Several conditions in Orthopaedics and Traumatology are characterized by a bone loss. Bone auto- or allo-grafting was considered sufficient to fullfill the defects decades ago; however, large bone defects were challenging for the Surgeons, particularly in case of necessity of structural and biological properties. Bioindusrty proposed over the years synthetic biomaterials, as Demineralized Bone Matrix, bioactive surfaces for implant coponents, and recently recombinant Bone Morphogenetic Proteins. At the same time, the concept of the "biological chamber" and "diamond concept" allowed the scientific community to consider the need of a more complex interaction between scaffolds (matrix), cells (mesenchymal cells), and signaling (growth factors) in order to induce bone regeneration and also to fill small or large bone defects. A brief overview is made on the processes of a physiologic bone metabolism (induction, conduction, osteogenesis), on the latest therapeutical procedures, based on the use of autologous growth factors and cells, and the recent prosthetic or synthetic scaffolds, and the common clinical conditions that may beneficiate of these modern approaches.
Keywords: bone graft; bone loss; tissue engineering.