Xie RX, Xing YX, Sun NZ. Advancing bone regeneration: Clinical implications of synthetic biomaterials and fibrin derivatives. World J Orthop 2025; 16(8): 109149 [DOI: 10.5312/wjo.v16.i8.109149]
Corresponding Author of This Article
Nian-Zhe Sun, MD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2025; 16(8): 109149 Published online Aug 18, 2025. doi: 10.5312/wjo.v16.i8.109149
Advancing bone regeneration: Clinical implications of synthetic biomaterials and fibrin derivatives
Ren-Xian Xie, Yi-Xuan Xing, Nian-Zhe Sun
Ren-Xian Xie, Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515031, Guangdong Province, China
Yi-Xuan Xing, Department of Emergency, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
Nian-Zhe Sun, Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Nian-Zhe Sun, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Co-corresponding authors: Yi-Xuan Xing and Nian-Zhe Sun.
Author contributions: Xie RX contributed to this work as first author; Sun NZ, Xing YX and Xie RX designed the concept and outline and contributed to the writing and review of literature; Sun NZ was responsible for oversight and coordination; and all authors contributed to the editing of the manuscript. Prof. Xing YX served as co-corresponding author throughout this study, overseeing the design, validation, and manuscript drafting and reviewing. Prof. Sun NZ, co-corresponding author, directed project conceptualization and final editing. Both authors independently managed critical aspects: Prof. Xing YX led validation and analysis, while Pro. Sun NZ guided the research framework and integration. This distinction clarifies their complementary, non-overlapping responsibilities.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nian-Zhe Sun, MD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Received: May 6, 2025 Revised: June 13, 2025 Accepted: July 10, 2025 Published online: August 18, 2025 Processing time: 100 Days and 1.9 Hours
Abstract
Bone defects caused by trauma, infection, or congenital anomalies remain a significant challenge in orthopedic and dental practice, necessitating innovative strategies to enhance healing and functional restoration. This systematic review by Pagani et al synthesizes evidence on the synergistic role of synthetic biomaterials, such as hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), combined with fibrin derivatives in bone regeneration. Analyzing 21 studies, the authors demonstrate that HA and β-TCP composites exhibit superior osteoconductivity and biocompatibility when integrated with fibrin sealants or platelet-rich fibrin, promoting cellular adhesion, osteogenic differentiation, and accelerated healing. While these studies underscore the potential of these biomaterial-fibrin hybrids, limitations such as variability in fibrin preparation, lack of long-term data, and insufficient standardization hinder clinical translation. This editorial contextualizes these findings within the evolving landscape of regenerative medicine, emphasizing the need for optimized formulations, interdisciplinary collaboration, and robust clinical trials to bridge laboratory innovation to bedside application.
Core Tip: The integration of synthetic biomaterials, for example hydroxyapatite and β-tricalcium phosphate, with fibrin derivatives enhances bone regeneration by improving scaffold stability, cellular recruitment, and mechanical support. While promising, clinical adoption requires standardized protocols, long-term outcome validation, and personalized approaches to address complex bone defects in aging and comorbid populations.
