Bone graft substitutes

Today’s surgeon faces many situations that require bone grafting. Autologous bone is the traditional standard for treating conditions requiring bone graft. However, autologous bone grafting has drawbacks such as donor site morbidity and increased operative time. Graft substitutes for autologous bone are an appealing alternative. Substitutes include allograft, mineral composites, ceramics, mineral cements, bioactive glass, proteins, and growth factors. The use and availability of these products has expanded exponentially. The large number of alternatives available and the relative lack of quality information regarding their indications and effectiveness leave the surgeon desiring to use the products with a daunting task. This article provides the surgeon with an overview of the basic concepts of bone grafting and discusses the most commonly used bone-graft substitutes and their potential indications.