BIOACTIVE BIOMATERIALS AND BONE REGENERATION IN MAXILLOFACIAL RECONSTRUCTIONS: A SYSTEMATIC LITERATURE REVIEW
DOI:
https://doi.org/10.56238/revgeov17n3-130Keywords:
Bioactive Biomaterials, Bone Regeneration, Maxillofacial Reconstruction, Bioactive Glass, Tissue EngineeringAbstract
Bone regeneration in maxillofacial reconstructions is one of the main challenges in contemporary maxillofacial surgery, especially in critical defects resulting from trauma, tumor resections, infections, or alveolar bone loss associated with implant-supported rehabilitation. Although autogenous bone grafts remain widely recognized as the gold standard due to their osteogenic, osteoinductive, and osteoconductive properties, limitations such as donor site morbidity, restricted bone volume availability, and unpredictable resorption have driven the search for biomaterial alternatives. In this context, bioactive biomaterials emerge as innovative therapeutic strategies, capable of biologically interacting with host tissue through the controlled release of ions and the formation of a superficial hydroxyapatite layer, stimulating osteoblastic differentiation and angiogenesis. This study aimed to conduct a systematic literature review on the application of bioactive biomaterials in bone regeneration in maxillofacial reconstructions, analyzing biological mechanisms, experimental performance, and clinical evidence. The review was conducted according to the PRISMA 2020 guidelines, using searches in the PubMed/MEDLINE, Scopus, Web of Science, Embase, and SciELO databases, including studies published between 2010 and 2024. In vivo studies, clinical trials, and experimental research involving bioactive glasses, mesoporous bioactive glasses, calcium phosphates, and polymer-ceramic composites applied to maxillofacial bone defects were selected. The results demonstrated that these biomaterials promote significant bone formation, adequate tissue integration, and favorable modulation of the cellular response, highlighting the role of ionic dissolution in the activation of osteogenic and angiogenic pathways. It was also observed that scaffolds produced by additive manufacturing present relevant structural advantages, such as porosity control and anatomical customization. It is concluded that bioactive biomaterials represent a biologically active and promising approach for complex maxillofacial reconstructions, potentially reducing the dependence on autogenous grafts. However, the need for controlled clinical trials and longitudinal studies to consolidate standardized therapeutic protocols and evaluate long-term results is evident.
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