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

Table 3 Classification of bone substitute biomaterials according to information provided by the manufacturers: Synthetic and composite biomaterials

Ref.	Commercial name/country/company	Composition	Physical properties	Biological properties	Mechanical properties	Resorption/integration	Clinical efficacy	Form/cost
[179]	Alobone poros®/Brazil/Osseocon	Synthetic: Low-crystallinity hydroxyapatite	Porous granules, promote vascularization	Biocompatible, osteoconductive, protein-free	Suitable for filling bone defects	Gradual, replaced by new bone	Positive results in sinus lift, ridge augmentation, and preservation	Granules (0.25-1 mm)/affordable
[180,181]	BioGran®/United States/Zimmer Biomet	Alloplastic; bioactive glass 45S5 (calcium sodium silicate)	Translucent white; microporous; high surface area	Biocompatible; osteoconductive; potentially osteoinductive; stimulates osteogenesis, angiogenesis, and HA formation	Stable in small to moderate defects; no structural support in load-bearing areas	Rapid (3-6 months); efficient	Good results in alveolar, peri-implant, periodontal, and sinus regeneration	Granules (0.3-0.35 mm)/moderate to high
[182]	Bonecerami®/Switzerland/Straumann	Alloplastic; 60% HA + 40% β-TCP	3D structure similar to cancellous bone	Biocompatible; osteoconductive; cell adhesion; no significant inflammatory response	Lightweight and stable; not indicated for high-load areas without protection	4-6 months; β-TCP resorbs first; HA maintains volume	High predictability in GBR, sinus lift, and alveolar filling; comparable to xenografts	Granules (0.5/1.0-2.0 mm)/moderate to high
[181]	Calcigen S®/United States/Zimmer Biomet	Alloplastic; calcium sulfate	Moldable (spheres, blocks, wedges); powder-liquid mix; sets in 4-6 minutes	Biocompatible; osteoconductive; promotes bone growth	Quick application; not indicated for load-bearing support	8-12 weeks	Used as filler in orthopedics and dentistry; conducive environment for bone regeneration	Powder for mixing/moderate to high
[171]	GenPhos HA TCP®/Brazil/Baumer	Synthetic: 70% HA + 30% β-TCP	Porous granules, similar to cancellous bone	Biocompatible, osteoconductive, protein-free	Good initial strength, lower than ceramics	Slow (7-9 months); gradual integration	Positive use in sockets, ridge augmentation, and peri-implant areas	Granules (0.5-0.75 mm)/affordable
[183]	Grafton DBM®/United States/Medtronic	Allogeneic; demineralized human bone + glycerol	Moldable; ready to use; adapts to irregular defects	Biocompatible; osteoconductive and potentially osteoinductive; stimulates osteogenesis and angiogenesis; forms HA in situ	Limited support; not indicated for load-bearing areas	3 months to 12 months (variable)	Widely used in reconstructions, implants, and orthopedics	Gel, paste, sponge, strip/high cost
[184]	HAP-91®/Brazil/JHS Biomaterials	Synthetic; pure synthetic HA	White, homogeneous granules; high volumetric stability; non-collapsing	Biocompatible; osteoconductive; non-immunogenic; promotes bone conduction	Good initial strength; adequate support for load and non-load areas; non-moldable	Very slow (18-24 months)	Indicated for alveolar grafts, sinus lift, GBR, peri-implant, and ridge augmentation; volumetric maintenance and osseointegration	Granules (0.15 mm; 0.3 mm; 0.5 mm; 1.0 mm; 2.0 mm)/affordable cost
[185]	MinerOss®/United States/BioHorizons	Allogeneic; human cortical and/or cancellous bone	Dry and rehydratable particles; easy adaptation	Biocompatible; osteoconductive; possible residual osteoinduction	Intermediate support	4 months to 9 months (variable)	Widely used in implant dentistry and GBR	0.25 mm to 1.0 mm; particulate (cortical, cancellous, or mix)/moderate to high cost
[186]	Nanosynt®/Brazil/National OsteoBiotec	Synthetic: 60% hydroxyapatite + 40% β-TCP	Porous nanostructure, high capillarity	Biocompatible, osteoconductive, non-immunogenic	Good initial stability; intermediate mechanics	Controlled/moderate; β-TCP resorbs in 4-6 months; HA persists	Good outcomes in preservation, bone augmentation, and peri-implant procedures; systematic reviews	Granules (0.25-2 mm)/affordable
[187]	OsteoGen®/United States/Intra-Lock	Alloplastic; synthetic HA	Dry, lightweight granules; maintains stability	Biocompatible; osteoconductive; non-immunogenic	Fragile; moderate support in cavities	6-9 months	Used in implants, post-extraction sockets, and periodontics; good but limited literature compared to others	Granules (0.3-0.5 mm), dry/Lyophilized; strips/Low to intermediate cost
[188]	Vitoss®/United States/Stryker Corp	Synthetic β-tricalcium phosphate (β-TCP)	Lightweight, porous, hydrophilic texture; easy to handle	Biocompatible; osteoconductive; stimulates vital bone formation	Fragile structure; compressible and adaptable but requires stabilization; not recommended for load-bearing sites	Moderate (4-9 months)	Effective in small to medium defects; indicated for trauma, spine, orthopedics, implantology, and periodontics	Granules and moldable putty/moderate to high cost

HA: Hydroxyapatite; β-TCP: Beta-tricalcium phosphate; GBR: Guided bone regeneration.