Herbal-derived bioactive compounds in alveolar bone regeneration: a narrative review

Adequate alveolar bone volume is essential for successful implant therapy; however, current regenerative approaches are limited by donor-site morbidity, the biological passivity of bone substitutes, and safety concerns surrounding high-dose growth factors. This narrative review evaluates the potential of herbal-derived bioactive compounds to address these limitations through targeted osteoimmunomodulation, with particular emphasis on establishing a microenvironment conducive to predictable alveolar bone regeneration. The biological mechanisms of five major classes of herbal-derived bioactive compounds-flavonoids, polyphenols, terpenoids, alkaloids, and polysaccharides-were examined through a literature search of English-language articles published between 2000 and 2025. The review focused on their capacity to resolve inflammation, promote angiogenesis, and stimulate osteogenesis. Current evidence suggests that these agents exert pleiotropic effects that may improve nonpermissive recipient sites and restore a healing microenvironment favorable to bone formation. The literature also indicates a shift from compositionally variable crude extracts toward chemically defined and structurally modified compounds. QG3030 exemplifies this approach as a lappaconitine derivative designed to enhance osteoinductive potency while reducing systemic toxicity. Despite encouraging in vitro and in vivo findings, a substantial translational gap remains because few high-quality clinical trials have evaluated quantifiable hard-tissue outcomes. Herbal-derived bioactive compounds may therefore provide a useful means of biofunctionalizing conventional scaffolds. Future studies should prioritize the integration of chemically defined agents with stimuli-responsive biomaterials to achieve spatiotemporally controlled drug release and determine whether preclinical efficacy can be translated into predictable alveolar bone regeneration.