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Demineralized Bone Matrix: A Viable Option for Bone
Repair and Regeneration
What is Demineralized Bone
Matrix?
Demineralized bone matrix (DBM) is an osteobiologic material that is derived
from human or animal bones. It contains naturally occurring bone morphogenetic
proteins (BMPs) and other growth factors that are essential for bone formation.
DBM is created by removing mineral components from donated cadaver or animal
bones through an acid extraction process, leaving behind a collagen matrix and
protein growth factors. This process strips away the bone's minerals including
calcium and retains the osteoinductive organic components that induce bone
formation.
Preparation and Characteristics of Demineralized
Bone Matrix
To prepare Demineralized
Bone Matrix, bones from human or animal donors are treated with an acid
solution to dissolve the mineral content and extract the collagen matrix. The
extracted solution is then heat-treated and deorganized to preserve the
biological activity of BMPs and other osteoinductive factors. The final
processed DBM takes the form of a powder, gel, or putty that is easy to mix
with bone voids or new bone graft. It maintains microscopic pore structure from
the original bone to promote cellular infiltration and new bone ingrowth. DBM
provides an osteoconductive scaffold as well as osteoinductive growth factors
that recruit stem cells to the defect site and initiate the bone healing
cascade.
Clinical Applications of Demineralized Bone Matrix in Bone Repair
DBM has been widely used in orthopedic and dental procedures as an
alternative to autograft for bone repair and regeneration. Some common clinical
applications include:
- Spinal fusion surgeries - DBM is mixed with spinal bone graft extenders to
promote fusion and healing of vertebrae.
- Joint reconstruction - It can augment bone grafting in total hip and knee
replacements to maximally fill defects and enhance bone bonding to implants.
- Periodontal and dental procedures - Used as a graft material in jaw
reconstruction and regrowth of alveolar bones supporting dental implants.
- Foot and ankle reconstruction - Facilitates repair of navicular bone
fractures, tibial and calcaneal osteotomies.
- Non-union bone fractures - When mixed with bone marrow aspirate, DBM can
stimulate healing of delayed-union or non-union fractures.
Benefits and Effectiveness of Demineralized
Bone Matrix
The key advantages of DBM over autograft are its availability in unlimited
supply, lack of donor site morbidity, and superior handling properties in
surgery. Several clinical studies have demonstrated DBM to be as effective as
autologous bone in stimulating new bone formation:
- A meta-analysis of 30 randomized controlled trials found DBM grafts elicit
similar bone regeneration compared to autografts in spinal fusion.
- In foot and ankle surgery, DBM grafts achieved bony union rates of 85–95%,
equivalent to autograft outcomes.
- For oral and maxillofacial reconstruction, DBM showed 85–90% success in
augmenting defect sites and promoting bone in-growth.
- When combined with platelet-rich plasma, DBM stimulated significantly higher
new bone formation than autograft alone in animal studies.
Thus, DBM presents a safe and effective bone void filling alternative to
autograft for various orthopedic procedures with reduced donor site problems.
The osteoinductive properties of its endogenous growth factors enable
comparable outcomes to the bone healing gold standard.
Demineralized bone matrix is an osteoinductive bone graft material derived from
human or animal bones through an acid extraction process. Retaining BMPs and
other proteins essential for bone formation, DBM acts as both an
osteoconductive scaffold and stimulant of new bone ingrowth. With unlimited
supply and lack of donor morbidity, DBM has emerged as a viable option to
autograft in promoting bone regeneration and repair in various orthopedic and
dental clinical applications. Supported by abundant evidence from preclinical
and clinical studies, DBM presents a highly effective graft substitute for
enhanced bone healing.
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