Biological approaches and biomaterial-based solutions for bone reconstruction: A comprehensive review

Abstract

Reconstruction of bone defects remains a major challenge in contemporary orthopedic practice and related reconstructive fields, including dental applications, particularly in cases involving trauma, surgical resections, implants, and prostheses. Regenerative medicine has evolved through the integration of biological sciences, engineering, and technology to promote functional and predictable bone regeneration. Although autogenous grafts are still the gold standard because of their osteogenic, osteoinductive, and osteoconductive properties, their use is limited by donor site morbidity, extended surgical time, and volume constraints. Alternative grafts, such as allogeneic, xenogeneic, and synthetic materials, offer distinct advantages in terms of biocompatibility, resorption, and tissue integration. The development of advanced biomaterials, including bioactive scaffolds, has improved extracellular matrix mimicry, enhancing cell adhesion, vascularization, and mineralized tissue formation. This review aims to provide an integrative analysis of current biological and synthetic strategies for bone reconstruction in orthopedics and related fields, emphasizing their principles, properties, clinical applications, and limitations. Innovative approaches such as tissue engineering, cell therapy, and photobiomodulation with low-level laser therapy have shown promising outcomes in promoting osteogenesis and repair. The integration of biological approaches with synthetic solutions is emerging as a promising path toward more effective, individualized, and evidence-based regenerative treatments.

Keywords: Bone regeneration; Biomaterials; Orthopedics; Dentistry; Regenerative medicine; Low-level laser therapy; Photobiomodulation

Core Tip: Regenerative medicine combines biology, engineering, and technology to achieve predictable bone regeneration. While autogenous grafts remain the gold standard for their osteogenic properties, they pose limitations such as donor site morbidity and volume constraints. Alternatives like allogeneic, xenogeneic, and synthetic materials improve biocompatibility and tissue integration. Advanced biomaterials, including bioactive scaffolds, enhance extracellular matrix mimicry, supporting cell adhesion, vascularization, and mineralized tissue formation. Emerging strategies in tissue engineering, cell therapy, and photobiomodulation show promise for osteogenesis and repair. Integrating biological approaches with synthetic solutions offers a path toward individualized, effective, and evidence-based regenerative treatments in orthopedics.