Demineralized bone products play an important role in modern orthopedic, spine, trauma, and reconstructive surgery. Among the most widely used forms are demineralized bone matrix, commonly called DBM, and demineralized bone fiber, often referred to as DBF. While both materials originate from human bone and are used to support bone repair, they differ in structure, handling properties, and how they are commonly applied in surgical settings.
Table of Contents
- Understanding Demineralized Bone Products
- What Demineralized Bone Matrix Is
- What Demineralized Bone Fiber Is
- How DBM and DBF Are Processed
- Structural Differences Between DBM and DBF
- Handling and Surgical Application Differences
- Biological Principles That Apply to Both DBM and DBF
- Common Surgical Uses for DBM
- Common Surgical Uses for DBF
- Storage and Preparation Considerations
- Safety and Regulatory Oversight
- DBM and DBF Compared to Other Bone Graft Options
- Supporting Surgical Grafting With Trusted Allografts
- Frequently Asked Questions
Understanding Demineralized Bone Products
Demineralized bone products are derived from donated human bone that has undergone a process to remove the mineral content while preserving the natural bone collagen and other organic components. The purpose of demineralization is to expose biological elements that support bone healing while maintaining a structure that allows for integration with surrounding tissue.
DBM and DBF are both forms of demineralized bone. They share the same origin and general biological purpose, but they are shaped and processed in different ways to support different surgical handling needs and procedural goals.
Understanding the distinction between these two materials begins with understanding how each one is created and how those differences affect their use in the operating room.
What Demineralized Bone Matrix Is
Demineralized bone matrix is a processed form of human bone in which the mineral content has been removed. The remaining material consists primarily of collagen and naturally occurring proteins that are part of the original bone structure.
DBM is commonly produced in particulate or putty form. In many cases, the material is blended with a carrier to improve handling characteristics and allow the graft to conform to irregular defects. Some DBM products are formulated without synthetic carriers and rely solely on bone-derived components.
Because DBM is available in moldable forms, it is often used in areas where the surgeon needs a graft that can adapt to complex shapes while maintaining contact with surrounding bone surfaces.
What Demineralized Bone Fiber Is
Demineralized bone fiber is also produced from donated human bone that has undergone demineralization. The difference lies in the physical structure. Instead of being processed into fine particles or putty, DBF is processed into long, thin fibers.
These fibers form a flexible, interconnected network that can be packed into defects or layered across graft sites. The fibrous structure allows DBF to resist migration once placed and helps it maintain position within a surgical site.
DBF is often selected when mechanical interlocking and spatial stability are desired within the grafted area.
How DBM and DBF Are Processed
Both DBM and DBF begin with donated human bone recovered through regulated tissue donation programs. The bone is screened, recovered, and processed under established standards designed to support safety and traceability.
Demineralization Process
The mineral content of the bone is removed using controlled chemical processes. This exposes the organic matrix of the bone, including collagen and naturally occurring proteins associated with bone repair.
Shaping and Forming
After demineralization, the bone is shaped into either:
- Fine particulate material for DBM
- Long strands or fibers for DBF
Each form is produced using controlled mechanical processing techniques to achieve consistent size and structure.
Final Packaging
The processed material is then placed into sterile packaging and prepared for distribution according to applicable tissue banking regulations.
Structural Differences Between DBM and DBF
The most visible difference between DBM and DBF is their physical form. This structural distinction influences how each material behaves inside a bone defect and how surgeons handle it during implantation.
DBM Structure
DBM typically appears as:
- Fine granules
- Putty-like material
- Flowable paste depending on formulation
This structure allows it to conform easily to voids and irregular bone surfaces. It can be packed tightly into defects and smoothed into place.
DBF Structure
DBF consists of:
- Long, thin fibers
- Interwoven strands
- Flexible graft network
The fibrous structure creates a three dimensional lattice within the defect. This helps the material hold its shape and resist movement after placement.
Handling and Surgical Application Differences
While both DBM and DBF are used for bone repair, surgeons often select one over the other based on how the material behaves during surgery.
Handling Characteristics of DBM
DBM is generally soft and moldable. Surgeons can press it into spaces where full contact with surrounding bone is needed. Because of its putty-like consistency, it is often used in:
- Irregular bone voids
- Areas where smooth contouring is needed
- Sites where uniform contact is important
DBM can be layered or packed depending on the surgical technique.
Handling Characteristics of DBF
DBF behaves more like a mesh or web. It can be packed into a defect while maintaining internal structure. Surgeons may select DBF when they want:
- Mechanical interlocking within the defect
- Reduced graft migration
- Increased structural stability in noncontained spaces
DBF fibers can bridge gaps more effectively than particulate materials in certain applications.
Biological Principles That Apply to Both DBM and DBF
DBM and DBF share the same fundamental biological properties because they originate from the same tissue source.
Osteoconduction
Both DBM and DBF provide a physical scaffold that supports the attachment and migration of bone-forming cells. This scaffold guides the growth of new bone across the graft site.
