Use Of Autologous Bone Research Articles

Characterization of additively manufactured lumbar interbody fusion cages based on triply periodic minimal surfaces

The advent of laser powder bed fusion (LPBF) allows the fabrication of open-porous bone implants such as lumbar interbody fusion (LIF) cages. However, common LIF cages feature massive support structures and cavities for bone substitute material to meet regulatory requirements with respect to mechanical and biological properties. Since the use of autologous bone substitutes involves significant costs and risks, research is being conducted into alternative designs. This is where the present study comes in by exploring the potential of triply periodic minimal surfaces (TPMS) for metallic LIF cages without supports and cavities in a holistic approach. Specifically, various homogeneous and graded scaffolds with pore size of 400–1100μm and volume fraction of ≤0.25 are designed before being produced from Ti-6Al-4V ELI powder using LPBF. Morphological characterization demonstrates a high process fidelity with a maximum of 8.7% target/actual deviation for the volume fraction. This promotes structural integrity so that the compressive strength of 69MPa or 20.6kN complies with the minimum requirements of ASTM F2077. Based on in vitro cell tests, a mineralization process including bone matrix formation is observed in all variants, with the homogeneous scaffold with 1100μm pore size proving to be particularly beneficial. In conclusion, the results encourage the further development of TPMS based LIF cages without support structures and cavities.

Titanium Versus Autologous Bone-Based Cranioplasty: A Systematic Review and Meta-Analysis.

At present, there is no gold standard when looking at reconstructive evidence for cranioplasty with the use of autologous bone as well as other synthetic materials. Titanium has been considered recently as a good option due to its unique properties such as strength and biocompatibility. Numerous studies have previously compared titanium with autologous bone for cranioplasty yet no meta-analysis has been performed within the literature to provide guidelines for craniofacial surgeons. A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of electronic information was conducted to identify all comparative studies of autologous bone vs. titanium implants in cranioplasty following a craniectomy. The primary outcomes were measured as re-operation rates and cosmesis, the secondary outcome measures included the incidence of complications, for example, bone resorption and infection. Five studies were selected, enrolling 323 cases. A high reoperation rate (p > 0.007) was seen in autologous cranioplasty using bone due to the significantly high resorption rate reported in this group. Cosmetic outcomes demonstrated no significant difference between the two groups examined. Finally, costs and infection rates (p > 0.18) were found to be comparable. Overall, titanium implants used in cranioplasty offer lower re-operation rates in comparison to autologous bone grafts whilst there was no major increase in adverse outcomes such as postoperative cost or rates.

Autologous versus synthetic cranioplasty

Background. Cranioplasty has been described in history as far back as the 16th century. The use of autologous cranioplasty has been published since 1821 and is still under practice today worldwide. Recent evidence however has suggested increased complication and revision rates with the use of autologous bone. We compared our results of autologous cranioplasty versus synthetic material. Methods. A retrospective study was carried out of cranioplasty procedures at our unit between August 2009 and March 2018. Bone flaps were placed in a sterile sealed plastic container and stored at -81 degrees. Swabs and bone chips were used for cultures and bone flap disposed if positive. On re-implantation, the bone was thawed at room temperature and soaked in gentamicin. Synthetic cranioplasties were constructed using thin-slice CT to design a custom flap for each patient. Results. 144 cranioplasties were studied. 51 own bone and 93 synthetic. The average delay in cranioplasty was 286 days (Range 16 – 1264 days). The overall complication rate for all 144 cranioplasties was 20.8%; Autologous 31.4% and synthetic 15.1%; p 0.031. Bone flap infection rate overall for all 144 cases was 9.7% - Autologous 11.8% and Synthetic 8.6%; p 0.565. The revision rate was found to be 13.2% overall; 23.5% for autologous and 7.5% for synthetic. The difference in revision rate was found to be statistically significant (p 0.01). Conclusion. Revision rate and overall complication rate were higher in the own bone group with P<0.05. There was no difference in infection. Our results mirror recent publications and should be considered when undertaking a cranioplasty.

