Research Progress in Bone Defect Repair Based on Piezoelectric and Natural Polymeric Materials

Xiangyi Ning; Jianing Nie; Yubin Pang; Weiwei Fan; Peng Wang; Jiupeng Deng

doi:10.6911/WSRJ.202606_12(6).0003

Authors

Xiangyi Ning
Jianing Nie
Yubin Pang
Weiwei Fan
Peng Wang
Jiupeng Deng

DOI:

https://doi.org/10.6911/WSRJ.202606_12(6).0003

Keywords:

Bone defect; piezoelectric material; natural polymer; silk fibroin; chitosan; bone tissue engineering.

Abstract

Natural polymer materials have attracted considerable attention in bone tissue engineering and oral and maxillofacial bone defect repair because their structures are highly similar to the extracellular matrix (ECM) in the human body. However, single natural polymer materials usually have several limitations related to osteogenesis, including insufficient mechanical properties, difficulty in controlling the in vivo degradation rate, and limited three-dimensional structural stability.In recent years, researchers have combined piezoelectric materials with natural polymers to mimic the microelectrical signals generated by bone tissue under mechanical stimulation. Piezoelectric ceramics, such as barium titanate, potassium sodium niobate, and zinc oxide, as well as piezoelectric polymers such as poly-L-lactic acid, can generate microelectrical signals under mechanical force. These signals can promote osteoblast proliferation and differentiation, enhance mineral deposition in bone tissue, and ultimately contribute to bone defect repair.This review focuses on the current research progress of piezoelectric materials, natural polymer materials, and bone defect repair. It summarizes the characteristics, biological mechanisms, and application advances of different materials. This review aims to promote further research on natural polymer-based piezoelectric composites for bone defect repair and improve their translational potential for future clinical applications.

Downloads

Download data is not yet available.

References

[1] Amini, A. R., Laurencin, C. T., & Nukavarapu, S. P. (2012). Bone tissue engineering: Recent advances and challenges. Critical Reviews in Biomedical Engineering, 40(5), 363–408. https://doi.org/10.1615/CritRevBiomedEng.v40.i5.20

[2] Laurencin, C., Khan, Y., & El-Amin, S. F. (2006). Bone graft substitutes. Expert Review of Medical Devices, 3(1), 49–57. https://doi.org/10.1586/17434440.3.1.49

[3] Tandon, B., Blaker, J. J., & Cartmell, S. H. (2018). Piezoelectric materials as stimulatory biomedical materials and scaffolds for bone repair. Acta Biomaterialia, 73, 1–20. https://doi.org/10.1016/j.actbio.2018.04.026

[4] Marino, A., & Becker, R. O. (1970). Piezoelectric effect and growth control in bone. Nature, 228(5270), 473–474. https://doi.org/10.1038/228473a0

[5] Yang, C., Ji, J., Lv, Y., Li, Z., & Luo, D. (2022). Application of piezoelectric material and devices in bone regeneration. Nanomaterials, 12(24). https://doi.org/10.3390/nano12244340

[6] D'Alessandro, D., Ricci, C., Milazzo, M., Strangis, G., Forli, F., Buda, G., Petrini, M., Berrettini, S., Uddin, M. J., Danti, S., & Parchi, P. (2021). Piezoelectric signals in vascularized bone regeneration. Biomolecules, 11(11). https://doi.org/10.3390/biom11111622

[7] Filippi, M., Born, G., Chaaban, M., & Scherberich, A. (2020). Natural polymeric scaffolds in bone regeneration. Frontiers in Bioengineering and Biotechnology, 8, 474. https://doi.org/10.3389/fbioe.2020.00474

[8] Melke, J., Midha, S., Ghosh, S., Ito, K., & Hofmann, S. (2016). Silk fibroin as biomaterial for bone tissue engineering. Acta Biomaterialia, 31, 1–16. https://doi.org/10.1016/j.actbio.2015.12.009

[9] Chen, W., Yu, Z., Pang, J., Yu, P., Tan, G., & Ning, C. (2017). Fabrication of biocompatible potassium sodium niobate piezoelectric ceramic as an electroactive implant. Materials, 10(4). https://doi.org/10.3390/ma10040407

[10] Zhao, R., Yang, R., Cooper, P. R., Khurshid, Z., Shavandi, A., & Ratnayake, J. (2021). Bone grafts and substitutes in dentistry: A review of current trends and developments. Molecules, 26(10). https://doi.org/10.3390/molecules26103007

