Bone microtissue grafts mimicking skeletal features and organogenesis are an emerging strategy, different from the traditional tissue engineered bone grafts using the 3D cell encapsulation and the top cell seeding, and remain challenging in regenerative medicine and drug discovery, because the existing scaffold-free and microcarrier-based microtissue systems are difficult to manipulate the microtissue morphologies towards native bone microstructures limited by their mechanical weakness and the absence of interconnected inner cavities. Herein, we synthesized a supramolecular cryogel by an ice-templated freezing-polymerization process, acquiring a promising microcarrier resembling native bone trabecular morphology for 3D culture of trabecular bone microtissue grafts. In our strategy, a macromolecular chitosan monomer and two supramolecular monomers including glycinamide and phytic acid constituted the supramolecular cryogel, the modification using glycinamide and phytic acid components enables the cryogel microcarrier with porous cavities and compression-resistant abilities like the native trabecular bone tissues. Moreover, the mineralization of the cryogel microcarriers was also improved by the modification of phytic acid monomers, consequently strengthening osteogenic differentiation of bone-marrow-derived mesenchymal stem cells (BMSCs) and in vitro microtissue biomineralization. The in vivo results also revealed that a trabeculae-like bone microtissue forms on the cryogel microcarriers, with vessel invasion into inner cavities of the trabecular bone microtissues. After in situ implantation of the prepared trabecular bone microtissues, the bone regeneration characterized by raising bone mineral density and remodeling bone trabecular microstructures was observed on a rat femur condyle defect model. Last but not least, we also discovered the intestinal bacterial communities and compositions are closely related to the bone regeneration after implantation of the engineered bone microtissue grafts, which is the first evidence focusing on the intestinal microbiota response to the bone injury and bone regeneration events representing a feasible approach to bone regeneration examination. In brief, the supramolecular cryogels we developed in this study have been proved to be a promising microcarrier for the construction and 3D culture of trabecular bone microtissues, and this work offers a novelty insight into microtissue engineering and bone regeneration.
BACKGROUND This retrospective study aimed to radiographically compare injectable platelet-rich fibrin (I-PRF)-enriched bone graft matrix (sticky bone) with conventional particulate grafting during lateral sinus lift procedures performed simultaneously with implant placement in patients exhibiting insufficient posterior maxillary residual bone height. MATERIAL AND METHODS Twenty-four systemically healthy, non-smoking patients who underwent lateral sinus lift surgery between January 2014 and June 2023 were included. Patients were retrospectively allocated into groups according to grafting material: conventional particulate bone graft (group 1, n=12) and I-PRF-enriched bone graft matrix (sticky bone) (group 2, n=12). Radiographic bone height measurements were obtained using panoramic radiographs acquired preoperatively, immediately postoperatively, and at 6 months postoperatively. Measurements were conducted using calibrated digital software. Inter- and intragroup comparisons were analyzed via paired and independent samples t-tests, using a statistical significance threshold of P<0.05. RESULTS Immediate postoperative bone gain was significantly higher in group 1 than in group 2 (11.94 mm vs 10.15 mm; P<0.05). However, bone resorption at 6 months was significantly greater in group 1 than in group 2 (2.61 mm vs 1.07 mm; P<0.05). Bone loss percentage also was significantly higher in group 1 than in group 2 (16.50% vs 7.74%; P<0.05), indicating superior bone preservation in group 2. CONCLUSIONS Although conventional grafting resulted in greater initial bone gain, I-PRF-enriched bone graft matrix demonstrated significantly reduced bone resorption at 6 months. Sticky bone may provide a clinical advantage in bone preservation after sinus lift procedures.