The use of autologous bone for augmentation procedures leads to low prevalence of peri-implantitis–a retrospective study over a 20-year period

The aim of this study was to compare the prevalence of peri-implantitis in implants inserted into pristine bone (control) to implants where autologous bone was used for grafting procedures (study).All patients who underwent implant surgery during a 20 years interval by one maxillofacial implant surgeon and received a prosthodontic rehabilitation afterwards were eligible for inclusion in the study. Periimplant bone resorption and periimplant disease were assessed.Of 421 patients 384 (91.2%) patients responded to a recall after having been treated over a 20-year period by one maxillofacial surgeon and several dentists. A total of 110 patients had 239 implants in pristine bone, and 274 patients had 607 implants placed in combination with autologous bone grafting procedures. Mean time in function was 74 months (range 15–236 months). In all, 342 implants (34.8%) were in function for longer than 7 years. A total of 64 implant sites (7.6%) in 39 patients (10.2%) showed signs of peri-implant mucositis. In addition, 17 implants (2.0%) in 14 patients (3.6%) revealed signs of peri-implantitis, of which five implants were in the control group (2.09%) whereas 12 implants were in the study group (1.98%), with no statistically significant difference (p = 0.8405). More than half of the patients with peri-implantitis had a history of periodontitis. Three implants were lost due to peri-implantitis and four implants failed for other reasons, resulting in an overall success rate of 99.2% in 846 implants. ConclusionsWithin the limitations of the study it seems that the use of autologous bone still is a relevant option when performing augmentation procedures because of the low prevalence of peri-implantitis.

Considerations for Choice of Cranioplasty Material for Pediatric Patients

Introduction: Optimal material and timing of cranioplasty in the pediatric population continue to be debated. Autologous and alloplastic materials have various indications for use and risk factors for complications. Methods: A single-center retrospective cohort study was undertaken of all pediatric patients who underwent cranioplasty with any material from 1991–2021. Results: 149 cranioplasty implants were included. Younger age (6 years old or under), a diagnosis of craniosynostosis as reason for implant, use of autologous bone, and shorter times to cranioplasty were predictive of need for revision surgery. No factors studied had a statistically significant impact on rate of removal of implant at time of revision surgery. Conclusion: Autologous and alloplastic cranioplasty materials both have good outcomes with low rates of revision surgery in the pediatric population. Alloplastic implants may be considered in the setting of infection as reason for craniectomy given the lower rate of revision surgery and need for removal. Patients with craniosynostosis as reason for cranioplasty have a higher risk of requiring revision or additional surgeries, regardless of implant used.

Monetite as a potential ideal bone substitute: A short review on fabrication and properties

The use of autologous bone for grafting, although remains as gold standard, still presents high complication rate. Calcium phosphates have been developed to fulfil the requirements as an ideal bone substitute. Among calcium phosphates, hydroxyapatite (HA), beta-tricalcium phosphate (β-TCP), and brushite are considered popular. Albeit being the most popular, those are not without drawbacks. The main issues with hydroxyapatite, β -TCP, and brushite is their solubility and resorption behaviour. On the other hand, monetite, the anhydrous form of brushite, were proven to have better solubility and resorption rate. Past studies have confirmed its osteoconductive and osseo-integrative ability, proving it as a material of importance in bone grafting field. Seeing its potentials, monetite is starting to gain more popularity to be an ideal candidate for bone grafting. This paper intends to present a review of monetite as a bone substitute material. Here, we narrate a review of the fabrication and properties of monetite that have been conducted from previous studies. We also discuss the application of monetite as graft in dental and orthopaedic field. Hopefully readers may find this review helpful to find key information about the emerging importance of monetite and utilize this work as a conduct for further research.

Immediate implants with buccal defects filled with bone from the tuberosity or a xenograft: 1-year randomized trial.

The aim of this study was to compare the use of autologous bone from tuberosity (TUBER) and deproteinized bovine bone mineral (DBBM) in immediate implants with buccal bone defects. A total of 31 patients with one single tooth in the upper anterior region indicated for extraction presenting tomographic buccal bone defect were analyzed. Immediate implantation was conducted for all patients. In one group, DBBM and a collagen membrane were inserted into the buccal defect; in the other group, a small block of bone from tuberosity was used. The primary outcome was facial-palatal ridge thickness (FPT) measured in casts 1 year after function. The implant success rate was 100% in both groups. FPT changes were <0.5 mm and did not differ significantly between groups. FPT reductions in the DBBM and TUBER groups were 1% and 0.6%, respectively, at the gingival margin and 5% and 2%, respectively, at 6 mm apical of the gingival margin (p > 0.05). No significant differences were observed between groups for patient's esthetic, satisfaction, pain and quality of life. Pink esthetic scores for the DBBM and TUBER were 11.5±1.7 and 10.8±1.9, respectively (p=0.37). It can be concluded that DBBM and TUBER did not differ in terms of ridge alterations, peri-implant clinical parameters and patient-reported outcomes.