[11] Sakkas, A., Wilde, F., Heufelder, M., Winter, K., & Schramm, A. (2017). Autogenous bone grafts in oral implantology-is it still a "gold standard"? A consecutive review of 279 patients with 456 clinical procedures. International Journal of Implant Dentistry, 3(1), 23. https://doi.org/10.1186/s40729-017-0082-2

[12] Ding, H., Cheng, Y., Niu, X., & Hu, Y. (2021). Application of electrospun nanofibers in bone, cartilage and osteochondral tissue engineering. Journal of Biomaterials Science, Polymer Edition, 32(4), 536–561. https://doi.org/10.1080/09205063.2020.1846043

[13] Elgali, I., Omar, O., Dahlin, C., & Thomsen, P. (2017). Guided bone regeneration: Materials and biological mechanisms revisited. European Journal of Oral Sciences, 125(5), 315–337. https://doi.org/10.1111/eos.12270

[14] Ren, Y., Fan, L., Alkildani, S., Liu, L., Emmert, S., Najman, S., Rimashevskiy, D., Schnettler, R., Jung, O., Xiong, X., & Barbeck, M. (2022). Barrier membranes for guided bone regeneration (GBR): A focus on recent advances in collagen membranes. International Journal of Molecular Sciences, 23(23). https://doi.org/10.3390/ijms232314792

[15] Liu, J., & Kerns, D. G. (2014). Mechanisms of guided bone regeneration: A review. The Open Dentistry Journal, 8, 56–65. https://doi.org/10.2174/1874210601408010056

[16] Yue, W., Zhang, W., Zhang, J., Qin, W., Bie, X., Zhao, Y., & Xu, G. (2025). The role of piezoelectric materials in bone remodeling and repair: Mechanisms and applications. International Journal of Nanomedicine, 20, 11593–11616. https://doi.org/10.2147/IJN.S448711

[17] Khare, D., Basu, B., & Dubey, A. K. (2020). Electrical stimulation and piezoelectric biomaterials for bone tissue engineering applications. Biomaterials, 258, 120280. https://doi.org/10.1016/j.biomaterials.2020.120280

[18] Zaszczyńska, A., Zabielski, K., Gradys, A., Kowalczyk, T., & Sajkiewicz, P. (2024). Piezoelectric scaffolds as smart materials for bone tissue engineering. Polymers, 16(19). https://doi.org/10.3390/polym16192466

[19] Wei, Y., Liang, Y., Qi, K., Gu, Z., Yan, B., & Xie, H. (2024). Exploring the application of piezoelectric ceramics in bone regeneration. Journal of Biomaterials Applications, 39(5), 409–420. https://doi.org/10.1177/08853282231226764

[20] Huang, H., Wang, K., Liu, X., Liu, X., Wang, J., Suo, M., Wang, H., Chen, S., Chen, X., & Li, Z. (2025). Piezoelectric biomaterials for providing electrical stimulation in bone tissue engineering: Barium titanate. Journal of Orthopaedic Translation, 51, 94–107. https://doi.org/10.1016/j.jot.2025.01.004

[21] Yao, T., Chen, J., Wang, Z., Zhai, J., Li, Y., Xing, J., Hu, S., Tan, G., Qi, S., Chang, Y., Yu, P., & Ning, C. (2019). The antibacterial effect of potassium-sodium niobate ceramics based on controlling piezoelectric properties. Colloids and Surfaces B: Biointerfaces, 175, 463–468. https://doi.org/10.1016/j.colsurfb.2019.01.009

[22] Li, Y., Liao, C., & Tjong, S. C. (2019). Electrospun polyvinylidene fluoride-based fibrous scaffolds with piezoelectric characteristics for bone and neural tissue engineering. Nanomaterials, 9(7). https://doi.org/10.3390/nano9070952

[23] Ramasamy, M. S., Kaliannagounder, V. K., Rahaman, A., Park, C. H., Kim, C. S., & Kim, B. (2022). Synergistic effect of reinforced multiwalled carbon nanotubes and boron nitride nanosheet-based hybrid piezoelectric PLLA scaffold for efficient bone tissue regeneration. ACS Biomaterials Science & Engineering, 8(8), 3542–3556. https://doi.org/10.1021/acsbiomaterials.2c00367

