A critical translational review of smart, bioinspired and multifunctional regenerative biomaterials for oral implant-site repair

Abstract This critical translational narrative review evaluates smart, bioinspired and multifunctional biomaterials for oral implant-site repair. The review addresses a specific translational problem: regenerative materials must stabilise a defect, support vascularised bone and soft-tissue healing, interact appropriately with host immunity and microorganisms, and remain manufacturable, sterile, affordable and regulatorily tractable. PubMed/MEDLINE, Scopus and Web of Science were searched through 30 April 2026 using standardised database-specific update strings. The searches retrieved 765 records; 346 unique records remained after deduplication, and 106 records were retained after application of the eligibility filters and included in the final synthesis. Eligibility criteria, evidence appraisal and author-consensus procedures are reported explicitly. The evidence is organised into five functional classes: structural, bioactive, responsive/adaptive, multifunctional and patient-specific systems. A defect-based clinical algorithm then links containment, vascularity, mechanical demand, wound closure and patient risk to material selection. Established grafts and membranes remain the clinical reference for many indications, but they are not intrinsically smart. Growth-factor carriers, platelet products, hyaluronic acid, enamel matrix derivative, antimicrobial and osteoimmunomodulatory systems, biofunctionalised surfaces, cells, genes, three-dimensional/four-dimensional constructs and peptide-functionalised materials are assessed according to distinct mechanistic, animal, human and routine-use evidence. The most credible next-generation products are not those with the greatest number of components, but those that solve a defined failure mode while preserving manufacturing control and clinical usability. Translation therefore depends on reproducible production, sterility assurance, release and degradation specifications, shelf life, regulatory classification, cost, reimbursement and comparative benefit within realistic surgical workflows.