Clinical and Radiographic Outcomes After Fixation of Chondral Fragments of the Knee in 6 Adolescents Using Autologous Bone Pegs.

Background:Little is known regarding the optimal treatment for displaced, purely chondral fragments in the knee.Purpose:To report the clinical and radiographic outcomes of chondral fragment fixation in adolescents through use of autologous bone pegs.Study Design:Case series; Level of evidence, 4.Methods:This retrospective, single-center study evaluated 6 patients (mean age, 12.9 years) who underwent fixation of chondral fragments (no visualized bone attached) using autologous bone pegs (mean postoperative follow-up, 5.2 years; range, 1.4-10.9 years). The causes were trauma (n = 5) and osteochondritis dissecans (n = 1). Lesions were located in the trochlear groove (lateral, n = 3; medial, n = 2) or posterior part of the lateral femoral condyle (n = 1). The mean lesion size was 3.8 cm2 (range, 0.8-9.0 cm2). Patients were evaluated via physical examination and magnetic resonance imaging (MRI) using magnetic resonance observation of cartilage repair tissue scores.Results:In total, 5 patients successfully returned to sports without restrictions at a mean of 7 months (range, 6-8 months) postoperatively. At the latest follow-up, these 5 patients had full range of motion and no joint effusion. The mean magnetic resonance observation of cartilage repair tissue score was 85 (range, 70-95) at a mean duration of 3 years (range, 1-5 years). One patient experienced failure at 1.3 years postoperatively after a traumatic injury and subsequently underwent removal of the fixed fragment and a drilling procedure.Conclusion:In most adolescents, fixation of chondral fragments with no visualized bony portion using autologous bone pegs provided a satisfactory success rate and good healing of cartilage tissue confirmed on MRI scans.

Clinical study on repair of metacarpal bone defects using titanium alloy implantation and autologous bone grafting.

Due to various limitations in the use of autologous bone and allogeneic bone in the repair of bone defects, the use of synthetic bone graft substitute has become a hot topic in orthopedic surgery and repair medicine. A total of 53 patients treated for trauma-induced metacarpal bone defects were recruited. These patients were divided into the TiAl6V4 titanium alloy implantation group (group A) and the autologous bone graft group (group B). The symptoms of patients in the two groups were closely observed and followed up. The operation time, time to bone fusion, post-surgical pain [visual analog scale (VAS) scores], hand function recovery [total active flexion scale (TAFS) scores] and complications were compared between the two groups. Following surgery, none of the patients had necrosis of fingers or bone non-union. The recovery was rated as excellent and good in up to 91.6% of patients, indicating high clinical efficacy. Compared with the use of autologous bone grafting as the gold standard (group B), there was no significant difference in the excellent and good recovery rate based on TAFS scores at 16 weeks after surgery (91.7 vs. 89.7%, P>0.05), and there was also no significant difference in the incidence of post-operative complications (33.3 vs. 41.3%, P>0.05). The operation time (82.08±6.64 min), time to bone fusion (7.75±1.73 weeks) and VAS scores at 3 days after surgery were all significantly lower in group A than in group B (P<0.05). The values of group B were 104.69±8.63 min, 9.17±2.78 weeks and [5(5, 6)], respectively. However, the hospitalization cost (22,657.8±1,595.4Ұ) was significantly higher than that in group B (14,808.2±2,291.3Ұ; P<0.05). In conclusion, the use of titanium alloy implantation may avoid new injury to the donor site, reduce the operation time and post-operative pain and accelerate bone fusion. Therefore, this method is worthy of popularization for defective bone reconstruction and recovery in the clinic.

A novel economically viable solution for 3D printing-assisted cranioplast fabrication

Cranioplasty is a common neurosurgical procedure which makes use of autologous bone or alloplastic material for cranial defect reconstruction. Alloplastic reconstruction is routinely done in cases where viable autologous bone is not available due to various reasons. Hydroxyapatite implants, patient-specific titanium and PEEK are widely employed materials due to their biocompatibility, durability, and high adaptation accuracy. However, their high cost and limited availability make them a less viable option for the common man. Polymethyl methacrylate (PMMA) is one of the commonly used alloplastic material for cranioplasty. This note presents a novel, economic, patient-specific, 3D printing-assisted and heat polymerized PMMA cranioplast fabrication technique with an accuracy comparable to that of patient-specific titanium and PEEK cranioplast.