Osteoporosis (OP) is a systemic metabolic bone disorder. The excessive activation of osteoclasts (OCs) leads to a decrease in bone mass and damage to the bone microstructure, which plays a crucial role in OP. β-Hydroxybutyrate (BHB), the main component of ketone bodies, not only serves as an ancillary fuel substituting for glucose but also induces anti-oxidative, anti-inflammatory, and cardioprotective features via binding to several target proteins, including histone β-hydroxybutyrylation (Kbhb). Recent research has found that BHB has a positive therapeutic effect on OP, but the underlying molecular mechanism remains unclear. In this study, we established osteoporosis (OP) animal models induced by estrogen deficiency and type 2 diabetes using ovariectomized (OVX) and db/db mice, respectively, and administered BHB to OP mice via free drinking in vivo. Our results indicated that BHB increased bone mineral density (BMD), improved bone microstructure, and inhibited the OC formation. Additionally, BHB upregulated the levels of PanKbhb, H3K9bhb, and H3K27bhb modifications in the bone tissue of OP mice. In vitro, we found that BHB or β-hydroxybutyryl-CoA (BHB-CoA) could inhibit RANKL-induced OC differentiation and bone resorption, and upregulate histone Kbhb levels in a concentration-dependent manner. Furthermore, the effects of BHB or BHB-CoA-induced histone Kbhb were reversed by inhibiting the activity of Acyl-CoA synthetase short-chain family member 2 (ACSS2) or histone acyltransferase P300. In summary, our data reveal that BHB may alleviate bone loss caused by estrogen deficiency and type 2 diabetes through ACSS2/P300-induced histone Kbhb.
Osteoporosis remains challenging to treat because no approved therapy can simultaneously suppress bone resorption and stimulate bone formation. Here we report a lysosome-triggered nanotherapy that converts osteoclast death into a regenerative signal. We first synthesized docosahexaenoyl ceramide (DHA-ceramide) by replacing the native fatty acid of ceramide with docosahexaenoic acid and encapsulated it in aspartate-modified liposomes (Asp-Lip@Cer) to target osteoclasts. After cellular uptake, lysosomal acid ceramidase cleaves DHA-ceramide to release sphingosine (SPH) and DHA. Asp-Lip@Cer selectively disrupts the osteoclast lysosomal membrane and triggers apoptosis, and produces abundant osteoclast-derived apoptotic bodies (OC-ABs) enriched with SPH and DHA that are efficiently internalized by mesenchymal stem cells and endothelial progenitor cells. In recipient cells, DHA activates AKT signaling to promote osteogenesis, whereas SPH is converted to S1P to activate ERK signaling and enhance angiogenesis. In an ovariectomized mouse model of postmenopausal osteoporosis, systemic administration of Asp-Lip@Cer suppressed osteoclast activity, improved bone mineral density and trabecular architecture, increased osteopontin expression, and expanded CD31⁺/EMCN⁺ vasculature. This "one-stone-two-birds" strategy unites potent anti-resorptive activity with amplified pro-anabolic effects in a single platform, offering a promising therapeutic paradigm for osteoporosis and other disorders of impaired bone remodeling. ONE SENTENCE SUMMARY: Lysosome-triggered Asp-Lip@Cer nanotherapy turns osteoclast death into SPH/DHA-rich apoptotic bodies, simultaneously suppressing bone resorption and promoting bone formation.
Bone remodelling is essential for maintaining skeletal integrity by preserving the balance between bone formation and resorption, with excessive osteoclast activity contributing to osteoporosis. Osteocytes act as central regulators of osteoclastogenesis through mechanically sensitive paracrine signals, yet the influence of osteoblasts and their mesenchymal precursors remains less defined. Extracellular vesicles (EVs) have recently emerged as mediators of bone cell communication, although their role in osteoclast regulation are still underexplored. This study demonstrates that mesenchymal-derived bone cells inhibit osteoclastogenesis through an EV-dependent mechanism shaped by their differentiation stage and mechanical environment. Mechanically stimulated osteocyte-derived EVs showed the strongest anti-catabolic response. Notably, we identify miR-150-5p as a mechano-responsive miRNA enriched within osteocyte EVs, capable of inducing a dose-dependent reduction in osteoclastogenesis. Transcriptomic analyses reveal that EV treatment and miR-150-5p delivery induce substantial transcriptional changes in osteoclast precursors, including downregulation of shared target genes linked to bone remodelling. Overall, we highlight mechanically activated osteocytes as key regulators of osteoclastogenesis through an EV-mediated mechanism, in which miR-150-5p represents a promising candidate contributor within the broader EV cargo landscape, highlighting their potential for future cell-free therapeutic strategies.
