Update on synthetic biomaterials combined with fibrin derivatives for regenerative medicine: Applications in bone defect treatment: Systematic review

Figure 1 Schematic representation of the bone regeneration process facilitated by biomimetic scaffold implantation combined with fibrin derivatives. A: Illustration of a critical bone defect, characterized by the loss of structural integrity and the need for regenerative intervention; B: Implantation of a bioactive scaffold at the defect site, creating a microenvironment conducive to cellular adhesion, proliferation, and tissue growth; C: Multicomponent strategy to enhance bone regeneration, incorporating synthetic biomaterials such as hydroxyapatite (HA), β-tricalcium phosphate (β-TCP), experimental calcium phosphate (ECP), deproteinized bovine bone (DBB), collagen-hydroxyapatite (C-HA), and mineralized plasmatic matrix (MPM). This approach is further optimized by integrating mesenchymal stem cells (MSCs), vascular endothelial growth factor (VEGF), and fibrin sealants, which collectively improve scaffold stabilization, cellular recruitment, osteoconductivity, and angiogenesis; D: Final stage of the bone repair process, demonstrating the formation of structurally integrated, mature bone tissue, restoring the biomechanical properties of the affected region. HA: Hydroxyapatite, β-TCP: β-tricalcium phosphate; ECP: Experimental calcium phosphate; DBB: Deproteinized bovine bone; C-HA: Collagen-hydroxyapatite; MPM: Mineralized plasmatic matrix; MSCs: Mesenchymal stem cells; VEGF: Vascular endothelial growth factor.

Figure 2 Identification and organization of articles from databases through the PRISMA flow diagram. PRF: Platelet-rich fibrin.

Figure 3 Distribution of studies published since 2013 by type of experimental model.

Figure 4 Proportion of types of animal models used in the studies evaluated.

Figure 5 Percentages of each biomaterial used in the studies evaluated. PRF: Platelet-rich fibrin; HA: Hydroxyapatite; β-TCP: β-tricalcium phosphate; PLGA: Poly (D,L-lactide-co-glycolide); BCP: Biphasic bioceramic.