Łuczak Julia Weronika, Palusińska Małgorzata, Matak Damian, Pietrzak Damian, Nakielski Paweł, Lewicki Sławomir, Grodzik Marta, Szymański Łukasz
Department of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Postępu 36A, 05-552 Magdalenka, Poland.
Department of Nanobiotechnology, Institute of Biology, Warsaw University of Life Sciences, Ciszewskiego 8, Bldg. 23, 02-786 Warsaw, Poland.
Int J Mol Sci. 2024 Nov 27;25(23):12766. doi: 10.3390/ijms252312766.
Bone defects and fractures present significant clinical challenges, particularly in orthopedic and maxillofacial applications. While minor bone defects may be capable of healing naturally, those of a critical size necessitate intervention through the use of implants or grafts. The utilization of traditional methodologies, encompassing autografts and allografts, is constrained by several factors. These include the potential for donor site morbidity, the restricted availability of suitable donors, and the possibility of immune rejection. This has prompted extensive research in the field of bone tissue engineering to develop advanced synthetic and bio-derived materials that can support bone regeneration. The optimal bone substitute must achieve a balance between biocompatibility, bioresorbability, osteoconductivity, and osteoinductivity while simultaneously providing mechanical support during the healing process. Recent innovations include the utilization of three-dimensional printing, nanotechnology, and bioactive coatings to create scaffolds that mimic the structure of natural bone and enhance cell proliferation and differentiation. Notwithstanding the advancements above, challenges remain in optimizing the controlled release of growth factors and adapting materials to various clinical contexts. This review provides a comprehensive overview of the current advancements in bone substitute materials, focusing on their biological mechanisms, design considerations, and clinical applications. It explores the role of emerging technologies, such as additive manufacturing and stem cell-based therapies, in advancing the field. Future research highlights the need for multidisciplinary collaboration and rigorous testing to develop advanced bone graft substitutes, improving outcomes and quality of life for patients with complex defects.
骨缺损和骨折带来了重大的临床挑战，尤其是在骨科和颌面应用中。虽然较小的骨缺损可能能够自然愈合，但临界尺寸的骨缺损则需要通过植入物或移植物进行干预。包括自体骨移植和异体骨移植在内的传统方法的应用受到多种因素的限制。这些因素包括供体部位发病的可能性、合适供体的有限可用性以及免疫排斥的可能性。这促使骨组织工程领域进行广泛研究，以开发能够支持骨再生的先进合成材料和生物衍生材料。理想的骨替代物必须在生物相容性、生物可吸收性、骨传导性和骨诱导性之间取得平衡，同时在愈合过程中提供机械支撑。最近的创新包括利用三维打印、纳米技术和生物活性涂层来制造模仿天然骨结构并促进细胞增殖和分化的支架。尽管有上述进展，但在优化生长因子的控释以及使材料适应各种临床情况方面仍存在挑战。本综述全面概述了骨替代材料的当前进展，重点关注其生物学机制、设计考量和临床应用。它探讨了增材制造和基于干细胞的疗法等新兴技术在推动该领域发展中的作用。未来的研究强调需要多学科合作和严格测试，以开发先进的骨移植替代物，改善复杂缺损患者的治疗效果和生活质量。