Women experience musculoskeletal changes following pregnancy that may increase musculoskeletal injury risk. This trial explored 18-weeks combined rehabilitation and endurance and resistance training (Intervention, n = 17) compared with standard-of-care (Control, n = 14) on areal bone mineral density (aBMD), tibial bone, and patella tendon properties in postpartum UK Servicewomen. Intervention received standard care plus pelvic floor and core strength exercises from week 1 to 18 (week 6 to 24 postpartum), and combined high-intensity interval and resistance training from week 6 to 18 (week 12 to 24 postpartum). Control received standard care. Whole-body DXA and tibial HRpQCT scans (4% and 30% sites) were taken at week 1 and 18. Patella tendon properties at rest and during isometric contractions were measured by ultrasound at weeks 1, 6, and 18. There was no effect of training on aBMD (p ≥ 0.100) but trunk (-1.6%) and spine (-2.3%) aBMD decreased from week 1 to 18, irrespective of group (p ≤ 0.021). There was no effect of training on tibial bone (p ≥ 0.151) or patella tendon properties (p ≥ 0.185). An 18-week rehabilitation and endurance and resistance training programme had no effect on bone or tendon properties in postpartum Servicewomen.
Bone defect repair presents a significant clinical challenge in oral and maxillofacial surgery and orthopedics. Implant-associated infection and insufficient osseointegration often compromise clinical outcomes, while traditional repair materials still struggle to simultaneously provide mechanical support, antibacterial activity, and osteogenic efficacy. This study employed magnetron sputtering to fabricate high-entropy nitride (HEN) coatings with varying silver (Ag) contents. Among these, the stable single-phase solid solution (TiZrNbHfTaAg)N coating with 5.7 at. percentage (at%) Ag exhibited outstanding comprehensive properties. This coating combines favorable biocompatibility with potent antibacterial activity, exhibiting antibacterial rates of 90.6% and 97.1% against common oral pathogens F. nucleatum and P. gingivalis, respectively. It also promotes osteoblast differentiation and mineralization by activating the MAPK/ERK signaling pathway, thereby upregulating the expression of genes and proteins associated with osteogenesis. In vivo validation using a rabbit tibia defect model showed that implantation of the (TiZrNbHfTaAg)N coating significantly improved indicators of bone regeneration and osseointegration strength. This coating offers a novel surface modification approach to address bone defect repair challenges through its "antibacterial-osteogenic" synergistic effect and bone regeneration mechanism mediated by the MAPK/ERK pathway, demonstrating considerable potential for clinical translation.
The aim of this study was to examine how maras powder (MP) affects on the cortical and trabecular bone of the mandible using the radiomorphometric indexes and fractal dimension (FD). A retrospective analysis of radiographic records of 150 male individuals, 50 of whom used MP, 50 of whom smoked cigarettes, and 50 of whom were healthy and did not use any tobacco derivatives, was performed. Cortical bone was evaluated with mandibular cortical width (MCW) and panoramic mandibular index (PMI). Trabecular bone in mandibular anterior was evaluated by FD. The ANOVA test was used to compare normally distributed variables across the three groups, and the Kruskal Wallis test was used to compare non-normally distributed variables across the three groups. The mean age of MP users was 42.92 ± 10.21; in smokers, 40.46 ± 10.51; and in the healthy control group, 40 ± 15.05. When the FD measurements were examined in regions of interest (ROI) 1, ROI 2, ROI 3, and the mean ROI values, no significant difference was found between the three groups in terms of FD (p > 0.05), but the fractal dimension was found to be lower in individuals using MP. No significant difference was found between the groups in terms of histogram values ​​and MCW and PMI measurements (p > 0.05). No significant differences were found between users of MP, smokers, and healthy individuals. However, the decreasing trend in FD values ​​may indicate early effects of MP. Studies with larger sample sizes and advanced imaging techniques are needed.
