Application of Bone Substitutes and Its Future Prospective in Regenerative Medicine

Abstract

Bone is a hard and dense connective tissue that supports and maintains the body structure and functions. Several factors like aging, drugs, hormonal changes, and physical activities lead to several kinds of bone injuries/fracture. To address these problems, autologous bone graft is considered an ideal material. However, limited availability and complications related to its harvesting process like donor site morbidity and pain limit the use of autologous bone graft in bone regeneration. With increasing advances in technology, several bone substitute materials such as synthetics, bioceramics, and polymers are emerging as a substitute of auto-or allogenous bone for the treatment of bone defect. These bone substitute materials should be biocompatible, bioresorbable, osteoconductive, osteoinductive, and support the ingrowth of new bone. In this chapter, we summarize the currently available bone graft and bone substitute materials including biological and bio-inorganic factors. An overview of the associated advantages, challenges, and future perspectives to clinical implication is also discussed.

Boosting the Osteogenic and Angiogenic Performance of Multiscale Porous Polycaprolactone Scaffolds by In Vitro Generated Extracellular Matrix Decoration

“…5 An acellular alternative to the autograft is an allograft, which is more abundantly available without size limitations. 6 However, allografts need to be processed and cleaned after isolation to prevent an immune response and disease transmission. 7,8 These treatments considerably affect the physical and biological properties of the bone, and the process results in grafts with comparably poor regenerative potential and/or weak mechanical properties depending on the treatment (demineralization, deproteination, and irradiation).…”

“…Autogenous bone grafts are considered to be the gold standard as they have osteogenic, osteoinductive, and osteoconductive properties. − However, the autologous bone is mostly harvested from the iliac crest (hip) with limited availability and carries the risk of donor site morbidity . An acellular alternative to the autograft is an allograft, which is more abundantly available without size limitations . However, allografts need to be processed and cleaned after isolation to prevent an immune response and disease transmission. , These treatments considerably affect the physical and biological properties of the bone, and the process results in grafts with comparably poor regenerative potential and/or weak mechanical properties depending on the treatment (demineralization, deproteination, and irradiation). , The regulations of the European Union for medical devices, known as the Medical Device Directive (MDD), were replaced with a new set of Medical Device Regulations (MDR) in 2017, and the new MDR will come into force on May 2020.…”

Osteoconductive Metallic Implants Using Hydroxyapatite Nanoparticles

“…But the fractures of bones due to various trauma or natural aging are a typical type of a tissue failure. An operative treatment frequently requires implantation of a temporary or a permanent prosthesis, which still is a challenge for orthopedic surgeons, especially in cases of large bone defects as observed after bone tumor resections and severe nonunion fractures [26,27].…”

Towards Stem Cell Therapy for Critical-Sized Segmental Bone Defects: Current Trends and Challenges on the Path to Clinical Translation

“…Over two million bone graft surgeries are performed annually [9,10], making bone the most highly transplanted tissue after blood [11]. A literature search was conducted on the Web of Science using the terms 'bone tissue engineering', 'clinical', and 'critical-sized bone defects' to identify studies published within the last 10 years (Figure 1a) and their geographical distribution.…”