Autologous guided bone regeneration: a comprehensive narrative review

Bone defect is a prevalent and complex challenge in orthopedics and oral-maxillofacial surgery, severely compromising skeletal integrity and functional recovery. Autologous Guided Bone Regeneration (GBR) has emerged as a highly effective therapeutic strategy, demonstrating remarkable efficacy in treating long bone fractures, nonunions, post-tumor resection bone defects, and alveolar bone augmentation for dental implant procedures. This narrative review comprehensively synthesizes the latest research progress, core mechanisms, technical innovations, existing challenges, and future prospects of Autologous GBR through an extensive analysis of domestic and international literature. Its core mechanism relies on selective cell occlusion theory: barrier membranes construct a bone regeneration microenvironment, blocking non-osteoblastic invasion while promoting osteoblast migration and differentiation. Autologous components play key roles: autologous bone (gold standard for grafting) has osteogenic activity, osteoinductivity and osteoconductivity; autologous bone marrow provides mesenchymal stem cells (MSCs) for osteoblast differentiation and microenvironment regulation; autologous growth factors (e.g., Bone Morphogenetic Proteins [BMP], Transforming Growth Factor-β [TGF-β]) regulate bone regeneration via cell signaling pathways. Technical advances include site-specific autologous bone harvesting (ilium, mandible, etc.) and optimized barrier membranes (absorbable Poly Lactic-co-Glycolic Acid [PLGA]/collagen, non-absorbable expanded Polytetrafluoroethylene [ePTFE]). Cell-molecular studies (MSCs differentiation, Wnt pathway) offer theoretical basis. Challenges include surgical infection, potential immune rejection and poor osseointegration. Prospects involve 3D-printed scaffolds, gene therapy-tissue engineering combination, and application in complex diseases like osteogenesis imperfecta. This review provides references for researchers and clinicians.