Efficacy of Bacterial Nanocellulose in Hard Tissue Regeneration: A Review

Bacterial nanocellulose (BNC, as exopolysaccharide) synthesized by some specific bacteria strains is a fascinating biopolymer composed of the three-dimensional pure cellulosic nanofibrous matrix without containing lignin, hemicellulose, pectin, and other impurities as in plant-based cellulose. Due to its excellent biocompatibility (in vitro and in vivo), high water-holding capacity, flexibility, high mechanical properties, and a large number of hydroxyl groups that are most similar characteristics of native tissues, BNC has shown great potential in tissue engineering applications. This review focuses on and discusses the efficacy of BNC- or BNC-based biomaterials for hard tissue regeneration. In this review, we provide brief information on the key aspects of synthesis and properties of BNC, including solubility, biodegradability, thermal stability, antimicrobial ability, toxicity, and cellular response. Further, modification approaches are discussed briefly to improve the properties of BNC or BNC-based structures. In addition, various biomaterials by using BNC (as sacrificial template or matrix) or BNC in conjugation with polymers and/or fillers are reviewed and discussed for dental and bone tissue engineering applications. Moreover, the conclusion with perspective for future research directions of using BNC for hard tissue regeneration is briefly discussed.