The role of growth factors on acceleration of bone regeneration during distraction osteogenesis

The distraction osteogenesis (DO) technique has been used worldwide to treat many complex orthopedic and craniofacial conditions. One limitation of this technique is the long time of fixator needs to be left in place until the bone is completely consolidated. Various biophysical, mechanical, and biological methods have been investigated to accelerate bone regeneration during DO. Several growth factors (GFs) are known to enhance bone regeneration such as bone morphogenic proteins, transforming growth factor beta, fibroblast growth factor, insulin growth factor, vascular endothelial growth factor, and platelet-derived growth factor. These GFs are known to stimulate cellular growth, proliferation, migration, and differentiation. In this review, an extensive overview of these GFs development and applications on acceleration of bone regeneration in the context of DO is discussed. Current challenges and alternative tissue engineering techniques to address the delivery and sustain release of these factors are also discussed. Finally, we highlighted our view regarding the remaining questions and future research directions.