Biomedical approaches to improve bone healing in distraction osteogenesis: a current update and review

Induction of new bone formation through distraction osteogenesis (DO) has widespread clinical applications in the treatment of bone defects, limb deformities, and fracture nonunion. However, a lengthy period of external fixation is usually needed to allow the new bone to consolidate, and complications such as refracture at the distraction gap are often seen. To date, little has been reported on the use of biomaterials as carrier materials for sustained release of growth factors in bone regeneration. One area of focus is the delivery of osteogenic factors in an attempt to modulate the formation of bone. These applications allow the efficient delivery of osteogenic growth factors directly into the defect site, resulting in localized drug delivery and reducing possible toxic systemic effects. However, studies on these biomaterials have only just begun; there are still many unanswered questions and unexplored frontiers that can greatly influence the role of nanostructured materials as improved bone implants. This review article seeks to demonstrate the potential of biomaterials to improve biological applications pertinent to osteodistraction.