Next-generation craniomaxillofacial implants for reconstructive surgery: balancing biomechanics, biocompatibility, and bioactivity

Next-generation craniomaxillofacial implants (CMFIs) are redefining personalized bone reconstruction by balancing and optimizing biomechanics, biocompatibility, and bioactivity-the "3Bs". This review highlights recent progress in implant design, material development, additive manufacturing, and preclinical evaluation. Emerging biomaterials, including bioresorbable polymers, magnesium alloys, and composites with bioactive ceramics, enable patient-specific solutions with improved safety and functionality. Triply periodic minimal surface (TPMS) architectures exemplify how structural design can enhance both mechanical performance and biological integration. Additive manufacturing technologies further allow the fabrication of geometrically complex, customized implants that meet individual anatomical and pathological needs. In parallel, multiscale evaluation techniques-from mechanical testing to in vitro and in vivo models-provide comprehensive insights into implant performance and safety. Looking ahead, the field is poised to benefit from several transformative trends: the development of smart and multifunctional biomaterials; AI-driven design frameworks that leverage patient-specific data and computational modeling; predictive additive manufacturing with real-time quality control; and advanced biological testing platforms for preclinical evaluation. Together, these advances form the foundation of a data-informed, translational pipeline from bench to bedside. Realizing the full potential of next-generation CMFIs will require close interdisciplinary collaboration across materials science, computational engineering, and clinical medicine.