It has been more than 40 years since Dr. Marshall Urist’s initial discovery of the osteoinductive activity of bone morphogenetic protein (BMP) [1, 2]. Today, as a direct result of that discovery, orthopedic surgeons have the ability to control osteogenesis through the local application of BMP in their patients. Osteoinduction is defined as the ability of a protein to mediate and induce bone formation in an extraossesous site. BMPs are the family of osteoinductive proteins that can be extracted from bone matrix and are responsible for embryonic skeletal formation, skeletal regeneration and bone healing. The first publications on the clinical use of extracts of human BMP from allograft bone matrix began in the late 1980s. This was followed in 1988 by the isolation of the DNA for individual BMP molecules from a purified extract and the subsequent recombinant production of different BMPs [3]. This recombinant production process is similar to the method used to manufacture human insulin and other protein-based drugs (such as erythropoietin and interferon); it enables the reproducible production of a single BMP, at a known concentration and at very high purity. The availability of recombinant human bone morphogenetic protein-2 (rhBMP-2, also known as dibotermin alfa) permitted the large-scale testing of different carriers and concentrations in preclinical animal models, prior to starting clinical studies and gaining regulatory approval of a synthetic rhBMP-2 product.