In treating infectious bone defects, bacterial eradication alone is insufficient, as impaired blood perfusion characterized by low fluid shear stress (FSS) hampers angiogenesis, thereby compromising osteogenesis and delaying bone repair. Herein, we engineered a low-FSS-activated, pro-angiogenic implant coating with antibacterial properties. This coating comprises a Fe3+-tannic acid (Fe3+-TA) chelation network as the adhesive sublayer, anchoring black phosphorus (BP) nanosheets preloaded with metformin (Met), and is further capped by an outer layer of Lactobacillus animalis-derived extracellular vesicles (BEVs). The Fe3+-TA and BP components synergistically provide photothermal and photodynamic antibacterial activity, while the BEV layer promotes M2 macrophage polarization and modulates the sustained release of Met and phosphate ions from BP degradation, fostering a pro-regenerative microenvironment. Simultaneously, the BP-mediated photodynamic effect exacerbates local oxygen consumption, amplifying the angiogenic potential of Met under hypoxia. The hypoxia-activated Met lowers the FSS threshold required to enable a laminar shear-protective endothelial phenotype, even under pathological low-FSS conditions. This process drives orderly angiogenesis, restores microvascular perfusion, and supports downstream osteogenesis. Overall, this bioinspired coating integrates "hypoxia activation, vascular guidance, and laminar-flow protection" to promote angiogenesis and osteogenesis, and is augmented by synergistic antimicrobial and immunomodulatory benefits, offering a promising strategy for treating infectious bone defects.
This study presents the fabrication and optimization of poly(lactic acid)/gelatin (PLA/Gel) composite nanofibrous scaffolds simultaneously reinforced with hydroxyapatite (HA) and silica (SiO₂) nanoparticles using a dual-nozzle electrospinning approach. Separate PLA/SiO₂ and Gel/HA solutions were electrospun simultaneously, but each from one distinct syringe to enable independent control of processing parameters. Compositional and processing parameters were systematically optimized using the Taguchi design method, a novel approach for this type of hybrid scaffold. Morphological analysis showed that fiber diameter could be tuned by adjusting formulation parameters, with average diameters ranging from approximately ~200 nm to ~1000 nm under stable electrospinning conditions. Uniform, bead-free nanofibers were obtained at balanced compositions, whereas higher nanoparticle loadings led to greater diameter variability and bead formation. Surface wettability was tunable, with contact angles ranging from 130° to 28°, depending on composition. Thermal analyses revealed that both nanoparticle content and polymer blend ratio significantly influenced degradation and crystallization behavior. The optimized scaffold, consisting of a 50/50 Gel/PLA with 2 wt% HA and 2.5 wt% SiO₂, exhibited uniform, bead-free morphology, favorable hydrophilicity, and mechanical properties suitable for bone tissue engineering (tensile strength 3.5 MPa; Young's modulus 180 MPa). In vitro evaluations demonstrated enhanced cell viability, proliferation, mineralization, and osteogenic differentiation, particularly in HA/SiO₂-reinforced structures. Overall, these findings underscore the effectiveness of dual-nozzle electrospinning combined with Taguchi optimization for tailoring PLA/Gel nanofibers structure and performance in advanced bone tissue engineering applications.
