Composition and Biological Properties of Demineralized Bone Matrix
Main Characteristics:
- Osteoinduction: Activation of mesenchymal cells for osteoblastic differentiation.
- Osteoconduction: Structural support that facilitates bone growth along the surface of the graft.
- Biocompatibility: As it is derived from human tissue, DBM has a low risk of immunological reaction.
Clinical Applications of Demineralized Bone Matrix
1. Maxillofacial Surgery:
In maxillofacial surgery, DBM is frequently used in bone reconstruction procedures, such as alveolar regeneration after tooth extractions, site preparation for implants, and correction of congenital or acquired defects. The use of DBM in combination with barrier membranes, such as collagen, has proven effective in guided bone regeneration (GBR), allowing for the regeneration of lost bone volume and improving the stability of dental implants.
- Maxillary sinus grafts (sinus elevation): DBM facilitates bone regeneration in the sinus cavity, providing adequate support for the placement of dental implants.
- Alveolar reconstruction: Ideal for the preservation of alveolar ridges and regeneration of peri-implant defects.
2. Periodontal Surgery:
DBM plays a fundamental role in bone regeneration in periodontal defects, especially in furcation defects, dehiscences, and the regeneration of interdental papillae. Its ability to induce new bone formation in combination with other biomaterials such as autogenous bone or alloplastic bone substitutes makes it a valuable resource in regenerative periodontics.
- Treatment of intra-bony defects: DBM is used alongside advanced regenerative techniques to improve prognosis in complex bone defects.
- Guided Tissue Regeneration (GTR): It is employed in combination with barrier membranes to promote the selective regeneration of periodontal tissues.
3. Surgical Endodontics:
In the context of endodontic surgery, DBM is used to fill residual cavities after apical resection or for the repair of root perforations. The osteoinductive capacity of DBM is especially valuable in these cases, where bone regeneration around the dental root is crucial for the success of the treatment.
- Apicoectomy with retrograde filling: DBM is employed to promote bone regeneration at the surgical site, improving long-term prognosis.
- Root perforations: Use of DBM for the regeneration of the peri-radicular bone defect.
Other Uses
4. Orthopedic and Spinal Surgery:
In spinal fusion procedures, DBM is a key component to ensure vertebral union. Its use has extended to the repair of complex fractures and bone reconstruction after tumor resection. The combination of DBM with additional growth factors or autogenous grafts can significantly improve clinical outcomes.
- Spinal fusions: DBM is used as a bone substitute to promote bone formation at the spinal junction.
- Post-tumor reconstruction: In cases where regeneration of large bone volumes is required.
References
- Madrob Pharmaceutical. (2020). Demineralized Bone Matrix: Complete Guide to Use in Surgery. Retrieved from https://madrobpharmaceutical.com/en/wp-content/uploads/2024/08/MATRIZ-OSEA-DESMINERALIZADA-CON-pBMP-2.pdf