Abstract
Millions of patients suffer yearly from bone fractures and disorders such as osteoporosis or cancer, which constitute the most common causes of severe long-term pain and physical disabilities. The intrinsic capacity of bone to repair the damaged bone allows normal healing of most small bone injuries. However, larger bone defects or more complex diseases require additional stimulation to fully heal. In this context, the traditional routes to address bone disorders present several associated drawbacks concerning their efficacy and cost-effectiveness. Thus, alternative therapies become necessary to overcome these limitations. In recent decades, bone tissue engineering has emerged as a promising interdisciplinary strategy to mimic environments specifically designed to facilitate bone tissue regeneration. Approaches developed to date aim at three essential factors: osteoconductive scaffolds, osteoinduction through growth factors, and cells with osteogenic capability. This review addresses the biological basis of bone and its remodeling process, providing an overview of the bone tissue engineering strategies developed to date and describing the mechanisms that underlie cell–biomaterial interactions.
Highlights
Bone is a dynamic connective tissue that plays a crucial role in locomotion, mechanical support and protection of soft tissues, calcium and phosphate storage, and harboring of bone marrow [1,2].Bone presents the intrinsic capacity for modeling and remodeling in order to preserve skeletal size, shape, and structural integrity [3]
Osteolytic metastasis is present in the great majority of bone cancers, destroying normal bone primarily mediated by osteoclasts, parathyroid hormone-related peptide (PTHrP) and RANKL
Allografts provide an alternative method, in areas with larger bone defects, based on transplanting donor bone tissue between genetically non-identical individuals of the same species [21,39]. They present reduced osteoinductive properties when compared to autografts [40], taking longer for a defect to be filled by native bone tissue [29], which leads to mechanical stress and immunogenesis [39]
Summary
Bone is a dynamic connective tissue that plays a crucial role in locomotion, mechanical support and protection of soft tissues, calcium and phosphate storage, and harboring of bone marrow [1,2]. Larger bone defects and diseases require additional stimulation to fully regenerate and heal In this context, millions of patients suffer yearly from bone fractures, mainly caused by accidental fractures, aging-related disorders, and autoimmune diseases [5]. Alternative therapies become necessary to overcome these limitations In this context, bone tissue engineering (BTE) emerged in recent decades as a promising strategy for treatment of bone pathologies. Computational modeling has emerged as an excellent tool to predict and optimize the clinical potential in terms of cell proliferation and differentiation, tissue growth, adaptation, and maintenance [12]. The basis of bone biology and the remodeling process are examined, providing an overview of the BTE strategies developed to date and the biological phenomena that underlie cell–biomaterial interactions. Computational modeling approaches for BTE are examined as a potential tool to help design better biomimetic materials
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