Bone fracture healing requires coordinated regulation of osteogenesis, angiogenesis, and immune homeostasis within a dynamically evolving microenvironment. However, current biomaterials rarely integrate these three regulatory dimensions. Herein, we engineered L-arginine-loaded zeolitic imidazolate framework-8 (L-Arg@ZIF-8) nanoparticles to remodel the immune-osteogenic-angiogenic microenvironment and accelerate fracture healing. L-Arg@ZIF-8 nanoparticles exhibited uniform morphology, positive surface charge, and stable L-Arg incorporation, enabling efficient cellular uptake and sustained bioactivity. Using two physiologically relevant 3D co-culture spheroid models (osteoblast-macrophage and osteoblast-endothelial), we demonstrated that L-Arg@ZIF-8 promotes osteogenic differentiation, endothelial activation and the upregulation of angiogenic markers, and strengthens osteogenesis-angiogenesis coupling. Bulk transcriptomic profiling further revealed activation of regenerative pathways, including PI3K-Akt and Wnt signaling, along with coordinated modulation of cytokine-receptor interactions and immune-related remodeling programs. In vivo, L-Arg@ZIF-8 markedly accelerated fracture repair in a rat rib fracture model, characterized by enhanced callus formation, increased bone mineral density, greater trabecular thickness, and a significantly elevated mineral apposition rate. Histological and immunofluorescence analyses confirmed upregulation of key osteogenic markers (OPN, OSX) at the fracture site. Together, these findings demonstrate that L-Arg@ZIF-8 functions as a bioengineered microenvironment-modulating nanoplatform that orchestrates immune regulation, osteogenesis, and angiogenesis to promote efficient fracture healing. This strategy offers a promising therapeutic avenue for translational management of complex fractures.
In this study, a novel HPMC/gelatin composite scaffold was prepared by incorporating 13-93B3 borate bioactive glass (BBG) microparticles and cerium oxide (CeO₂) submicrometric particles as a discrete phase, enabling higher ceria loadings without disrupting the bioactive glass chemistry. Composite hydrogel inks containing 5 wt% BBG microparticles and up to 20 wt% CeO₂ submicrometric particles were successfully extrusion-printed into porous scaffolds with interconnected pore architecture. CeO₂ incorporation preserved printability and mechanical strength while significantly enhancing scaffold deformation ability. Degradation behavior was tunable, with BBG microparticles reducing swelling and CeO₂ submicrometric particles modulating water uptake and pH evolution. BBG microparticles and CeO₂ submicrometric particles synergistically promoted apatite formation following 7 days of SBF incubation. In vitro studies using MC3T3-E1 pre-osteoblasts confirmed high cytocompatibility and Alizarin red study showed enhanced mineralization in CeO₂-containing scaffolds. Additionally, BBG and CeO₂ incorporated scaffolds exhibited strong antibacterial activity against Staphylococcus aureus and Escherichia coli. Overall, this multifunctional scaffold platform demonstrates promise for bone tissue engineering applications.
Osteoarthritis is a leading cause of disability worldwide, and cell-based treatments including adipose-derived and bone marrow aspirate have been sought by the lay and medical community as treatment options. To perform a scoping review of published literature on cell-based injections allowed by the U.S. Food and Drug Administration for the treatment of osteoarthritis to synthesize existing evidence and identify research gaps for future evaluation. A comprehensive search of five databases was executed from inception through January 2, 2025. Studies that met the inclusion criteria were original research studies written in English on Food and Drug Administration-allowed cell-based treatments in adults with osteoarthritis of any joint. The database search yielded 4257 unique records. After screening, 84 studies met the inclusion criteria, encompassing 9996 patients and a total of 10,508 procedures. The primary research study designs were cohort studies (n = 62), focused on treatment of knee osteoarthritis (n = 63), and described bone marrow aspirate (n = 42) and adipose-derived (n = 42) treatments. Postprocedure monitoring ranged from 6 weeks to 5 years, with most studies ≤1 year (n = 59). Patient-reported outcomes were reported in 83 of 84 studies; few provided imaging outcomes including magnetic resonance imaging (n = 9) or radiographs (n = 2). This review identified limited randomized controlled trials, limited studies outside the knee, limited description of cell-based treatments, and treatment protocols, along with inconsistent patient-reported outcomes limited to 1 year in most studies. We propose establishing reporting guidelines in research on cell-based therapies.
