Abstract
This review analyzes the literature of bone grafts and introduces tissue engineering as a strategy in this field of orthopedic surgery. We evaluated articles concerning bone grafts; analyzed characteristics, advantages, and limitations of the grafts; and provided explanations about bone-tissue engineering technologies. Many bone grafting materials are available to enhance bone healing and regeneration, from bone autografts to graft substitutes; they can be used alone or in combination. Autografts are the gold standard for this purpose, since they provide osteogenic cells, osteoinductive growth factors, and an osteoconductive scaffold, all essential for new bone growth. Autografts carry the limitations of morbidity at the harvesting site and limited availability. Allografts and xenografts carry the risk of disease transmission and rejection. Tissue engineering is a new and developing option that had been introduced to reduce limitations of bone grafts and improve the healing processes of the bone fractures and defects. The combined use of scaffolds, healing promoting factors, together with gene therapy, and, more recently, three-dimensional printing of tissue-engineered constructs may open new insights in the near future.
Highlights
Unlike other tissues, the bone can regenerate and repair itself: in many instances, bone injuries and fractures heal without scar formation [1,2]
Using a rat ectopic bone formation model, rhBMP-2 was injected into a collagen matrix and the results showed that using collagen, it is possible to functionally deliver bone-based growth factors to produce new bone formation in vivo [81]
The results suggest that systemic zoledronic acid administration may improve osseointegration of titanium implants in bone
Summary
The bone can regenerate and repair itself: in many instances, bone injuries and fractures heal without scar formation [1,2]. Using a rat ectopic bone formation model, rhBMP-2 was injected into a collagen matrix and the results showed that using collagen, it is possible to functionally deliver bone-based growth factors to produce new bone formation in vivo [81] Despite their excellent bioactivity, collagen-based scaffolds have low mechanical properties and are susceptible to substantial shrinkage during cell culture, which limits their potential applications in tissue engineering of bone. After seeding with human MSCs and osteoblasts, the composite imparted beneficial cellular growth capability and gene expression, and mineralization abilities were well established suggesting its potential application in bone regeneration [91] As another strategy, a combination of different polymers has been tried to increase the cell cytocompatibility of the synthetic-based scaffolds. Commercial bovine bone matrix, allograft bone matrix, calcium sulfate, and bioactive silicate are other available options with variable osteoconductivity and osteoinductivity
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