[Updates on Bone Grafts and Substitutes]
Edgard Eduard Engel1, Nelson Fabrício Gava1, Mariana Avelino Dos Santos1
1Departamento de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Abstract:
Bone defects caused by trauma infections neoplasms and other conditions are commonly treated with autologous grafts which are considered the gold standard due to their osteoinduction osteoconduction and osteogenesis properties. However their use has limitations including limited availability donor-site morbidity and increased surgical time. Alternatively allogeneic grafts xenografts and synthetic bone substitutes including ceramics bioglasses resins and metals have been developed and are often modified with osteoinductive elements such as growth factors and bioinorganic ions. The ideal bone replacement should be biocompatible bioabsorbable mechanically resistant porous and capable of promoting osseointegration. Although synthetic substitutes have advanced they have not yet achieved the effectiveness of autologous grafts especially concerning osteointegration and economic viability. However innovations in molecular biology bone proteins and gene therapies offer promising prospects for the development of new biomaterials. The current article introduces the reader to bone substitutes by presenting a classification of the materials used and the main characteristics of each group.
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