Press-fit acetabular components achieve long-term fixation through osseointegration, yet the extent of bone ingrowth necessary for durable stability in well-functioning implants remains unclear. Postmortem retrievals provide a unique opportunity to directly assess the bone-cup interface in clinically successful total hip arthroplasties (THAs). This study evaluated osseointegration and biomechanical fixation strength in deceased-donor acetabular components to better define the characteristics of stable long-term fixation. Cadaver pelvis specimens containing uncemented THAs from a single institution were evaluated. There were 29 acetabular components that underwent axial pull-out testing using a universal testing machine. A total of seven of these were additionally processed for histologic evaluation, including dehydration, acrylic embedding, thin-sectioning, staining, and digital imaging. Osseointegration was quantified by bone-area fraction occupancy (%BAFO), representing the proportion of bone occupying the porous thread spaces of the cup. All 29 specimens failed through fracture of the ilium rather than at the bone-cup interface, indicating that the mechanical integrity of the osseointegrated construct exceeded that of the surrounding bone under axial tension. Among the seven histologically analyzed components, %BAFO ranged from 4.2 to 27.0% (mean 15.1%), despite all implants being clinically stable at the time of death. There were no significant linear correlations observed between %BAFO and time implanted, fracture load, or body mass index. A significant quadratic relationship between %BAFO and age was identified, peaking near 81 years. Cementless acetabular components exhibited strong fixation despite modest osseointegration, with failure occurring through host bone on axial testing. Durable biological fixation appears achievable with limited, but mechanically favorable bone ingrowth.
Low-intensity pulsed ultrasound (LIPUS), such as Exogen device, stimulates osteogenesis and angiogenesis without harmful thermal effects, enhancing bone strength and shortening recovery time. This experimental study evaluated the application of Exogen low-intensity pulsed ultrasound (LIPUS) device in promoting alveolar bone healing and reducing post-orthodontic relapse in rabbits model after induction of teeth movement by semi orthodontic appliance. 12 adult rabbits underwent orthodontic tooth movement for lower anterior teeth, followed by appliance removal. Animals were randomly assigned to two groups: a control group with no LIPUS treatment, and an Exogen group that received daily low-intensity pulsed ultrasound (LIPUS) therapy for 20 days. Clinical measurements of relapse distance were recorded at days 0, 10, and 20 in mm. Histological and histomorphometric analyses were performed to assess osteoblast and osteoclast counts, vascular density, and periodontal ligament (PDL) width in both cervical and apical regions. showed that the Exogen group exhibited a significantly smaller relapse distance from day 10 onwards (p≤0.01) and approximately 35% less relapse at day 20 compared with controls. Histomorphometric data revealed higher osteoblast counts, lower osteoclast counts, increased vasculature, and narrower PDL width in the Exogen group, indicating enhanced bone formation, reduced bone resorption, and improved periodontal stability. Histological examination confirmed greater organization of lamellar bone, denser osteoblastic lining, and more pronounced vascularization in treated animals. These findings suggest that the Exogen LIPUS device may serve as an effective adjunct tool in orthodontics to accelerate alveolar bone healing and to achieve greater stability of teeth following orthodontic interventions.
