botgraftsubstituten

Bone graft substitutes are materials designed to replace missing bone or enhance bone healing when autologous bone grafts are not available or desirable. They aim to provide a scaffold for new bone growth, support structural stability, and sometimes deliver biological signals to promote repair.

Substitutes fall into several broad groups. Autografts use the patient’s own bone and provide osteogenesis, osteoconduction, and osteoinduction but require a second surgical site. Allografts come from a donor and mainly offer osteoconductive properties with variable osteoinductivity and a risk of disease transmission. Xenografts use tissues from other species and are largely osteoconductive, with more restricted biological activity. Synthetic and bioceramic substitutes include calcium phosphate materials such as hydroxyapatite and beta-tricalcium phosphate, often osteoconductive and gradually resorbed; calcium sulfate and bioactive glasses are other options. Demineralized bone matrix provides collagen-rich, osteoinductive factors. Composite products combine these materials, sometimes with growth factors such as bone morphogenetic proteins (BMPs) to enhance osteoinduction.

Clinical use spans orthopedic surgery, spinal fusion, long-bone nonunions, and dental or maxillofacial reconstruction. Indications typically involve filling defects, augmenting fusion mass, or supporting load-bearing regions when autograft is insufficient or contraindicated. Advantages include avoiding donor-site morbidity and enabling defect-specific shapes; limitations involve variable osteoinductive potential, slower or uncertain remodeling, cost, and, for biologics like BMPs, potential adverse events. Regulation varies by jurisdiction: some products are regulated as devices, others as biologics or tissues, with differing evidence requirements and labeling. Evidence for effectiveness is mixed and often depends on the specific material and clinical context.