Current state of bioceramic bone repair materials in immune regulation: a review

Extensive bone defects represent a significant clinical challenge, often leading to severe impairment of patients function and quality of life. Traditional treatments, such as autografts and allografts, are widely used but have notable limitations, including donor site morbidity and immunogenicity. As a result, tissue engineering has attracted increasing attention as a viable alternative. Bioceramic bone repair materials provide both mechanical support and bioactive functions in the treatment of bone defects. They modulate the immune microenvironment to promote cellular behaviors and signaling pathways conducive to bone regeneration. The immunoregulatory effects of these materials play a critical role throughout the bone repair process and are pivotal in determining the success of regeneration. For instance, hydroxyapatite can induce the polarization of macrophages towards the M2 phenotype, exerting anti-inflammatory effects that promote bone tissue repair. This review summarizes recent advancements in the research of bioceramics for bone tissue engineering, with a focus on the classification of bioceramic materials, their immunomodulatory mechanisms in bone regeneration, current fabrication techniques, and the status of clinical translation. We aim to provide insights that support future research and the development of improved strategies for bone defect repair.