Use of demineralized bone matrix in the repair of bone defects
Utilização de matriz óssea desmineralizada para reparo de falhas ósseas
Barboza, Carlos Augusto Galvão; Xavier, Lucas; Silva, Gabriel Lamak Almeida da; Soares, Diego Moura; Silva, José Sandro Pereira da
Rev. odontol. UNESP, vol.41, n3, p.209-214, 2012
Abstract
Several biomaterials have been proposed as a substitute for autogenous bone in surgical procedures, highlighting the demineralized bone matrix (DBM). Objective: The paper consists of a systematic review of the literature on the use of DBM in the repair of bone defects. Material and method: The literature search was performed on PubMed and Science Direct databases, limited to papers published in English, using four search terms. Result: The literature shows that DBM is a type of allograft consisting of collagen and various growth factors, and it presents a better performance when compared to autograft - once it provides a good osteoinductive capacity and does not require another surgical site. DBM is considered less immunogenic than the mineralized bone and the preparation process promotes the effective elimination of viruses such as HIV. It has been used to repair stable bone defects as cystic cavities and for the treatment of jaw fractures, among others, and their performance depends on the patient’s general state of health. Conclusion: Due to its favorable biological characteristics, DBM has a broad spectrum of clinical use; however, the understanding of its properties is required to base their choice on surgical repair.
Keywords
Bone transplantation, bone matrix, osseointegration.
Resumo
Diversos biomateriais têm sido propostos como substituto do osso autógeno em procedimentos cirúrgicos, destacando-se a Matriz Óssea Desmineralizada (MOD). Objetivo: O presente trabalho consiste em uma revisão sistemática da literatura sobre a utilização da MOD aplicada à regeneração óssea. Material e método: Realizou-se uma busca nas bases de dados PubMed e Science Direct, limitados a artigos publicados em inglês, utilizando-se quatro descritores relacionados ao tema. Resultado: A literatura mostra que a MOD é um tipo de aloenxerto constituída principalmente por colágenos e diversos fatores de crescimento e que apresenta um melhor desempenho quando comparada com o autoenxerto, pois proporciona uma boa capacidade osteoindutiva e não exige outro sítio cirúrgico para a sua obtenção. A MOD é considerada menos imunogênica do que o osso homólogo mineralizado e sua preparação promove a eliminação efetiva de vírus, como o HIV. Tem sido utilizada no reparo de falhas ósseas estáveis como cavidades císticas e no tratamento de fraturas maxilares, dentre outras, e seu desempenho depende de um bom estado geral de saúde do paciente. Conclusão: A MOD tem um amplo espectro de utilização clínica por suas características biológicas favoráveis, todavia o entendimento de suas propriedades é necessário para determinar a escolha da MOD nos procedimentos cirúrgicos reparadores.
Palavras-chave
Transplante ósseo, matriz óssea, osseointegração.
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