Bone replacement grafts (bone grafts and bone graft substitutes) provide a structural framework for clot development, maturation, and remodeling that supports bone formation in osseous defects. Bone grafting materials also exhibit a variable capacity to promote the coordinated formation of bone, cementum, and periodontal ligament when placed and retained in periodontal defects. Bone grafting materials must possess the attributes of biocompatibility (lacking an immunogenic response) and osteoconductivity (providing a structure and surface topography that permit cellular attachment, proliferation, and migration). Bone replacement grafts may also possess other properties that support osteogenesis. Osteogenic grafting materials, such as cancellous bone/bone marrow, contain living cells that are capable of differentiation and formation of bone.

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