Allogenic Bone and Bone Healing

Abstract

Within the scope of the specialty, the use of exogenous materials capable of promoting bone regeneration or bone healing constitutes an extremely valuable adjunct to current reconstructive modalities. Areas where these technologies may be applied include the reconstruction of skeletal defects, correction of developmental clefts, augmentation of alveolar ridges for dental implants, accelerated repair of fracture and osteotomy sites and the treatment of non-unions. Where defects or non-unions exist, the principal advantage of utilizing bone substitutes is the avoidance or minimization of autogenous bone harvesting. Appropriate selection of existing materials or the development of new substitutes relies upon a comprehensive understanding of the physiological mechanisms involved in bone formation. These processes, osteogenesis, osteoinduction and osteoconduction, will be summarized and the abilities of several commercially available products to promote these biological mechanisms reviewed. Proper material selection must also take into account the various functional requirements posed by a specific skeletal defect. Included in these considerations are loading patterns, physical characteristics of the defect, and potential for exposure to an external environment. The physical properties of different types of bone substitutes will be discussed in relation to these demands.