Костная аутопластика дефектов большеберцовой кости при эндопротезировании коленного сустава

Objective: to study the results of total knee arthroplasty in the presence of tibial bone defect plateau using an original technique of bone autoplasty. Methods. The analysis of the results of treatment of 12 patients (7 women, 5 men). In 7 patients, primary gonarthrosis was diagnosed, in 2 – post-traumatic, in 3 – secondary arthrosis on the background of rheumatoid arthritis (RA). All patients, due to the presence of tibial condyle defects, underwent bone autoplasty using an original technique. The average defect depth was 13.1±5.2 mm (from 7 to 20 mm), width – 14.2±4.3 mm (from 10 to 22 mm). The observation period was 40±24 months (from 28 to 60 months). The average duration of the operation was 115.7±13.2 minutes (from 90 to 127 minutes). Results. Functional assessment according to the Knee Society Scores (KSS) questionnaire: 6 patients obtained excellent results, 4 – good, 2 – satisfactory (patients with RA). No infectious and thromboembolic complications were recorded. According to X-ray data, there were no signs of instability of the endoprosthesis components. No infectious and thromboembolic complications were recorded. According to the X-ray data, no signs of instability of the components of the endoprosthesis were revealed. Conclusions. Bone autoplasty with resected tibial condyles makes it possible to restore defects up to 20 mm deep. The use of autologous bone reduces the likelihood of allergic reactions, increases the chances of a complete restructuring of the graft and restoration of the supporting surface. The original technique of bone autoplasty provides stable fixation of the graft until its consolidation without additional fixation with metal structures.

Autologous Bone Cranioplasty: A Retrospective Comparative Analysis of Frozen and Subcutaneous Bone Flap Storage Methods

The use of autologous bone for cranioplasty offers superior cosmesis and cost-effectiveness compared with synthetic materials. The choice between 2 common autograft storage mechanisms (subcutaneous vs. frozen) remains controversial and dictated by surgeon preference. We compared surgical outcomes after autologous bone cranioplasty between patients with cryopreserved and subcutaneously stored autografts. Ten-year retrospective comparative analysis of patients undergoing cranioplasty with autologous bone stored subcutaneously or frozen at a tertiary academic medical center. Ninety-four patients were studied, with 34 (36.2%) bone flaps stored subcutaneously and 59 (62.8%) frozen. The 2 groups were similar in demographics, comorbidities, and craniectomy indication, with only body mass index and race differing statistically. The mean operation time was greater within the subcutaneous group (P < 0.001), which also had a greater number of ventriculoperitoneal shunt (VPS) placements (P= 0.02). There were no significant differences in complications, readmissions, unplanned reoperations, or length of stay between the 2 groups. VPS placement during cranioplasty increased length of stay (P < 0.001), and placement prior to cranioplasty increased both length of stay (P= 0.009) and incidence of hospital-acquired infection (P= 0.03). Subcutaneous and frozen storage of autologous bone result in similar surgical risk profiles. Cryopreservation may be preferred because of shorter operation time and avoidance of complications with the abdominal pocket, whereas the portability of subcutaneous storage remains favorable for patients undergoing cranioplasty at a different institution. VPS placement prior to cranioplasty should be avoided, if possible, due to the increased risk of hospital-acquired infection.

Innovation to Pediatric Cranioplasty.

Pediatric cranioplasty poses a reconstructive challenge because of children's developing anatomy and dynamic growth. Although several studies have advocated the use of autologous bone over synthetic material in pediatric population, the full coverage of the cranioplasty defect can be not fulfilled in the majority of the cases due to the size of the defect and the limited bone stock. There is an ongoing research for the development of alloplastic bone substitutes that avoid rigid fixation and promote graft transformation into viable tissue to improve outcomes in alloplastic pediatric cranioplasty. The aim of this study is to offer a detailed review on evolution, evaluation, planning, materials, and outcomes of cranioplasty in pediatric patients.

