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 Demineralised
 Bone Matrix
 and Grafts
 
 

 

 

 

 

 

       
           
           
           
           
           
       
Living cells
 
           
           
           
 
Demineralised Bone Matrix (DBM)
is allograft bone that has had the inorganic
mineral removed, leaving behind the organic collagen
matrix. It was first discovered by Marshall Urist in 1965
that the removal of the bone mineral exposes more
biologically active bone morphogenetic proteins.
These growth factors modulate the differentiation
of progenitor cells into osteo-progenitor cells, which
are responsible for bone and cartilage formation.
As a result of the demineralisation process, DBM
is more biologically active than mineralised bone
grafts; conversely the mechanical properties are
significantly diminished.
   
Three dimensional
scaffolding which
allows for bone
growth





Ability to induce
bone formation
• Bone Morphogenetic
   Proteins (BMP)
• Particle size is
   important

 

 

     
   

demiminiralsed-2 deminiralised-2  
Cross linked Collagen
Syringes

CAB: 1/2cc
   50% Collagen
   50% Cancellous DBM
COB: 1/2/5/10cc
   50% Collagen
   50% Cortical DBM
CCAB: 0,25/0,5/1/2cc
   40% Collagen
   60% Cancellous DBM
CCOB: 0,5/1/2cc
   40% Collagen
   60% Cortical DBM
 
Indication
Contained defects

• Sinus lifts
• Spinal Cages
• Periodontal defects
• Peri-implant defects
• Extraction Sockets
• Other Osseous defects
such as apicoectomies
and tumor resection
KEEP FROZEN
deminiralised-3  
* Fuse On
   Demineralised
   Cortical DBM
   with C-Link collagen
Fuse On: 1/2/4/8g
Fuse On Inj: 1cc/1/2/4g
   NB: For Best results
   To be reconstituted
   using autogenous
   Blood Fibrin
 
Indication
Uncontained defects

if reconstituted with autogenous
Blood Fibrin
• As above indications
• Mal or non union
   fractures
• Posterior Fusion
• Any partially uncontained bone
   defects/lesions
• Arthrodesis procedures
   LYOPHILISED
   (Stored at room
   Temperature).
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* Revise On
   Demineralised
   Cortical DBM
   with C-Link Collagen
Rev.10: 10g
Rev.20: 20g

   NB: For Best results
   To be reconstituted
   using autogenous
   Blood Fibrin
   DBM.10
   Demineralised
   Cortical DBM
DBM 10: 10g
(No Collagen)
 
Indication
Uncontained defects

if reconstituted with autogenous
Blood Fibrin
Weight bearing
• Hip Revision
• Knee Surgery
• Impaction Grafting for
Acetabulum or Femoral Shaft
LYOPHILISED
(Stored at room
Temperature).
 
 
     
       
demin-1 demin-2  
* Demin Cancellous
Recon Block

DCRB: 32-18-12 (L)
Demin Spinal Cage
Block
DSCB: 11-7-5 (L)
 
Indication
For pliability
LYOPHILISED
    (Stored at room
    temperature).
demin-3  
* Demin Cancellous
   Matchsticks

DCMS: 1/3/6pcs
 
LYOPHILISED
    (Stored at room
    temperature).
demin-4  
* Demin Femoral
   Cortical Strut

DFCS: 15cm
 
LYOPHILISED
    (Stored at room
    temperature).
demin-5  
* Collagenous
   Tissue Matrix

CTM: 60 x 60mm
          50 x 50mm
          50 x 25mm
          35 x 25mm
          20 x 25mm
          15 x 10mm
 
LYOPHILISED
    (Stored at room
    temperature).
       
* Partially DBM: Rehydration required before use   
 
     
 
Demineralised Bone Matrix from Bone SA

The processing of DBM is of utmost importance to keep the osteoinductive potential of the Demineralised Bone Matrix (DBM) viable. Herewith the processing of cortical/cancellous DBM from Bone SA. The product cortical/cancellous DBM range undergoes the following pertinent steps in the course of its processing:
  • Only donors below 45 years of age are processed for the cortical/cancellous DBM.
    No pooling is allowed.
  • Particle Sizes: 125-1000μm is used for Fuse On. DBM in the 500-700 micron size range showed the highest osteoinductive potential as per the following quote from the article “Effects of the Demineralised Process on Osteoinductivity of DBM by Min Zhang,
    Ralph M. Powers, Lloyd Wolfinbarger Jr., et al published in J. Periodontal November 1997.
  • Demineralised Bone Matrix is prepared by acid extraction of allograft bone, resulting in loss of most of the mineralised component but
    retention of collagen and non-collagenous proteins, including growth factors. This allows the BMP to be exposed and increases the inductive potential of the DBM.
  • Defatting: This process is used in order to promote better graft incorporation, as per the following quote from the article: “Lipid Extracted Bank Bone” by Klas Thoren, MD, et al published in Clinical Orthopaedics and Related Research number 311, pp 232-246.
    “It was concluded that lipid extraction produced a graft that was better incorporated than a non defatted graft, with no loss of mechanical function.”
  • Lyophilisation: This process is used for two reasons, namely to suppress the immune response to the graft once implanted and to render a graft which is room temperature stable. Suppression of immunogenicity through lyophilisation: “Studies for the Transplantation of Bone” by Burwell et al published in the Journal of Bone and Joint Surgery 45B, pp 386-401.
  • Irradiation: This process is used for two principal reasons, namely to further suppress the immune response to the graft once implanted
    and to sterilise the graft. Grafts are gamma irradiated at a dose of 25kGy to preserve the BMP within the DBM. Suppression of
    immunogenicity through irradiation: “Humoral Immune Responses to allografts of Bone” by Elves MW et al published in Int Arch Allergy Appl Immunol 47, pp 708 – 715.
     
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