Bone grafts: which is the ideal biomaterial?

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Cranio-Maxillofacial Surgery

Background:

• Current cranio-maxillofacial bone replacement relies heavily on bovine xenografts and synthetic biomaterials with limited clinical predictability.
• Upcoming European regulations are anticipated to restrict the use of allografts.
• Despite extensive laboratory research, few novel bone graft (BG) substitutes reach clinical availability, often due to high production costs associated with advanced features.

Purpose of the Study:

• To investigate the discrepancy between the abundance of bone graft research and the limited clinical availability of new substitutes.
• To identify the essential characteristics of an ideal bone graft material for clinical application.

Main Methods:

• A narrative review of existing literature on bone graft substitutes.
• Analysis of key properties of current bone substitutes.
• Discussion of future biomaterial requirements for bone replacement.

Main Results:

• Identified critical properties of contemporary bone substitutes.
• Highlighted the need for diverse mechanical and biological properties tailored to specific applications.
• Provided insights to aid clinical decision-making regarding bone substitutes.

Conclusions:

• Future bone replacement materials are expected to be composite materials.
• These advanced materials will feature heightened bioactivity.
• An optimal balance between bioabsorption and volume maintenance is crucial for achieving ideal bone remodeling.