Hydrogel-based materials for mandibular reconstruction

Mandibular reconstruction remains a significant clinical challenge due to irregular defect geometries, high functional restoration requirements, and complex oral environments. Traditional vascularized bone grafts, while effective, are limited by donor site complications and poor osseointegration. Hydrogel-based materials have emerged as promising alternatives due to their biocompatibility, tunable mechanical properties, and capacity to mimic the extracellular matrix for osteogenesis and angiogenesis. This review highlights recent advances in hydrogel design strategies tailored for mandibular regeneration. Key considerations include mechanical reinforcement through nanocomposites and dual-network architectures, which enhance compressive strength and toughness to withstand masticatory loads. Injectable hydrogels demonstrate minimally invasive delivery and shape adaptability for irregular defects, while biomimetic wet adhesives achieve robust tissue integration through covalent and coordination bonding mechanisms. Functionalization with bioactive factors and stem cells promotes spatiotemporal regulation of osteogenesis and angiogenesis, as evidenced by successful mandibular regeneration in preclinical models. Antibacterial strategies integrating metal ions, antibacterial agents, or peptides can contribute to addressing oral microbial challenges. This review underscores the potential of multifunctional hydrogels to bridge structural and functional regeneration in craniofacial reconstruction while identifying critical research gaps for future innovation.