Microstructured beta-tricalcium phosphate for alveolar cleft repair: a two-centre study

The current standard of care in alveolar cleft repair is timing the procedure in the mixed dentition stage and making use of autologous bone to restore the maxillary defect. Using a synthetic bone substitute bypasses the risk of donor site morbidity and reduces the operation time. In this study, the outcome of alveolar cleft repair using microporous beta-tricalcium phosphate (β-TCP) was investigated in patients with unilateral cleft lip and palate. Twenty patients were enrolled prospectively in this study, divided between two centres. Continuity of the alveolar process, recurrence of oronasal fistulas, and eruption of teeth into the repaired cleft were evaluated at 1year postoperative. Also, cone beam computed tomography scans were analyzed using a volume-based semi-automatic segmentation protocol. No adverse events were reported. The mean residual bone volume in the repaired cleft at 1year postoperative was 65%. There was no recurrence of oronasal fistula. Furthermore, 90% of the teeth adjacent to the cleft erupted spontaneously and all patients showed a continuous alveolar process. Secondary alveolar grafting using microporous β-TCP can safely be used in the clinical situation. Residual calcified tissue, canine eruption, and complication rates at the recipient site are comparable to those with autologous grafts.

Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications.

An irregular craniofacial contour along the temporal fossa, known commonly as 'temporal hollowing deformity,' (THD) can arise from multiple etiologies. In fact, up to half of all patients who undergo neurosurgical pterional dissections develop some form of temporal contour deformities. Unfortunately, temporal hollowing correction remains surgically challenging with many techniques resulting in high rates of failure and/or morbidity. Herein, we describe anatomy contributing to postsurgical temporal deformity as well as time-tested prevention and surgical correction techniques. In addition, a review of 25 articles summarizing various techniques and complication profiles associated with temporal hollowing correction are presented. Complications included infection, implant malposition, revision surgery, pain, and implant removal because of implant-related complications Augmentation with either autologous fat or dermal filler is associated with the highest number of reported complications, including catastrophic events such as stroke, pulmonary embolism, and death. No such complications were reported with use of alloplastic material, use of autologous bone, or free tissue transfer. Furthermore, careful attention to adequate temporalis muscle resuspension and position remain paramount for stable restoration of craniofacial symmetry. Catastrophic complications were associated with injection augmentation of both fat and dermal filler in the temporal region. In contrast, use of alloplastic materials was not found to be associated with any catastrophic complications. As such, for the most severe cases of THD, we prefer to employ alloplastic reconstruction.

Modifications to advanced Core decompression for treatment of Avascular necrosis of the femoral head

Background“Advanced Core Decompression” (ACD) is a new technique for treatment of osteonecrosis of the femoral head (ONFH) that includes removal of the necrotic tissue using a percutaneous expandable reamer followed by refilling of the drill hole and the defect with an injectable, hard-setting, composite calcium sulphate (CaSO4)-calcium phosphate (CaPO4) bone graft substitute. As autologous bone has been shown to be superior to all other types of bone grafts, the aim of the study is to present and evaluate a modified technique of ACD with impaction of autologous bone derived from the femoral neck into the necrotic defect.MethodsA cohort of patients with an average follow-up of 30.06 months (minimum 12 months) was evaluated for potential collapse of the femoral head and any reasons that led to replacement of the operated hip. Only patients in stages 2a to 2c according to the Steinberg classification were included in the study.ResultsIn 75.9% the treatment was successful with no collapse of the femoral head or conversion to a total hip replacement. Analysis of the results of the different subgroups showed that the success rate was 100% for stage 2a lesions and 84.6% respectively 61.5% for stages 2b and 2c lesions.ConclusionsPrevious studies with a comparable follow-up reported less favourable results for ACD without autologous bone. Especially in stages 2b and 2c the additional use of autologous bone has a positive effect. In comparison to other hip-preserving techniques, the modified ACD technique is a very promising and minimally invasive method for treatment of ONFH.Trial registrationGerman clinical trials register (DRKS00011269, retrospectively registered).

Exploring for the optimal structural design for the 3D-printing technology for cranial reconstruction: a biomechanical and histological study comparison of solid vs. porous structure.

