reconstructive purposes by orthopaedic surgeons, neurosurgeons, plastic surgeons, craniofacial surgeons and periodontists. Autogenous bone graft is used routinely. It heals best but during the procedure of its collection there is high complication rate at donor site including infection, haematoma, nerve damage, chronic pain in donor site, frequent donor site deformation or even pelvic instability. Because of the mentioned limitations on autogenous bone graft, bone graft substitutes are used more and more frequently. Bone graft substitutes can be divided into 3 groups according to their origin and immunological properties: allografts, synthetic materials and xenografts. The aim of the work was to characterize the properties of each group of substitutes. The ideal bone graft substitute should be osteogenic, osteoinductive, osteoconductive, biocompatibile and bioreabsorbable and provide similar durability as natural bone. Barrier membranes and growth factors are used to improve healing process of autogenous and substitute bone grafts. This procedure is known as guided bone regeneration. Great expectations of bone grafting are connected with stem cells from patient's bone marrow cultured to osteoblasts on special, personalized, absorbable polymer scaffold