Autogenous bone is regarded as the gold standard for
bone graft materials as it provides 3 elements necessary
to generate and maintain bone: scaffolding for osteoconduction,
growth factors for osteoinduction, and
progenitor cells for osteogenesis. Allograft is more limited
than autograft in these essential elements and yields
more variable clinical results. Composite synthetic grafts
offer an alternative that can potentially unite the 3
salient bone-forming properties in more controlled and
effective combinations than can be obtained in many
clinical situations, without the disadvantages found with
autograft. This article examines the underemphasized
but crucial role of the osteoconductive scaffold in the
composite synthetic bone graft.