Use of demineralized bone matrix in the extremities

Abstract

Autologous bone graft is considered as the gold standard for all indications for bone grafting procedures but the limited availability and complications in donor site resulted in seeking other options like allografts and bone graft substitutes. Demineralized bone matrix (DBM) is an allograft product with no quantity limitation. It is an osteoconductive material with osteoinductive capabilities, which vary among different products, depending on donor characteristics and differences in processing of the bone. The purpose of the present review is to provide a critical review of the existing literature concerning the use of DBM products in various procedures in the extremities. Clinical studies describing the use of DBM alone or in combination with other grafting material are available for only a few commercial products. The Level of Evidence of these studies and the resulting Grades of Recommendation are very low. In conclusion, further clinical studies of higher quality are required in order to improve the Recommendation Grades for or against the use of DBM products in bone grafting procedures.

Strategies to develop endogenous stem cell-recruiting bioactive materials for tissue repair and regeneration

“…A more extensive evaluation of DBM as a clinical product for the treatment of bone disorders has been reviewed thoroughly by Drosos et al . [171]. …”

The effect of temperature exposure during shipment on a commercially available demineralized bone matrix putty

“…Throughout the world, DBM allografts are widely employed in orthopedic surgery as bone graft substitutes and extenders (Drosos et al 2015; Gruskin et al 2012; Tilkeridis et al 2014). While stability studies are routinely performed to ensure the grafts maintain their functional performance over the shelf-life of the product, the impact of extreme environmental exposure during distribution has received far less attention.…”

Biomaterials for Craniofacial Bone Regeneration

“…For optimal surgical handling, DBM is often mixed with binders, such as glycerol (Grafton®), poloxamer carrier (Dynagraft®), hyaluronan (DBX®), gelatin (Regenafil®), calcium sulphate (AlloMatrix™), lecithin (InterGro®), carboxymethyl cellulose (OsteoSelect®), bovine collagen with sodium alginate (PROGENIX® Plus), among other examples. It is also available in the form of freeze-dried powder, granules, gel, putty, or strips [49–51]. Since, DBM possess limited structural support and mechanical strength, it has been commonly utilized as a bone graft extender in well supported, stable skeletal defects [52].…”