High bone mineral density (BMD) is common and sometimes an incidental finding. The causes are numerous. Among them, none has previously been attributed to total body irradiation (TBI). We present the case of a 56-year-old female patient with a history of T-lymphoblastic lymphoma at age 33 who was treated with allogeneic hematopoietic stem cell transplantation following a conditioning regimen including a single-fraction 10 Gray TBI. This patient was in complete remission but experienced several transplant-related late effects. She presented to the rheumatology outpatient clinic with chronic mechanical low back pain and a history of early menopause. Bone assessment by densitometry revealed high bone mineral density with a lumbar spine L2-L4 T-score of +6.3 standard deviation (SD) (1.939 g/cm²), right femoral neck T-score of +7.2 SD (1.849 g/cm²), right total femur T-score of +4 SD (1.484 g/cm²), distal radioulnar T-score of +0.7 SD (0.495 g/cm²). Imaging revealed sclerotic lesions in the vertebrae, femoral cortices and pelvis. An etiological workup excluded other causes such as fluorosis, mastocytosis, renal osteodystrophy, hypoparathyroidism/pseudohypoparathyroidism and myelofibrosis. Bone growth factors and resorption markers were normal. Genetic sequencing showed no significant abnormalities. Based on this comprehensive evaluation, TBI was identified as a possible contributing factor to the occurrence of high BMD. The patient was managed with analgesics and regular follow-up. This case highlights the importance of a systematic etiologic approach to high bone mineral density and underscores the need for future scientific research to better understand this phenomenon for which the pathological relationship with radiation exposure remains unknown.
Osteoporotic fractures remain a major cause of morbidity and mortality worldwide. Current clinical assessment metrics (e.g., bone mineral density) are limited in their ability to identify fracture risk and bone strength. Statistical Shape and Appearance Modelling (SSAM) offers a method to quantify anatomical geometry and density patterns. This review examines advancements in SSAM for osteoporosis research. Recent literature demonstrates that SSAM can capture detailed bone geometry and internal density distribution. Increasingly, these models are combined with computational analytics, including finite element analysis and machine learning, to assess the mechanical and structural behavior of bone. SSAM provides a robust quantitative framework for bone research. Notably, SSAM is used to reconstruct 3D subjects from clinical 2D images for biomechanical evaluation. Although clinical adoption remains limited by generalizability, the advancement of deep learning and complex SSAM pipelines supports its potential for osteoporosis screening and fracture risk prediction.
To synthesize current evidence (2010-2025) on ketogenic, intermittent fasting, and low-calorie diets' effects on bone health, inflammation, osseointegration and identifying research gaps relevant to dental implantology. A systematic literature search was conducted across PubMed, Scopus, and Web of Science for human and animal studies, mechanistic work, and systematic reviews. Evidence was extracted and summarized, prioritizing studies on diet patterns, bone biology, and dental implant outcomes. Mechanistic and animal studies suggest dietary influence on bone remodeling, inflammation, and angiogenesis, crucial for osseointegration. Vitamin D level correlates with implant outcomes, and moderate intermittent fasting appears not to harm systemic bone markers short-term. Major gaps include peri-implant mechanistic data, comparative trials, and optimal dietary timing. Current evidence indicates a potential influence of different diets on dental implant success factors. Definitive dietary recommendations for implant patients are premature due to insufficient human clinical data. Comprehensive, implant-specific research is still needed to establish guidelines and integrate nutrition into implant practice.
Osteoporotic fracture healing is frequently complicated by elevated levels of reactive oxygen species and disrupted bone homeostasis. Biodegradable magnesium alloys are promising orthopedic implants, but rapid degradation in oxidative, acidic osteoporotic microenvironments limits their clinical application. In this study, we develop a reactive oxygen species-responsive hydrogel coating of tannic acid and gelatin methacryloyl on magnesium implants via a metal-phenolic network. We show that this firmly adhering coating significantly decelerates magnesium degradation while scavenging reactive oxygen species on demand. In osteoporotic rat models, we demonstrate that coated implants effectively reduce oxidative stress and facilitate bone healing. Mechanistically, single-cell transcriptomics reveals that the coating activates the nuclear factor erythroid 2-related factor 2 signaling pathway in bone marrow mesenchymal stromal cells and bone marrow-derived macrophages, enhancing osteogenesis while inhibiting osteoclastogenesis. Consequently, this multifunctional coating provides corrosion protection and a targeted therapeutic approach to enhance osteoporotic fracture healing under oxidative stress.