Contents



Preface

*"Experimentation and clinical tests have shown that for the graft to take root, not only should it be as viable as possible, but from the very beginning it should have a* 

Bone has an efficient ability to regenerate. But the critically large defects in bone, either postsurgical or after trauma, progress to nonunion and instability in 10% of patients and therefore require implantation of a bone graft [2]. In the USA alone about half a million bone grafting surgeries are done annually [3]. Furthermore, the rate of bone grafting procedures is expected to rise due to the constantly advancing techniques of

Autologous bone grafting is the gold standard for the reconstruction of critical bone defects. However, autologous grafts have several significant disadvantages, such as donor site morbidity and limited availability. The alternative use of allografts or xenografts is limited due to the risks of rejection, infection, and high nonunion rates. Progress in bone tissue engineering is essential to provide an unlimited source for autologous-like bone grafting source. There is an indication that the method to generate autologous bone-like material, as live autologous bone tissue, originating from patientspecific osteoblast-like cells, grown from bone marrow on β-tricalcium phosphate supporting three-dimensional matrix under optimal biomechanical conditions, is

But meanwhile other methods for effective bone grafting are under ongoing development aiming to achieve optimal osteoconductivity and osteoinductivity similar to the autologous bone graft material. Thus, the potential of the newly developed tissue engineering methods for bone grafting is discussed in this book. According to the ongoing research, progress of the methods to create readily available autologous-like bone grafting material that doesn't cause additional surgical morbidity, is anticipated to evolve. Naturally, these methods are expected to fulfill the regulatory requirements, including clinical studies, that will allow the start of widespread clinical use. For this purpose, a thorough understanding of bone regeneration control in vivo by systemic humoral and local factors is essential. In this book, several such factors are presented and discussed.

The classic method of local bone regeneration by means of distraction osteogenesis, which is based on mechanical stimulation at the bone deficient site is presented by Domingos et al. This widespread effective clinical method requires a good understanding of the optimal mechanical and humoral factors – those are presented in the chapter.

 *A- micrograph (HE staining) of a critical bone gap in rat calvarium, 6 weeks after the creation of the gap. No evidence of bone bridging. B- micrograph (HE staining) of bridging of the critical bone gap by young* 

*woven bone, 6 weeks after implantation with in vitro generated bone-like tissue.*

*strong relationship with the host" Vittorio Putti 1912 [1].*

bone grafting.

possible (**Figure 1**) [4, 5].

**Figure 1.**