[24] Kamel, N. A. (2022). Bio-piezoelectricity: Fundamentals and applications in tissue engineering and regenerative medicine. Biophysical Reviews, 14(3), 717–733. https://doi.org/10.1007/s12551-022-00987-9

[25] Liang, X., Guo, S., Kuang, X., Wan, L., Liu, F., Zhang, G., Jiang, H., Cong, H., He, S., & Tan, S. C. (2024). Recent advancements and perspectives on processable natural biopolymers: Cellulose, chitosan, eggshell membrane, and silk fibroin. Science Bulletin, 69(21), 3444–3466. https://doi.org/10.1016/j.scib.2024.08.020

[26] Ait Said, H., Mabroum, H., Lahcini, M., Oudadesse, H., Barroug, A., Ben Youcef, H., & Noukrati, H. (2023). Manufacturing methods, properties, and potential applications in bone tissue regeneration of hydroxyapatite-chitosan biocomposites: A review. International Journal of Biological Macromolecules, 243, 125150. https://doi.org/10.1016/j.ijbiomac.2023.125150

[27] Ressler, A. (2022). Chitosan-based biomaterials for bone tissue engineering applications: A short review. Polymers, 14(16). https://doi.org/10.3390/polym14163330

[28] Zhang, J., Liu, C., Li, J., Yu, T., Ruan, J., & Yang, F. (2025). Advanced piezoelectric materials, devices, and systems for orthopedic medicine. Advanced Science, 12(3), e2410400. https://doi.org/10.1002/advs.202410400

[29] Wu, H., Dong, Z., Tang, Y., Chen, Y., Liu, M., Wang, X., Wei, N., Wang, S., Bao, D., Yu, Z., Wu, Z., Yang, X., Li, Z., Guo, L., & Shi, L. (2023). Electrical stimulation of piezoelectric BaTiO3 coated Ti6Al4V scaffolds promotes anti-inflammatory polarization of macrophages and bone repair via MAPK/JNK inhibition and OXPHOS activation. Biomaterials, 293, 121990. https://doi.org/10.1016/j.biomaterials.2023.121990

[30] Guillot-Ferriols, M., Lanceros-Méndez, S., Gómez Ribelles, J. L., & Gallego Ferrer, G. (2022). Electrical stimulation: Effective cue to direct osteogenic differentiation of mesenchymal stem cells? Biomaterials Advances, 138, 212918. https://doi.org/10.1016/j.bioadv.2022.212918

[31] Rotaru, R., Melinte, V., & Trifan, I. S. (2024). Biophysical stimulation for bone regeneration using a chitosan/barium titanate ferroelectric composite. Physical Chemistry Chemical Physics, 26(18), 13875–13883. https://doi.org/10.1039/D4CP01240A

[32] Wu, P., Shen, L., Liu, H. F., Zou, X. H., Zhao, J., Huang, Y., Zhu, Y. F., Li, Z. Y., Xu, C., Luo, L. H., Luo, Z. Q., Wu, M. H., Cai, L., Li, X. K., & Wang, Z. G. (2023). The marriage of immunomodulatory, angiogenic, and osteogenic capabilities in a piezoelectric hydrogel tissue engineering scaffold for military medicine. Military Medical Research, 10(1), 35. https://doi.org/10.1186/s40779-023-00466-9

[33] Verma, A. S., Kumar, D., & Dubey, A. K. (2020). Antibacterial and cellular response of piezoelectric Na₀.₅K₀.₅NbO₃ modified 1393 bioactive glass. Materials Science and Engineering: C, 116, 111138. https://doi.org/10.1016/j.msec.2020.111138

[34] Tian, J., Paterson, T. E., Zhang, J., Li, Y., Ouyang, H., Asencio, I. O., Hatton, P. V., Zhao, Y., & Li, Z. (2023). Enhanced antibacterial ability of electrospun PCL scaffolds incorporating ZnO nanowires. International Journal of Molecular Sciences, 24(19). https://doi.org/10.3390/ijms241914760

[35] Chen, K., Wang, F., Sun, X., Ge, W., Zhang, M., Wang, L., Zheng, H., Zheng, S., Tang, H., Zhou, Z., & Wu, G. (2025). 3D-printed zinc oxide nanoparticles modified barium titanate/hydroxyapatite ultrasound-responsive piezoelectric ceramic composite scaffold for treating infected bone defects. Bioactive Materials, 45, 479–495. https://doi.org/10.1016/j.bioactmat.2025.02.020

