Innovations for brushite cements toward applications in bone regeneration and drug delivery

With the increase in life expectancy, the prevalence of bone-related pathologies will continue to rise. To address severe bone defects resulting from bone-related pathologies, autografts are conventionally used. However, the use of autografts is disadvantageous due to donor site morbidity and limited availability. Alternatives for autografts in the form of biomaterials have emerged for this reason over the last 40 years. In this regard, the bioavailability, biocompatibility, and bioactivity of calcium phosphate cements (CPCs) make them appealing for bone regenerative treatments. Brushite CPCs (bCPCs) offer advantages in minimally invasive applications by injection, moldability to perfectly fill a bone defect, and degradability to enable full replacement by newly formed bone within reasonable time frames. Interestingly, bCPCs have the potential to be used for local drug delivery, which provides an avenue for targeted therapy, enhancing treatment efficacy while minimizing adverse effects. The aim of this review was to explore the synergy between bCPCs and drug delivery mechanisms with comparison to apatitic CPCs, highlighting their potential to advance bone regeneration therapies and enhance patient outcomes in clinical orthopedic and dental care.