Pilipov Ilya A.¹, Orlova Anastasia², Frolov Daniil³, Kuznetsova Marina⁴, Sidorov Artem⁵, Volkova Kristina⁶, Ivanov Maksim⁷, Petrova Elina⁸, Egorov Denis⁹
ABSTRACT:
Reconstruction of bone defects in oral and maxillofacial surgery remains a critical clinical challenge due to the complexity of anatomical structures, the need for functional restoration, and limitations associated with traditional grafting techniques. Recent advances in biomaterials science and regenerative medicine have catalyzed a paradigm shift toward biologically active and patient-specific approaches for bone tissue engineering. Synthetic and natural biomaterials—such as hydroxyapatite, β-tricalcium phosphate, bioactive glasses, and collagen-based scaffolds—have been engineered to mimic the mechanical and biochemical properties of native bone while promoting osteoconduction and osteoinduction. Concurrently, cellular technologies involving autologous mesenchymal stem cells (MSCs), periosteal-derived progenitors, and bone marrow stromal cells have demonstrated significant potential to enhance regeneration through paracrine signaling and direct differentiation. Scaffold-based delivery systems incorporating growth factors like BMP-2, VEGF, and PDGF further augment vascularization and osteogenesis in challenging defect environments. Three-dimensional bioprinting, decellularized bone matrices, and gene-activated constructs represent cutting-edge techniques offering spatial control and targeted biological activity. Preclinical studies and early-phase clinical trials have validated the efficacy of these composite strategies, showing improved bone volume, faster integration, and reduced donor site morbidity. However, standardization of protocols, long-term safety data, and regulatory approval remain key barriers to widespread clinical adoption. Integration of digital surgical planning, intraoperative imaging, and CAD/CAM-designed grafts is also enhancing the precision and predictability of bone reconstruction procedures. As regenerative oral surgery evolves, the convergence of advanced biomaterials, stem cell biology, and tissue engineering holds promise for personalized, minimally invasive, and functionally superior outcomes in complex bone regeneration scenarios.