Demineralized Bone Matrix Putty

Demineralized bone matrix putty (DBM) is a malleable substance that is used for packing material, either by itself or mixed with other grafting material to increase volume.

Bone matrix contains small amounts of bone morphogenetic proteins (BMPs), and demineralization increases their bioavailabilty for interaction with mesenchymal stem cells. Bone morphogenetic proteins recruit these stem cells and modulate their conversion to bone-forming cells that produce new bone.

By itself, demineralized bone matrix putty is mostly osteoinductive (recruits and modulates mesenchymal stem cells to produce new bone). Combination with cancellous bone allograft, which is mainly osteoconductive (functions as a scaffold for bone growth), gives the mixture both osteoinductive and osteoconductive properties. Bone autograft by itself has both osteoinductive and osteoconductive properties. Using putty with bone allograft avoids harvest site

The putty by itself is barely perceptible post-operative radiographs. The combination with allograft (seen above) gives it a density on radiographs higher than medullary bone, but lower than cortical bone. On CT, the combination also has attenuation between that of medullary bone and cortical bone (~500–1000 HU).

References

• Beaman FD, Bancroft LW, Peterson JJ, Kransdorf MJ, Menke DM, DeOrio JK. Imaging characteristics of bone graft materials. Radiographics. 2006 Mar-Apr;26(2):373-88.
• Pietrzak WS, Perns SV, Keyes J, Woodell-May J, McDonald NM. Demineralized bone matrix graft: a scientific and clinical case study assessment. J Foot Ankle Surg. 2005 Sep-Oct;44(5):345-53.