[36] Chen, S., Wang, X., Zhang, D., Huang, Z., Xie, Y., Chen, F., & Liu, C. (2025). Tunable piezoelectric PLLA nanofiber membranes for enhanced mandibular repair with optimal self-powering stimulation. Regenerative Biomaterials, 12, rbae150. https://doi.org/10.1093/rb/rbae150

[37] Wu, H., Lin, K., Zhao, C., & Wang, X. (2022). Silk fibroin scaffolds: A promising candidate for bone regeneration. Frontiers in Bioengineering and Biotechnology, 10, 1054379. https://doi.org/10.3389/fbioe.2022.1054379

[38] Kim, J. Y., Yang, B. E., Ahn, J. H., Park, S. O., & Shim, H. W. (2014). Comparable efficacy of silk fibroin with the collagen membranes for guided bone regeneration in rat calvarial defects. Journal of Advanced Prosthodontics, 6(6), 539–546. https://doi.org/10.4047/jap.2014.6.6.539

[39] Tuwalska, A., Grabska-Zielińska, S., & Sionkowska, A. (2022). Chitosan/silk fibroin materials for biomedical applications-A review. Polymers, 14(7). https://doi.org/10.3390/polym14071424

[40] Sukpaita, T., Chirachanchai, S., Pimkhaokham, A., & Ampornaramveth, R. S. (2021). Chitosan-based scaffold for mineralized tissues regeneration. Marine Drugs, 19(10). https://doi.org/10.3390/md19100560

[41] Zhou, Y., Liu, X., She, H., Wang, R., Bai, F., & Xiang, B. (2022). A silk fibroin/chitosan/nanohydroxyapatite biomimetic bone scaffold combined with autologous concentrated growth factor promotes the proliferation and osteogenic differentiation of BMSCs and repair of critical bone defects. Regenerative Therapy, 21, 307–321. https://doi.org/10.1016/j.reth.2022.09.004

[42] Ye, P., Yu, B., Deng, J., She, R. F., & Huang, W. L. (2017). Application of silk fibroin/chitosan/nano-hydroxyapatite composite scaffold in the repair of rabbit radial bone defect. Experimental and Therapeutic Medicine, 14(6), 5547–5553. https://doi.org/10.3892/etm.2017.5227

[43] Ni, X., Cui, Y., Salehi, M., Nai, M. L. S., Zhou, K., Vyas, C., & Huang, P. Bartolo, B. (2025). Piezoelectric biomaterials for bone regeneration: Roadmap from dipole to osteogenesis. Advanced Science, 12(32), e14969. https://doi.org/10.1002/advs.202414969

[44] Joo, S., Gwon, Y., Kim, S., Park, S., Kim, J., & Hong, S. (2024). Piezoelectrically and topographically engineered scaffolds for accelerating bone regeneration. ACS Applied Materials & Interfaces, 16(2), 1999–2011. https://doi.org/10.1021/acsami.3c16163

[45] Huang, R. H., Sobol, N. B., Younes, A., Mamun, T., Lewis, J. S., Ulijn, R. V., & O'Brien, S. (2020). Comparison of methods for surface modification of barium titanate nanoparticles for aqueous dispersibility: Toward biomedical utilization of perovskite oxides. ACS Applied Materials & Interfaces, 12(46), 51135–51147. https://doi.org/10.1021/acsami.0c15216

[46] Sundar, U., Lao, Z., & Cook-Chennault, K. (2019). Investigation of piezoelectricity and resistivity of surface modified barium titanate nanocomposites. Polymers, 11(12). https://doi.org/10.3390/polym11122013

[47] Li, Y., Liu, Q., & Guo, Q. (2021). Silk fibroin hydrogel scaffolds incorporated with chitosan nanoparticles repair articular cartilage defects by regulating TGF-β1 and BMP-2. Arthritis Research & Therapy, 23(1), 50. https://doi.org/10.1186/s13075-021-02438-3

[48] Mao, Z., Bi, X., Yu, C., Chen, L., Shen, J., Huang, Y., Wu, Z., Qi, H., Guan, J., Shu, X., Yu, B., & Zheng, Y. (2024). Mechanically robust and personalized silk fibroin-magnesium composite scaffolds with water-responsive shape-memory for irregular bone regeneration. Nature Communications, 15(1), 4160. https://doi.org/10.1038/s41467-024-48404-9