Smart nanocomposite scaffolds for bone regeneration: Mechanobiological regulation and translational perspectives.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Critical-sized and load-bearing bone defects remain major clinical challenges. The intrinsic regenerative capacity of bone is frequently insufficient to achieve complete functional repair. Recent advances in smart nanocomposite scaffolds have shifted bone tissue engineering from passive structural support toward biologically instructive platforms capable of dynamically regulating cellular behavior and tissue repair. These advances represent a major conceptual and mechanobiological transformation in scaffold design; however, they should not be interpreted as indicating widespread clinical readiness. Despite encouraging preclinical outcomes, most smart scaffold systems remain in the preclinical or early translational stage because critical challenges related to mechanical reliability, scalable manufacturing, long-term biosafety, and regulatory approval remain unresolved. This review examines the mechanobiological mechanisms by which smart nanocomposite scaffolds regulate bone regeneration, with particular emphasis on interactions between scaffolds and stem cells, immune modulation, angiogenic coupling, and translational feasibility. Key regenerative pathways involving osteoconduction, mechanotransduction, ion-mediated signaling, electrical conductivity, and stimuli-responsive activation are analyzed in relation to scaffold composition, nanotopography, and microenvironmental regul

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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