R&D Institute of Korea Tooth Bank, Seoul, South Korea.
Adv Exp Med Biol. 2018;1077:487-499. doi: 10.1007/978-981-13-0947-2_26.
A bone graft and bone graft substitute should have at least one of the following properties: it should be (1) osteogenic, (2) osteoinductive and/or (3) osteoconductive. In addition, bone graft substitutes should be biocompatible and bioresorbable as well as easy to use and cost effective. Autologous cancellous bone is the clinical gold standard in bone grafting procedures1, 4 and it has osteogenic, osteoinductive, and osteoconductive properties. Because of disadvantages associated with harvesting autologous bone graft material, such as requiring an additional operation and possible donor site morbidity, there is a need for an alternative in terms of enhancing the bone healing for the treatment of large bony defects. One possible option is a newly developed biomaterial, the demineralized dentin matrix (DDM). It is based on autogenous tooth dentin and is produced through demineralization. It is osteoconductive and osteoinductive due to the fact that dentin contains extracellular Type I collagen and various growth factors. Based on the demineralization process the factors stay available to the host environment. In 1965, Urist already showed the formation of ectopic bone after implanting DDM into muscle pouches in rodents. DDM is used for example in dental surgery in the treatment of extraction socket preservation and guided bone regenerations. It functions as a scaffold to support bone regeneration, but can also be used as a carrier for rhBMP-2. When DDM serves as a carrier, it combines the properties of the grafting material with those of the delivered substances. This chapter will present the experimental and clinical studies of DDM for rhBMP-2 carrier as well as alternatives of bone graft substitute.
它应该是（1）成骨，（2）骨诱导和/或（3）骨传导。此外，骨代用品应该是生物相容的、可生物吸收的，易于使用且具有成本效益。自体松质骨是骨移植手术的临床金标准1,4，它具有成骨、骨诱导和骨传导特性。由于从自体骨移植物材料采集中存在的缺点，例如需要进行额外的手术和可能的供体部位发病率，因此需要一种替代物来增强骨愈合，以治疗大的骨缺损。一种可能的选择是一种新开发的生物材料，脱矿质牙本质基质（DDM）。它基于自体牙本质，通过脱矿质生产。由于牙本质含有细胞外 I 型胶原和各种生长因子，因此它具有骨传导性和骨诱导性。基于脱矿质过程，这些因子可保留在宿主环境中。1965 年，Urist 已经在啮齿动物的肌肉囊中植入 DDM 后证明了异位骨的形成。DDM 例如在牙科手术中用于拔牙窝保存和引导骨再生。它作为骨再生的支架，支持骨再生，但也可用作 rhBMP-2 的载体。当 DDM 用作载体时，它将移植物材料的特性与所输送物质的特性结合在一起。本章将介绍 DDM 作为 rhBMP-2 载体的实验和临床研究以及骨代用品的替代物。
