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<p>Bone regeneration is regulated by coupled mechanical and electrical signals, and native bone exhibits intrinsic piezoelectric behavior. Piezoelectric biomaterials have therefore emerged as self-powered platforms capable of converting mechanical stimuli into localized electrical cues to enhance osteogenesis. However, the efficiency for bone regeneration has not been systematically synthesized. This systematic review evaluated the efficiency of piezoelectric biomaterials in enhancing bone regeneration-related outcomes In vitro and in vivo compared with conventional non-piezoelectric materials. Following PRISMA guidelines and PROSPERO registration (CRD420251131697), PubMed-MEDLINE, Scopus, and Web of Science were searched for original experimental studies. In vitro and In vivo investigations of piezoelectric polymers, ceramics, and polymer-ceramic composites were included. Outcomes encompassed osteogenic differentiation, mineralization, bone formation, and biocompatibility. Due to methodological heterogeneity, a qualitative synthesis was performed. Thirty-seven studies published between 2009 and 2025 were included. Approximately 57% combined In vitro and In vivo models, while 30% were In vitro only and 13% In vivo only. Investigated materials were systematically classified as piezoelectric polymers, piezoelectric ceramics, or polymer-ceramic composites according to their dominant material composition and presence of ceramic reinforcement. Activation strategies included static polarization, self-powered physiological loading, and ultrasound-mediated stimulation. More than 85% of In vitro studies reported enhanced osteogenic marker expression or mineralization relative to controls, and nearly all In vivo studies demonstrated increased new bone formation or improved osseointegration. Current preclinical evidence supports the potential of piezoelectric biomaterials to enhance bone regeneration. However, greater standardization of material characterization, activation protocols, and long-term In vivo evaluation is required to support clinical translation.</p>

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Piezoelectric Biomaterials for Bone Regeneration: Mechanistic Insights and Preclinical Evidence—A Systematic Review of In Vitro and In Vivo Studies

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Nozimjon Tuygunov,
  • Akbarjon Mirzayev,
  • Matluba Mirzaeva,
  • Asadbek Sultonov,
  • Fazliddin Mutalibjonov,
  • Khabilov Davron,
  • Akhrorjon Kosimov,
  • Arief Cahyanto,
  • Feruz Tojiyev,
  • Davron Dastamovich Ibragimov,
  • Shukhrat A. Boymuradov,
  • Israilova Nigora Amanullaevna,
  • James Tsoi

摘要

Bone regeneration is regulated by coupled mechanical and electrical signals, and native bone exhibits intrinsic piezoelectric behavior. Piezoelectric biomaterials have therefore emerged as self-powered platforms capable of converting mechanical stimuli into localized electrical cues to enhance osteogenesis. However, the efficiency for bone regeneration has not been systematically synthesized. This systematic review evaluated the efficiency of piezoelectric biomaterials in enhancing bone regeneration-related outcomes In vitro and in vivo compared with conventional non-piezoelectric materials. Following PRISMA guidelines and PROSPERO registration (CRD420251131697), PubMed-MEDLINE, Scopus, and Web of Science were searched for original experimental studies. In vitro and In vivo investigations of piezoelectric polymers, ceramics, and polymer-ceramic composites were included. Outcomes encompassed osteogenic differentiation, mineralization, bone formation, and biocompatibility. Due to methodological heterogeneity, a qualitative synthesis was performed. Thirty-seven studies published between 2009 and 2025 were included. Approximately 57% combined In vitro and In vivo models, while 30% were In vitro only and 13% In vivo only. Investigated materials were systematically classified as piezoelectric polymers, piezoelectric ceramics, or polymer-ceramic composites according to their dominant material composition and presence of ceramic reinforcement. Activation strategies included static polarization, self-powered physiological loading, and ultrasound-mediated stimulation. More than 85% of In vitro studies reported enhanced osteogenic marker expression or mineralization relative to controls, and nearly all In vivo studies demonstrated increased new bone formation or improved osseointegration. Current preclinical evidence supports the potential of piezoelectric biomaterials to enhance bone regeneration. However, greater standardization of material characterization, activation protocols, and long-term In vivo evaluation is required to support clinical translation.