BIOMATERIALS USED IN ALVEOLAR BONE REGENERATION: A NARRATIVE REVIEW

Fady Ramadan, Haddad Lawrence, Mihnea Michetei, Hutanu Vasile, Agop-Forna Doriana

DOI : 10.62610/RJOR.2026.2.18.16

Abstract

Objectives. Although the range of biomaterials applicable for alveolar bone regeneration has expanded considerably over the last two decades, uncertainty persists regarding the best selection from autogenous, allogeneic, xenogeneic, synthetic and composite options. This narrative review sought to critically evaluate the current evidence on the biological rationale and clinical performance of these materials, with a focus on their mechanisms of action in the context of implant-prosthetic rehabilitation. Materials and Methods. A structured literature search was conducted in PubMed/MEDLINE, PubMed Central, Scopus and Web of Science, covering publications from 2000 to 2025. Narrative reviews, systematic reviews, randomized controlled trials and cohort studies were included. Primary outcomes were bone volume gain, graft integration rate, implant survival in augmented sites, resorption dynamics and complication profiles. Data were synthesized narratively due to heterogeneity among included studies. Results. Autogenous bone is gold standard, combining osteogenesis, osteoinduction and osteoconduction within a single material, though donor site morbidity and limited harvest volume limit its use in alveolar bone grafting. Allografts and xenografts provide reliable osteoconductive scaffolds, while demineralized bone matrix preserves have osteoinductive potential. Synthetic substitutes — hydroxyapatite, beta-tricalcium phosphate, calcium sulphate, bioactive glasses and calcium phosphate cements — have the advantage of limited resorption rate. Composite materials and growth factor-enriched represent promising biomaterials for alveolar bone grafting. No currently available material fulfils all criteria of an ideal bone substitute, and outcomes remain dependent on defect morphology, residual bone quality and systemic patient factors. Conclusions. Material selection for alveolar bone regeneration should follow a defect-specific and patient-centred approach, in which biological augmentation is viewed as synergistic to scaffold-based strategies. Further progress requires improved clinical trial design and deeper integration of regenerative biology into routine implant-prosthetic treatment planning.