Biological approaches and biomaterial-based solutions for bone reconstruction: A comprehensive review

Table 2 Classification of bone substitute biomaterials according to information provided by the manufacturers: Biomaterials of natural origin

Ref.	Commercial name/country/company	Composition	Physical properties	Biological properties	Mechanical properties	Resorption/integration	Clinical efficacy	Form/cost
[167]	Bonefill Porous®/Brazil/Bionnovation	Mineralized bovine spongy xenograft	White granules, irregular, porous	Biocompatible, osteoconductive, high interconnectivity	Lightweight, strong; maintains space and support	Slow and progressive (6-9 months)	Documented use in sinus lift, GBR, and alveolar filling	Granules (0.10-2.5 mm)/affordable
[168]	Cerabone®/Germany/Botiss	100% inorganic, calcined bovine bone	Purified ceramic; hard and stable particles	Biocompatible; osteoconductive; bone scaffold	High stability and strength	Very slow; progressive integration	Well-established use in peri-implant grafts, sinus lift, and bone augmentation	Granules and blocks (0.5-4 mm) high
[169]	Geistlich Bio-Oss®/Switzerland/Geistlich	Bovine xenograft	Porous, similar to human bone	Biocompatible, osteoconductive	Preserves volume and structure	Slow, promotes maintenance	Widely used in implant dentistry; proven clinical efficacy	Granules and blocks (0.25-2 mm) high
[172]	GenMix®/Brazil/Baumer	Inorganic bovine xenograft (cortical and cancellous matrix)	Dry granules, lightweight; high volumetric stability; good handling	Biocompatible; osteoconductive; promotes new bone formation; no transmission risk	Good initial strength; intermediate support	Slow and partial (some particles > 12 months); integration 6-9 months	Used in alveolar grafts, sinus lift, ridge augmentation; studies show predictability and maintenance	Granules (0.25 mm; 0.5 mm; 1.0 mm)/affordable cost
[195]	GenOx Inorg®/Brazil/Baumer	Inorganic bovine xenograft (mineral bone matrix, sintered)	Rigid, stable granules; resistant to rapid resorption; volume-maintaining	Biocompatible; osteoconductive; non-immunogenic; slow bone replacement	High initial strength; prolonged support; indicated for load-bearing areas	Very slow (> 24 months)	Used in sinus lifts, ridge augmentation, alveolar filling, and periodontal applications; proven efficacy	Granules (0.25 mm; 0.5 mm; 1.0 mm; 2.0 mm)/affordable cost
[170]	GenOx Org®/Brazil/Baumer	Organic and inorganic bovine matrix (type I collagen)	Lightweight, porous, and moldable; trabecular structure	Biocompatible, osteoconductive, potential osteopromotive effect	Lower resistance; suitable for low-load areas	6 months to 12 months	Effective in GBR, fillings, and esthetic areas; good remodeling	Granules (0.25-2 mm)/affordable
[173]	Lumina-Bone Porous®/Brazil/Critéria	Inorganic lyophilized bovine xenograft	Highly porous, bone-like	Biocompatible, osteoconductive	Preserves volume and structure	Slow (6-12 months or more)	Successful in reconstructions, sinus lift, and preservation	Granules (0.25-1 mm)/affordable
[174]	MinerOss XP®/United States/BioHorizons	Porcine xenograft (inorganic bone matrix)	Dry, sterile, irregular granules; high volumetric stability	Biocompatible; osteoconductive; good bone integration	Limited structural support; dimensional stability	Slow (6-9 months)	Widely used in GBR, sinus lift, alveolar preservation, and peri-implant defects; good volumetric maintenance and integration	Granules (0.25 mm; 1.0 mm; 2.0 mm)/high cost
[196]	OrthoGen Granules®/Brazil/Baumer	Bovine xenograft	Rigid granules; good volumetric stability; non-collapsing	Biocompatible; osteoconductive; guides bone growth; no rejection	Adequate structural support; maintains space; compatible with membranes/PRF	Very slow (up to 24 months)	Used in GBR, ridge augmentation, sinus lift, peri-implant, and post-extraction; studies show stability and osseointegration	Granules (0.25 mm; 0.5 mm; 1.0 mm; 2.0 mm)/affordable cost
[197]	OsteoBiol Apatos®/Italy/Tecnoss	Porcine or equine xenograft	Dry, rigid, trabecular granules	Biocompatible; osteoconductive; matrix for osteoprogenitor cells and new bone formation	High temporary resistance; good support and volume maintenance	Slow (9-12 months)	Effective for sinus lift, alveolar regeneration, and ridge augmentation; extensive clinical and histological evidence	Granules (0.25-2.0 mm)/moderate to high cost
[175]	OsteoBiol Gen-Os®/Italy/Tecnoss	Porcine or equine xenograft (cortical and cancellous bone + preserved collagen)	Natural trabecular structure; easy handling	Biocompatible; osteoconductive; native collagen promotes regeneration	Temporary structural support; maintains volume	Slow (6-12 months)	High efficacy; supported by multiple clinical and histological studies	Granules (0.25 mm; 1.0 mm; 2.0 mm)/intermediate cost
[176]	Osteosynt®/Brazil/EincoBio	Bovine xenograft (HA + β-TCP)	Dry, white granules; texture similar to cancellous bone; high volumetric stability	Biocompatible; osteoconductive; no inflammatory response; supports cell colonization and bone formation	Non-deformable; maintains space; limited mechanical load support	Slow (6-18 months)	Used in GBR, sinus lift, post-extraction sockets, and peri-implant defects; maintains volume; can be combined with membranes or PRF	Granules (0.25 mm; 1.0 mm; 2.0 mm), block, wedge, sphere/affordable cost
[177]	SmartBone®/Switzerland-Italy/IBI	Bovine xenograft (HA) + biodegradable polymers + type I collagen	Rigid trabecular structure	Biocompatible; osteoconductive; bioactive; rapid tissue integration	High compressive strength; excellent stability; can be fixed with plates or screws	Slow (6-18 months)	Recommended for load-bearing reconstructions in implantology, orthopedics, and oncology; extensive scientific documentation	Granules, blocks, and strips/high cost
[178]	THE Graf®/South Korea/Purgo	Porcine bone mineral matrix, similar to human bone	Interconnected pores, high hydrophilicity	Biocompatible, free of immunogenic agents, osteoconductive	Stable structure for regeneration	From 10 weeks	In vitro, in vivo and clinical studies	Granules/high

HA: Hydroxyapatite; β-TCP: Beta-tricalcium phosphate; PRF: Platelet-rich fibrin; GBR: Guided bone regeneration.