effectiveness of demineralized bone matrix in bone healing: systematic review and meta analysis

The demand for advanced bone grafts is increasing with more orthopedic surgeries. demineralized bone matrix (dbm) is an allograft with osteoconductive and osteoinductive properties. however, it retains type 1 collagen, non-collagenous proteins, and growth factors like bone morphogenetic protein (bmp) and transforming growth factor (tgf-β). the advantage of dbm lies in its low risk of immune rejection, as the demineralization process removes the antigenic surface. the aim of this study evaluates the dbm effectiveness in bone healing through a systematic review and meta-analysis and its role in bone formation and remodelling. we searched pubmed, ncbi, and cochrane databases and evaluated study quality using jbi and syrcle tools for in vivo studies. inclusion criteria were studies from the last 5 years, randomized controlled trials, dbm alone or with other materials, and studies with radiological and histopathological outcomes. exclusion criteria included case reports, case series, reviews, and in vitro studies. following prisma guidelines, we used rayyan.ai for screening, microsoft excel for data extraction, and review manager s.4 for meta-analysis, focusing on mean differences (md) and 95% confidence intervals (ci). a total of 26 studies were included in this study. the study by gruskin et al. showed that dbm significantly reduced fracture healing time compared to treatments without dbm (p = 0.04, 95% ci), demonstrating its strong osteogenic and osteoinductive properties. dbm effectively accelerates fracture healing and reduces bone defect areas, but further research is necessary.