Biological approaches and biomaterial-based solutions for bone reconstruction: A comprehensive review

Table 1 Horizontal comparison of the main categories of bone graft materials

Ref.	Type of graft	Main properties	Advantages	Limitations	Typical clinical applications
[142,143]	Autograft	Osteogenic, osteoinductive, osteoconductive; no immune response	Gold standard; high predictability; rapid integration	Donor-site morbidity; limited volume	Large defects, non-unions, orthopedic reconstruction, maxillofacial surgery
[144,145]	Allograft	Mainly osteoconductive; may retain osteoinductive potential depending on processing	No second surgical site; wide availability	Possible immune reaction; slower integration; disease transmission risk	Orthopedic revision surgery, spinal fusion, large defects
[146,147]	Xenograft	Highly osteoconductive; stable porous structure; slow resorption	Excellent volume maintenance; good scaffold for bone growth	Very slow remodeling; no osteogenic potential	Alveolar ridge preservation, sinus lift, moderate orthopedic defects
[148,149]	Synthetic (HA, β-TCP, bioceramics)	Controlled porosity; adjustable resorption; bioinert or bioactive depending on composition	No risk of disease transmission; unlimited availability; tunable properties	Lower mechanical strength; variable integration depending on formulation	Filling small to medium defects, orthopedic revisions, periodontal/trauma defects
[150,151]	Composite biomaterials	Combine organic and inorganic components; mechanical reinforcement; enhanced bioactivity	Balanced resorption; improved handling; increased mechanical stability	Higher cost; variable performance depending on formulation	Load-bearing defects, trauma reconstruction, implant dentistry

HA: Hydroxyapatite; β-TCP: Beta-tricalcium phosphate.