Biological responses to biomaterials: a review

Biomaterials stimulate diverse biological responses, including inflammation, wound healing, foreign body reactions, and fibrous encapsulation, all critical for evaluating biocompatibility and effectiveness. These responses are influenced by the material's physicochemical and biological properties, such as composition, texture, and surface characteristics. Adverse reactions, such as severe inflammation or fibrous encapsulation, can hinder tissue integration, jeopardizing patient health and increasing healthcare costs. This review aimed to summarize the current scientific evidence on biological responses to biomaterials. A systematic search was conducted through multiple databases (VHL, PubMed, SCOPUS, EMBASE, and Web of Science) including in vitro and in vivo studies that compared biomaterial interactions with the natural immune response (innate and adaptive). From the 791 articles identified, 25 met strict inclusion criteria. These studies revealed variations in immune responses and material surface characteristics, highlighting advancements made to enhance tissue integration. Bioactive materials demonstrated greater potential for tissue regeneration, while inert materials triggered moderate inflammatory reactions. This variability emphasizes the need for a personalized biomaterial selection, considering both short-term biocompatibility and long-term tissue functionality. This review underscores the importance of comprehensive evaluation to optimize biomaterial performance in clinical applications.