Influence of chitosan in bone regenerative biomaterials – A systematic review

Background: Chitosan is promising for bone regeneration due to biocompatibility, biodegradability and antimicrobial activity. Methods: Extensive literature review (Medline/PubMed, Cochrane) using PICO; in-vivo studies included. 53 articles met inclusion. Results: Studies used various animal models and chitosan composites with TCP/β-TCP, hydroxyapatite, xenografts, growth factors and stem cells. Delivery systems included sponges, hydrogels, aerogels, microspheres and composites. Chitosan composites enhanced mineralization and bone formation. Conclusion: Chitosan scaffolds and composites demonstrate efficacy in promoting in-vivo bone regeneration; incorporation of biologics further enhances outcomes.