MONOGRAPH Published: 08 December 2014
MONO62013002707

Chapter 7 | Review of State of the Art: Growth Factor-Based Systems for Use as Bone Graft Substitutes

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It is envisaged that, similar to autografts and allografts, bone graft substitutes should also possess osteoconductive, osteogenic, and osteoinductive properties. However, most synthetic graft substitutes fail to provide osteogenic and osteoinductive properties. To overcome this disadvantage of synthetic bone graft substitutes, they have often been supplemented with single or multiple growth factors. These factors are chosen based on their eflect on different cell types and their involvement in the natural healing process. The most widely used factors can broadly be divided into inflammatory factors (tumor necrosis factor-α and interleukins), proliferative and osteoinductive factors (transforming growth factor-α, bone morphogenetic proteins, insulin-like growth factors, fibroblast growth factors, and platelet-derived growth factor), and angiogenic factors (vascular endothelial growth factor). These factors have been explored either individually or in combination for augmenting bone regeneration. In combination studies, several combinations show synergism, thereby reducing overall growth factor dosage. The reduction in growth factor dosage not only decreases the cost of treatment but also the side eflects associated with a supraphysiological dose of a single factor. Synergism or other interactions between two factors not only depend on the factor type but also on their sequence, dosage, and ratio. These eflects make it imperative to determine the optimal combination types and design systems to precisely control the presentation of multiple growth factors. This chapter summarizes the eflects of various growth factors on bone regeneration, the methods that have been developed for their administration via bone graft substitutes, and the attempts that have been made to augment bone regeneration using single and multiple growth factors.

Author Information

Arora, Aditya
Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, IN
Bhattacharjee, Arijit
Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, IN
Katti, Dhirendra, S.
Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, IN
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Details
Developed by Committee: F04
Pages: 117–165
DOI: 10.1520/MONO62013002707
ISBN-EB: 978-0-8031-7061-2
ISBN-13: 978-0-8031-7060-5