Osteoinduction
Demineralization exposes naturally occurring growth factors within the bone matrix. These factors are associated with the signaling process that encourages stem cells to differentiate into bone-forming cells. While the presence and level of these proteins can vary, both DBM and DBF are associated with osteoinductive potential based on their biological composition.
Support for Natural Remodeling
Over time, both DBM and DBF are gradually remodeled by the body as new bone forms. The graft material is slowly replaced with the patient’s own bone tissue through normal biological processes.
Common Surgical Uses for DBM
DBM is widely used across many orthopedic and spinal procedures where its handling properties and biological composition are well suited to the surgical goals.
Spine Procedures
In spinal fusion surgeries, DBM is often used as a grafting material to support bone growth between vertebrae. It may be placed within interbody devices or along the posterolateral aspect of the spine depending on the surgical approach.
Trauma and Fracture Repair
DBM may be used to fill bone voids left behind after fracture stabilization. Its ability to conform to irregular spaces makes it useful in complex fracture patterns.
Joint Reconstruction
In some joint reconstruction procedures, DBM is used to restore bone volume around implants or within contained defects.
Dental and Maxillofacial Surgery
DBM is commonly used in ridge preservation, sinus augmentation, and implant site preparation where moldable graft material is needed.
Common Surgical Uses for DBF
DBF is selected when mechanical stability and structural interlocking are important within the graft site.
Spine Fusion Support
DBF may be used in spinal fusion procedures where its fiber network helps the graft maintain position within the fusion site.
Large or Noncontained Defects
In defects that lack natural bony walls to contain the graft, DBF can help reduce migration due to its interconnected fiber structure.
Revision Procedures
DBF is sometimes selected in revision surgeries where previous graft material or bone has been removed and greater structural integrity is needed within the defect.
Extremity Reconstruction
DBF may be used in reconstructive procedures involving long bones where fiber engagement helps fill complex spaces.
Storage and Preparation Considerations
Proper storage and preparation play an important role in maintaining the integrity of both DBM and DBF.
Room Temperature Storage
Many DBM and DBF products are designed for room temperature storage. This allows for easier inventory management in surgical facilities.
Sterile Packaging
Both materials are supplied in sterile containers to preserve sterility up to the point of use.
Surgical Preparation
Before implantation, the graft material is prepared according to the requirements of the specific procedure. This may include hydration or mixing with other graft materials depending on surgeon preference.
Safety and Regulatory Oversight
DBM and DBF are regulated human tissue products and are subject to established standards intended to support patient safety.
Donor Screening
All donors undergo medical history review, physical assessment, and laboratory testing prior to tissue recovery.
Processing Standards
Demineralized bone products are processed using validated methods designed to reduce the risk of contamination while preserving biological structure.
Documentation and Traceability
Each product is tracked through a regulated system that supports traceability from donor to end use.
DBM and DBF Compared to Other Bone Graft Options
Bone grafting materials fall into several broad categories, and DBM and DBF represent important biological options within that spectrum.
Autograft Bone
Autograft bone is taken directly from the patient. While it contains living cells, it requires a second surgical site and additional recovery.
Other Allograft Forms
In addition to DBM and DBF, bone grafts may include cancellous chips, cortical chips, and structural grafts.
Synthetic Bone Graft Materials
Synthetic bone void fillers are manufactured materials that may be used in certain applications. These do not originate from human tissue.
The selection of graft material is based on surgical goals, defect characteristics, and procedural preferences.
Supporting Surgical Grafting With Trusted Allografts
Understanding the differences between DBM and DBF begins with understanding how their structure, handling, and biological properties influence surgical use. While both serve to support bone repair, each offers distinct mechanical characteristics that surgeons consider when selecting graft materials for specific procedures.
At Acesso Biologics, we offer a full line of demineralized bone matrix and demineralized bone fiber allografts derived from 100 percent bone with no synthetic carriers. Our portfolio is designed to meet a wide range of clinical needs across spine, orthopedic, trauma, and reconstructive applications.
For additional product information, technical documentation, or ordering support, our team is available to provide accurate and timely assistance. Reach out to Acesso Biologics to learn more.
Frequently Asked Questions
1. What is the main difference between DBM and DBF?
The primary difference is physical structure. DBM is typically a particulate or putty-like material, while DBF consists of long, interwoven bone fibers.
2. Are DBM and DBF both made from donated human bone?
Yes. Both materials are derived from screened human bone that has undergone demineralization and controlled processing.
3. Do DBM and DBF function differently in the body?
They share the same biological foundation but differ in how they handle mechanically within the graft site due to their structure.
4. Can DBM and DBF be used together?
In some surgical approaches, different graft materials may be combined based on clinical need and surgeon preference.
5. Are DBM and DBF regulated medical products?
Yes. They are regulated as human tissue products and are processed under established tissue banking standards.