Cranioplasty for recovering skull defects carries the risk for a number of complications. Various materials are used, including autologous bone graft, metallic materials, and non-metallic materials, each of which has advantages and disadvantages. If the use of autologous bone is not feasible, those artificial materials also have constraints in the case of complex anatomy and/or irregular defects. This study used metal 3D-printing technology to overcome these existing drawbacks and analyze the clinical and mechanical performance requirements. To find an optimal structure that satisfied the structural and mechanical stability requirements, we evaluated biomechanical stability using finite element analysis (FEA) and mechanical testing. To ensure clinical applicability, the model was subjected to histological evaluation. Each specimen was implanted in the femur of a rabbit and was evaluated using histological measurements and push-out test. We believe that our data will provide the basis for future applications of a variety of unit structures and further clinical trials and research, as well as the direction for the study of other patient-specific implants.

Cranial Reconstruction Using Autologous Bone and Methylmethacrilate.

Having in mind the importance of reconstruction of the calvaria, our goal was to compare the complication rates following the use of autologous bone and methylmethacrilate grafts, and explain the factors influencing them. The authors collected information of all the patients undergoing cranial reconstructive surgery (N = 149) at the Military Medical Academy in Belgrade. Procedures were performed either using a craniotomy bone flap, removed and replaced in the same act, or using methylmethacrilate. These 2 groups were compared using the Chi-squared test, controlling for the confounding influence of the size of the defect. Intracranial neoplasms were the cause for the reconstruction in 71.1% of patients. The total complication rate was 7.4%, while the infection rate was 5.4%. The infection rate was significantly higher in those procedures done using methylmethacrilate (11.3% compared with 2.1%, P = 0.017), but when controlling for the confounding effect of the size of the defect treated, the difference in infection rate was significant only in large defects (13.9% compared with 2%, P = 0.031), while for small defects the difference was not statistically significant. Our study suggests that the material used for reconstruction of calvaria influences the infection rate only in large and complicated defects. Considering the importance of the reconstruction, further studies should explore and confirm the role of material type on the rate of complications.

Growing Skull Fracture and the Orbitocranial Variant: Nuances of Surgical Management

Aims: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. Methods: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015. Results: Four boys and 3 girls were operated during this period. The mean age at initial trauma was 2 years, and most of them sustained falls. The most frequent symptoms of GSF were progressive scalp swelling and proptosis. The most common location was the orbitofrontal region. Duraplasty with cranioplasty was performed in 5 patients, while duraplasty alone was only required in 2 patients. A postoperative complication was noted in 1 patient and managed successfully. Good cosmetic results were obtained in all of the cases. Conclusions: Duraplasty is essential in the repair of GSF and should be followed by cranioplasty to prevent recurrent leptomeningeal herniation. We recommend the use of autologous bone from the surgical site for cranioplasty. Orbital roof repair is advisable for good visual and cosmetic outcome in orbitocranial variants of GSF.

Bone regeneration in critical-sized bone defect enhanced by introducing osteoinductivity to biphasic calcium phosphate granules.

Biphasic calcium phosphate (BCP) is frequently used as bone substitute and often needs to be combined with autologous bone to gain an osteoinductive property for guided bone regeneration in implant dentistry. Given the limitations of using autologous bone, bone morphogenetic protein-2 (BMP2)-coprecipitated, layer-by-layer assembled biomimetic calcium phosphate particles (BMP2-cop.BioCaP) have been developed as a potential osteoinducer. In this study, we hypothesized that BMP2-cop.BioCaP could introduce osteoinductivity to BCP and so could function as effectively as autologous bone for the repair of a critical-sized bone defect. We prepared BMP2-cop.BioCaP and monitored the loading and release kinetics of BMP2 from it invitro. Seven groups (n=6 animals/group) were established: (i) Empty defect; (ii) BCP; (iii) BCP mixed with biomimetic calcium phosphate particles (BioCaP); (iv) BCP mixed with BMP2-cop.BioCaP; (v) BioCaP; (vi) BMP2-cop.BioCaP; (vii) BCP mixed with autologous bone. They were implanted into 8-mm-diameter rat cranial critical-sized bone defects for an invivo evaluation. Autologous bone served as a positive control. The osteoinductive efficacy and degradability of materials were evaluated using micro-CT, histology and histomorphometry. The combined application of BCP and BMP2-cop.BioCaP resulted in significantly more new bone formation than BCP alone. The osteoinductive efficacy of BMP2-cop.BioCaP was comparable to the golden standard use of autologous bone. Compared with BCP alone, significantly more BCP degradation was found when mixed with BMP2-cop.BioCaP. The combination of BCP and BMP2-cop.BioCaP showed a promising potential for guided bone regeneration clinically in the future.