The term bone substitute material includes those materials that are used in the reconstruction of bone substance as well as in the healing of dental implants. Bone graft substitute materials can be of both organic and inorganic origin (biological and synthetic compounds), with individual materials differing in properties such as pore size, particle size, and resorbability.
Decisive factors for the choice of the appropriate material are both donor-independent availability and the transplantation risk for the patient, which should be as low as possible for the material used. Furthermore, bone substitute materials are selected according to their biological value and the required mechanical stability.
Bone graft substitutes are divided into autologous, allogeneic, xenogeneic, and alloplastic materials:
- Autologous bone graft substitutes are materials taken from the patient’s own body. The use of autologous material offers the advantage of avoiding disease transmission as well as immune system rejection. Both bone materials are also similar in composition. However, autologous materials are only available in limited quantities and are therefore particularly suitable for minor procedures.
- Allogeneic bone substitute materials come from another person and thus, in practice, usually from a bone donor bank. They can be used in larger quantities and without the need for removal surgery; moreover, they have an osteoinductive potential, meaning that they are able to stimulate new bone formation. However, the use of allogeneic bone graft substitutes is regulated due to immunologic risks.
- Xenogenic bone substitutes are made from bone of a different species. This means that in the case of dental and oral implantation in humans, materials from the bones of animals are used. In particular, bovine and coral bone material, which is similar in structure to human bone, is used for this purpose. To prepare the material thus obtained for the treatment of humans, it is biologically processed and detached from all organic components.
- Alloplastic bone substitutes are synthetic materials that replace natural bone substance. Since these synthetic materials have no osteoinductive effect, they are often mixed with autologous bone substance.
